Miliary Tuberculosis in a patient with COVID-19 infection (Double Trouble). Case report
Keywords:
COVID-19, co-infection, miliary tuberculosis
Abstract
Tuberculosis is the infectious disease with high mortality in the world, and endemic in Ecuador, which to date registers about 10 million people affected and approximately 1.5 million deaths until 2018. (1) At least half a million people have multidrug resistant forms (MDR), generating a long, expensive and toxic treatment. In February 2020 the World Health Organization (WHO) designated as COVID-19 the virus that causes SARS CoV-2 (Severe Acute Respiratory Syndrome), the cause of the pandemic that to date remains in force worldwide. Like tuberculosis, this has a predilection for pulmonary involvement, which clinically and radiologically may have similarities at the time of evaluation, both with possible fatal outcomes if there is no adequate diagnosis and management in time. The evolution of a hospitalized patient with a diagnosis of miliary tuberculosis and COVID-19 coinfection is presented.
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References
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21. Madan M, Pahuja S, Mohan A, Pandey RM, Madan K, Hadda V, et al. TB infection and BCG vaccination: are we protected from COVID-19? [published online ahead of print, 2020 May 30]. Public Health 2020;185:91–2. https://doi.org/10.1016/j. puhe.2020.05.042.
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2. Position paper de la OMS sobre la vacuna BCG, febrero de 2018: publicación en Weekly Epidemiological Record (Wkly Epidemiol Rec. 2018;93(8):73-96), resumen y presentación con los aspectos claves.
3. WHO. Global Tuberculosis Report 2019.
4. Coronavirus disease 2019 (COVID-19) Situation Report https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200130-sitrep-10 ncov.pdf?sfvrsn=d0b2e480_2.
5. Liu Y, Bi L, Chen Y, Wang Y, Fleming J, Yu Y, et al. Active or latent tuberculosis increases susceptibility to COVID-19 and disease severity. medRxiv 2020; 16 mar. https://www.medrxiv.org/content/10.1101/2020.03.10.20033795v1.
6. Abdool Karim Q, Abdool Karim SS. COVID-19 affects HIV and tuberculosis care. Science 2020; 369:366-8.
7. Motta I, Centis R, D'Ambrosio L, García-García J-M, Goletti D, Gualano G, et al. Tuberculosis, COVID-19 and migrants: preliminary analysis of deaths occurring in 69 patients from two cohorts. Pulmonology 2020; 26:233-40.
8. Tadolini M, García-García JM, Blanc FX, Borisov S, Goletti D, Motta I, et al. On tuberculosis and COVID-19 co-infection. Eur Respir J 2020; 56:2002328.
9. McQuaid CF, McCreesh N, Read JM, Sumner T; CMMID COVID-19 Working Group; Houben RMGJ, et al. The potential impact of COVID-19-related disruption on tuberculosis burden. Eur Respir J 2020; 56:2001718.
10. Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020; 395:1033-4.
11. Li H, Liu L, Zhang D, Xu J, Dai H, Tang N, et al. SARS-CoV-2 and viral sepsis: observations and hypotheses. Lancet 2020; 395:1517-20.
12. Gu J, Gong E, Zhang B, Zheng J, Gao Z, Zhong Y, et al. Multiple organ infection and the pathogenesis of SARS. J Exp Med 2005; 202:415-24.
13. Ramos-Casals M, Brito-Zeron P, Lopez-Guillermo A, Khamashta MA, Bosch X. Adult haemophagocytic syndrome. Lancet 2014; 383: 1503–16.
14. Kaufmann SH, Weiner J, von Reyn CF. Novel approaches to TB vaccine development. Int J Infect Dis. 2017;56:263–267.
15. Mangtani P, Abubakar I, Ariti C, Beynon R, Pimpin L, Fine PE, Rodrigues LC, Smith PG, Lipman M, Whiting PF, Sterne JA. Protection by BCG vaccine against tuberculosis: a systematic review of randomized controlled trials. Clin Infect Dis. 2014 Feb;58(4):470-80. doi: 10.1093/cid/cit790. Epub 2013 Dec 13. PMID: 24336911.
16. Trunz BB, Fine P, Dye C. Effect of BCG vaccination on childhood tuberculous meningitis and miliary tuberculosis worldwide: a meta-analysis and assessment of cost-effectiveness. Lancet. 2006 Apr 8;367(9517):1173-80. doi: 10.1016/S0140-6736(06)68507-3. PMID: 1661656.
17. MSP Ecuador, OPS, & SENPLADES. (2017). Evaluación de la Estrategia Nacional de Inmunizaciones Ecuador (p. 49). Quito. Recuperado de ttps://www.paho.org/ecu/index.php?option=com_docman&view=downloa d&category_slug=inmunizaciones&alias=673-evaluacion-de-la-estrategia- nacional-de-inmunizaciones-ecu.
18. Ye Q, Wang B, Mao J. The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID-19. J Infect 2020;80(6):607–13. https://doi.org/10.1016/j. jinf.2020.03.037.
19. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available at https://www. covid19treatmentguidelines.nih.gov/.
20. Hegarty PK, Sfakianos JP, Giannarini G, DiNardo AR, Kamat AM. COVID-19 and Bacillus Calmette-Gu ́erin: what is the link? Eur. Urol Oncol 2020;3(3):259–61.
21. Madan M, Pahuja S, Mohan A, Pandey RM, Madan K, Hadda V, et al. TB infection and BCG vaccination: are we protected from COVID-19? [published online ahead of print, 2020 May 30]. Public Health 2020;185:91–2. https://doi.org/10.1016/j. puhe.2020.05.042.
22. Marimuthu Y, Nagappa B, Sharma N, Basu S, Chopra KK. COVID-19 and tuberculosis: a mathematical model based forecasting in Delhi, India. Indian J Tuberc 2020;67(2):177–81. https://doi.org/10.1016/j.ijtb.2020.05.006.
Published
2021-03-14
How to Cite
1.
Proaño R, Morales N, Cajiao D. Miliary Tuberculosis in a patient with COVID-19 infection (Double Trouble). Case report. PFR [Internet]. 2021Mar.14 [cited 2025Jun.22];6(1). Available from: https://practicafamiliarrural.org/index.php/pfr/article/view/194
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Casos clínicos y Ejercicios clínico patológicos
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