2019, Number 5
PDF size: 407.83 Kb.
ABSTRACTTuberculosis is typically considered a chronic disease, although it can be manifested acutely, whose form is reviewed in this clinical case. The pathogenesis of acute tuberculosis is usually related to epidemiological and genetic factors of the host. Septic shock due to Mycobacterium tuberculosis is rare, but it is well recognized, behaving similarly to bacterial septic shock, known as sepsis tuberculosa gravissima. Our patient was admitted with hemodynamic compromise and diagnosis of septic shock that evolved to multiorganic failure; despite antimicrobial and antituberculous management, patient died five days after admission to the intensive care unit. The spectrum of M. tuberculosis disease makes diagnosis difficult, unless clinical suspicion is high, but high mortality requires consideration. The early start of therapy is decisive to optimize the clinical outcome.
Silva R, Jara J, Soto T, Sepúlveda P. Sepsis tuberculosa gravissima: Una presentación infrecuente en paciente con tratamiento inmunosupresor. 2018.
Jacob J, Mehta A, Leonard M. Acute forms of tuberculosis in adults. Am J Med 122(1), pp.12-17.
Otu A, Hashmi M, Mukhtar A, Kwizera A, et al. The critically ill patient with tuberculosis in intensive care: Clinical presentations, management and infection control. J Crit Care 2018;45:184-196.
Duro R, Figueiredo Dias P, Ferreira A, Xerinda S, et al. Severe tuberculosis requiring intensive care: a descriptive analysis. 2018.
Bridges D, Bedimo R. Severe tuberculosis sepsis in an immunocompetent patient. Am J Med 119(3):e11-e14.
Michel P, Barbier C, Loubiere Y. Three cases of septic shock due to tuberculosis without HIV pathology. Intensive Care Med 2002;28:1827-8
Dellinger R, Levy M, Rhodes A, Annane D, et al. Surviving Sepsis Campaign. Crit Care Med 2013;41(2):580-637.
Kethireddy S, Light R, Mirzanejad Y, Maki D et al. Mycobacterium tuberculosis septic shock. Chest 2013;144(2):474- 482.
Caminero Luna J. Actualización en el diagnóstico y tratamiento de la tuberculosis pulmonar. 2018.
Caminero Luna JA. Guía de la tuberculosis para médicos especialistas. En: Disease IUATaL, editor. Paris: Imprimerie Chirat; 2003;1-390. 4. Farga V, Caminero
Underwood J, Cresswell F, Salam A, Keeley A, Cleland C, et al. Complications of miliary tuberculosis: low mortality and predictive biomarkers from a UK cohort. BMC Infectious Diseases 2017;17(1).