Open AccessReactivation of Pulmonary Tuberculosis in a Patient With COVID-19
Author(s) -
A.V. Pozdnyakov,
Andrew S. Jin,
Mazen S. Bader
Publication year - 2021
Publication title -
infectious diseases in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 21
eISSN - 1536-9943
pISSN - 1056-9103
DOI - 10.1097/ipc.0000000000001032
Subject(s) - medicine , tuberculosis , methylprednisolone , mycobacterium tuberculosis , respiratory distress , regimen , intensive care medicine , pediatrics , surgery , pathology
Given COVID-19 rise in populations with high burden of tuberculosis infection, the interplay between COVID-19 and tuberculosis reactivation needs further investigation. We report a case of a 64-year-old man who developed acute respiratory distress syndrome due to severe COVID-19 infection. He was managed with intubation, prone-position mechanical ventilation, inhaled nitric oxide, and methylprednisolone 40 mg intravenous twice daily for 5 days. He developed unexplained persistent fever and leukocytosis that failed to respond to empiric broad-spectrum antibacterial, antifungal agents, and a 3-day course of intravenous methylprednisolone 1000 mg for possible usual interstitial pneumonitis. His endotracheal aspiration samples tested positive for Mycobacterium tuberculosis , and antituberculosis regimen was started. The patient died as result of decision to withdraw life support. This report establishes the clinical picture of a tuberculosis reactivation in a COVID-19 patient. The complex interaction between COVID-19, steroids, and tuberculosis is a clinical dilemma of great significance.