Primary Extra-Pulmonary Tuberculosis Presenting as Pleural Effusion in A Resource- Limited Setting involving an Immunocompetent Elderly Male

Introduction: Although curable, tuberculosis remains one of the most common causes of pleural effusions globally, especially in developing countries. Many patients present with atypical symptoms, making tuberculosis recognition challenging. Extrapulmonary tuberculosis (EPTB) has been noted in some HIV-negative case reports, but, to our knowledge, it has never been described in an elderly patient. Case presentation: We present the case of an immunocompetent 50-year-old man from Uganda who had a two-month history of persistent chest pain. Investigations suggested tuberculous pleural effusion, and the patient responded positively to anti-tuberculous treatment. Conclusion EPTB has various clinical manifestations that pose diagnostic and treatment challenges. Therefore, it's crucial to always consider tuberculosis as part of the working diagnosis, especially in regions where it is endemic, until proven otherwise.