Disseminated tuberculosis in a child during the COVID-19 pandemic: a case report and literature review

Frontiers in Immunology

Immunology

Lei Zhang¹  Niwen Huang¹  Taoping Weng¹  Xianming Zhang¹  Shan Cao¹  Yaqiong Dong¹  Chenqu Zhao¹  Jing Tang¹  Danni Zhang¹ 

[1] Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, China;

关键词: tuberculosis;    disseminated tuberculosis;    COVID-19;    immunosuppression;    treatment;    case report;   

DOI  :  10.3389/fimmu.2023.1249878

 received in 2023-06-29, accepted in 2023-08-25,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundDisseminated tuberculosis is an uncommon but devastating form of tuberculosis, possibly developing with the immune response of patients. COVID-19 infection may produce an immunosuppressive effect with possible implications for tuberculosis dissemination.Case presentationA 17-year-old female patient with a history of tuberculous pleurisy presented to the hospital with a high fever and life-threatening dyspnea after contracting a COVID-19 infection. Her condition deteriorated rapidly with grand mal epilepsy and acute gastrointestinal bleeding with a grossly depressed CD4 T-cell count, which was indicative of her profoundly immunosuppressed state. After identifying Mycobacterium tuberculosis in her cerebrospinal fluid and a subcutaneous abscess in her left lower back, she was diagnosed with disseminated tuberculosis involving both lungs, the central nervous system, the terminal ileum, the liver, bilateral adnexal tissue, and subcutaneous soft tissue in accordance with the chest and abdominal CT. Empirical treatment was initiated with dexamethasone (5 mg/day) and an anti-tuberculosis regimen of isoniazid, rifampicin, pyrazinamide, amikacin, and meropenem, which was replaced with faropenem after she left the hospital. The therapeutic effect was considered satisfied in the second month of follow-up.ConclusionTo the best of our knowledge, we report the first case report of disseminated tuberculosis after COVID-19 infection. Tuberculosis may disseminate and progress during the COVID-19 pandemic, requiring more significant studies to provide better diagnosis and treatment options for the co-infection.

【 授权许可】

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Copyright © 2023 Weng, Dong, Huang, Zhao, Zhang, Cao, Tang, Zhang and Zhang