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Experimental Model to Evaluate Resolution of Pneumonia

Experimental Model to Evaluate Resolution of Pneumonia

Published on: February 17, 2023

Severe ARDS Complicated by Active Pulmonary Tuberculosis and Recurrent Nosocomial Infections: Therapeutic Challenges

Wei-Hung Chang¹, Yi-Ting Wang¹, Ting-Yu Hu^1,2

¹Department of Critical Care Medicine, MacKay Memorial Hospital, Taipei 104, Taiwan.

Life (Basel, Switzerland)

|July 29, 2025

Abstract:

Background: Acute respiratory distress syndrome (ARDS) secondary to tuberculosis (TB) is rare and associated with high mortality. Management is further complicated by comorbidities and ICU-related complications. Methods: We report a 43-year-old woman with post-polio sequelae and uncontrolled diabetes who developed ARDS due to pulmonary TB, complicated by recurrent nosocomial infections and gastrointestinal bleeding. Early bronchoscopy and GeneXpert MTB/RIF PCR were performed on ICU Day 2, enabling anti-TB therapy initiation by ICU Day 3. The patient received lung-protective ventilation, prone positioning, tailored antibiotics, and multidisciplinary care. Results: The patient's clinical course was complicated by two episodes of ventilator-associated pneumonia and gastrointestinal bleeding, but with individualized management, she achieved ventilator weaning and functional recovery. Conclusions: Early TB recognition in ARDS is crucial. Multidisciplinary ICU management, including prudent steroid use, improves outcomes.

Keywords:

ARDS bronchoscopy case report critical care gastrointestinal bleeding nosocomial infection polio tuberculosis ventilator-associated pneumonia

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