Pulmonary tuberculosis and COVID-19 coinfection: A new medical challenge

Submitted: August 7, 2021
Accepted: October 8, 2021
Published: December 3, 2021
Abstract Views: 1552
PDF: 596
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Radiological findings in chest radiography and respiratory symptomatology represent a great challenge of interpretation during the COVID-19 (Coronavirus Disease 2019) pandemic, as their patterns can generate uncertainty at the time of diagnosis. This case highlights the importance in achieving an adequate correlation between diagnostic imaging and the clinical picture. We present a male adult who was admitted for 8 days of respiratory symptoms. Management with steroids was initiated according to the RECOVERY (Randomized Evaluation of COVID-19 Therapy) protocol and later confirmation of SARS-CoV-2 infection was received. In the following weeks, he deteriorated slowly and progressively clinically, without reaching respiratory failure. Imaging showed a thick-walled cavitation in the right lower lobe. Tuberculosis was suspected and confirmed. The uniqueness of this case of COVID-19 coinfection in a patient with undiagnosed tuberculosis, represents a diagnostic and clinical management challenge, where the proper interpretation of chest radiology is a fundamental tool.

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Citations

Shereen MA, Khan S, Kazmi A, et al. COVID-19 infection: Emergence, transmission, and characteristics of human coronaviruses. J Adv Res 2020;24:91-98. DOI: https://doi.org/10.1016/j.jare.2020.03.005
Umakanthan S, Sahu P, Ranade AV, et al. Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgrad M J 2020;96:753.
World Health Organization. Global tuberculosis report 2020. Last access 15 December 2020 Available from: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2020
Wei M, Zhao Y, QianZ, et al. Pneumonia caused by mycobacterium tuberculosis. Microbes infect 2020;22:278-84. DOI: https://doi.org/10.1016/j.micinf.2020.05.020
Ufimtseva E, Eremeeva N, Vakhrusheva D, Skornyakov S. Mycobacterium tuberculosis shape and size variations in alveolar macrophages of tuberculosis patients. Eur Respir J 2019;54:PA4605. DOI: https://doi.org/10.1183/13993003.congress-2019.PA4605
Churchyard G, Kim P, Shah NS, et al. What we know about tuberculosis transmission: An overview. J Infect Dis 2017;216:S629–35. DOI: https://doi.org/10.1093/infdis/jix362
Migliori GB, Thong PM, Alffenaar J-W, et al. Gauging the impact of the COVID-19 pandemic on tuberculosis services: a global study. Eur Respir J 2021;58:2101786. DOI: https://doi.org/10.1183/13993003.01786-2021
Vanzetti CP, Salvo CP, Kuschner P, Brusca S. [Coinfección tuberculosis y COVID-19].[Article in Spanish]. Medicina (B. Aires) 2020;80:s100-3.
Pai M, Behr MA, Dowdy D, et al. Tuberculosis. Nat Rev Dis Primers 2016;2:16076. DOI: https://doi.org/10.1038/nrdp.2016.76
Osuchowski MF, Winkler MS, Skirecki T, et al. The COVID-19 puzzle: deciphering pathophysiology and phenotypes of a new disease entity. Lancet Respir Med 2021;9:622–42. DOI: https://doi.org/10.1016/S2213-2600(21)00218-6
Mousquer GT, Peres A, Fiegenbaum M. Pathology of TB/COVID-19 Co-Infection: The phantom menace. Tuberculosis 2021;126:102020. DOI: https://doi.org/10.1016/j.tube.2020.102020
Petrone L, Petruccioli E, Vanini V, et al. Coinfection of tuberculosis and COVID-19 limits the ability to in vitro respond to SARS-CoV-2. Int J Infect Dis 2021;S1201-9712(21)00176-4. Online ahead of print. DOI: https://doi.org/10.1016/j.ijid.2021.02.090
Udwadia ZF, Vora A, Tripathi AR, et al. COVID-19-Tuberculosis interactions: When dark forces collide. Indian J Tuberc 2020;67:S155–62. DOI: https://doi.org/10.1016/j.ijtb.2020.07.003
Nachiappan AC, Rahbar K, Shi X, et al. Pulmonary tuberculosis: Role of radiology in diagnosis and management. Radiographics 2017;37:52–72. DOI: https://doi.org/10.1148/rg.2017160032
Kwee TC, Kwee RM. Chest CT in covid-19: What the radiologist needs to know. Radiographics 2020;40:1848–65. DOI: https://doi.org/10.1148/rg.2020200159
Tadolini M, Codecasa LR, García-García JM, et al. Active tuberculosis, sequelae and COVID-19 co-infection: First cohort of 49 cases. Eur Respir J 2020;56:2001398. DOI: https://doi.org/10.1183/13993003.01398-2020
RECOVERY Collaborative Group, Horby P, Lim WS, et al. Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med 2021;384:693-704. DOI: https://doi.org/10.1056/NEJMoa2021436
Gopalaswamy R, Subbian S. Corticosteroids for covid-19 therapy: Potential implications on tuberculosis. Int J Mol Sci 2021;22:3773. DOI: https://doi.org/10.3390/ijms22073773
Motta I, Centis R, D’Ambrosio L, et al. Tuberculosis, COVID-19 and migrants: Preliminary analysis of deaths occurring in 69 patients from two cohorts. Pulmonology 2020;26:233-40. DOI: https://doi.org/10.1016/j.pulmoe.2020.05.002

How to Cite

Osejo-Betancourt, Miguel, Sebastian Molina-Paez, and Mariana Rubio-Romero. 2021. “Pulmonary Tuberculosis and COVID-19 Coinfection: A New Medical Challenge”. Monaldi Archives for Chest Disease 92 (3). https://doi.org/10.4081/monaldi.2021.2046.