Diagnosis and treatment of severe tuberculosis complicated by ARDS and MODS in a young immunosuppressed host: a case report
Abstract
Background: Severe tuberculosis (TB) presents with complex clinical manifestations and high mortality. Immunosuppressed hosts are at high risk for TB infection and prone to progress to severe disease.
Case presentation: A young female patient was admitted to our Respiratory Intensive Care Unit with fever, cough, and progressive dyspnea. She had a history of nephrotic syndrome and was on long-term corticosteroids and immunosuppressive agents, but without TB screening at baseline. Following admission, she rapidly developed acute respiratory distress syndrome (ARDS), diffuse alveolar hemorrhage, and multiple organ dysfunction syndrome (MODS). While providing broad-spectrum anti-infective therapy, invasive mechanical ventilation, continuous renal replacement therapy, and supportive care to maintain vital signs, we achieved an early definitive diagnosis of disseminated tuberculosis through rapid sputum acid-fast bacilli staining, Mycobacterium tuberculosis nucleic acid testing, and metagenomic next-generation sequencing (mNGS). A multidisciplinary team collaborated to formulate an individualized anti-tuberculosis treatment plan, leading to a favorable clinical outcome.
Conclusion: This case highlights the necessity of TB screening in immunosuppressed hosts, early recognition of severe TB, the importance of precise etiological diagnosis, and emphasizing the application of comprehensive treatment strategies in such patients.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Synthesis, In Vitro and In Silico Molecular Docking Studies of Novel Phthalimide–Pyrimidine Hybrid Analogues to Thalidomide as Potent Antitubercular Agents
- Exploring the inhibitory performance of expired moxifloxacin and norfloxacin on copper corrosion in saline environment
- Molecular investigation of antimicrobial peptides against Helicobacter pylori proteins using a peptide-protein docking approach
- Screening of novel narrow-spectrum benzofuroxan derivatives for the treatment of multidrug-resistant tuberculosis through in silico, in vitro, and in vivo approaches
- Synthesis, Characterization, Anticancer, Antioxidant, and In Silico Evaluation of Semicarbazides and Thiosemicarbazides
- Fast and accurate prediction of drug induced proarrhythmic risk with sex specific cardiac emulators
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.