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[The adult respiratory stress syndrome and septic shock associated with tuberculosis]
M Boronat1, J A Arzuaga, V Díez Balda
1Servicio de Medicina Interna II, Clínica Puerta de Hierro, Universidad Autónoma de Madrid.
Abstract:
The increase in the incidence of tuberculosis infection in the last few years has caused a recurrence of atypical clinical forms, as well as the development of associations and uncommon complications during the clinical course, which include the adult respiratory distress syndrome (ARDS) and septic shock. Three patients with ARDS are here reported; two patients had findings of septic shock and negative serology to human immunodeficiency virus and the only etiological agent documented was M. tuberculosis. The three patients required hemodynamic support and two of them mechanical ventilation. None of the patients survived the episode. Tuberculosis, particularly the disseminated forms, should be considered as possible etiology in high risk patients with septic shock, ARDS or both.
Insights
Tuberculosis infection can cause severe complications like adult respiratory distress syndrome (ARDS) and septic shock. Disseminated tuberculosis should be considered in high-risk patients presenting with these critical conditions.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Pulmonology
Background:
- Rising tuberculosis incidence has led to atypical presentations.
- Uncommon complications like ARDS and septic shock are increasingly observed.
Observation:
- Three patients with ARDS and septic shock were reported.
- M. tuberculosis was the documented etiological agent in all cases.
- Two patients had negative HIV serology.
Findings:
- All three patients required intensive hemodynamic support.
- Two patients necessitated mechanical ventilation.
- None of the patients survived the critical episode.
Implications:
- Disseminated tuberculosis is a critical differential diagnosis in high-risk patients.
- Consider tuberculosis in patients with ARDS and septic shock.
- Early recognition and treatment of disseminated tuberculosis are vital in critical care settings.