Acute myeloid leukemia presenting with pulmonary tuberculosis

Area of Science:

• Hematology
• Infectious Diseases
• Oncology

Background:

• Tuberculosis (TB) and acute myeloid leukemia (AML) are significant global health concerns.
• Co-occurrence of pulmonary TB and AML is exceptionally rare, particularly in immunocompetent individuals.
• Diagnostic challenges arise due to overlapping clinical and radiological features.

Purpose of the Study:

• To report a unique case of concurrent pulmonary tuberculosis and acute myeloid leukemia.
• To emphasize the importance of considering hematological malignancies in patients with persistent infections and atypical presentations.
• To highlight successful management strategies for this dual diagnosis.

Main Methods:

• Case report of a 58-year-old male with symptoms suggestive of infection and hematological abnormalities.
• Diagnostic workup included blood investigations, chest imaging, bronchoalveolar lavage, and bone marrow aspiration.
• Treatment involved standard antitubercular therapy and induction chemotherapy for AML.

Main Results:

• The patient presented with fever, cough, neutropenia, monocytosis, and bilateral lung infiltrates.
• Bronchoalveolar lavage confirmed Mycobacterium tuberculosis infection.
• Bone marrow aspiration revealed acute myeloid leukemia.
• The patient achieved remission after chemotherapy and completed antitubercular treatment without complications.

Conclusions:

• This case underscores the critical need for a high index of suspicion for hematological disorders in patients with severe or atypical infections.
• Integrated management of tuberculosis and acute myeloid leukemia is feasible and can lead to favorable outcomes.
• This is the first reported case of concurrent pulmonary tuberculosis and acute myeloid leukemia in Qatar.