Active pulmonary tuberculosis presenting with acute respiratory failure

Abstract

Four patients with active pulmonary tuberculosis (PTB) presenting with respiratory failure are reported here. Bronchogenic PTB, simulating an acute febrile illness or diffuse interstitial lung disease with short duration of symptoms, as a cause of acute respiratory failure is less recognized. If diagnosed and treated early, it has good prognosis. Three of the four patients presented here had an acute presentation with fever, dyspnoea, and hypoxemia with diffuse infiltrative lesions on radiography, and the other younger patient presented predominantly with lobar consolidation. These patients presenting with respiratory failure required intensive care management, and a diagnosis was made with bronchoalveolar lavage fluid and transbronchial lung biopsy. All four patients promptly received antitubercular therapy, showed clinicoradiological improvement, and were stable at 1 year follow up.

Prediction model for death in patients with pulmonary tuberculosis accompanied by respiratory failure in ICU: retrospective study

“…Respiratory failure is a common disorder in the intensive care unit (ICU) and it is associated with high mortality and morbidity (6). Although TB cases requiring ICU represent only 1-3% of all hospital admissions for TB, in-hospital TB mortality rates associated are higher (range: 29-83%) than for other infections (7,8). However, in China today, pulmonary TB is rarely considered as a primary cause of respiratory distress.…”

An Interesting Case of Pulmonary Tuberculosis with Hypoxemic Respiratory Failure Mimicking Interstitial Lung Disease

“…Even though TB ARDS has been documented in medical literature 5 , our patient with unilateral localized radiological lesions did not satisfy Berlin's criteria for ARDS. Bronchogenic pulmonary TB, extensive parenchymal consolidation, bilateral smooth interlobular septal thickening and miliary TB have been reported as causes of acute respiratory failure 6,7 . Our patient had unilateral localized interstitial involvement in the form of interlobular septal thickening along with consolidation, which to the best of our knowledge has not been reported in medical literature as a cause of hypoxemic respiratory failure in pulmonary TB.…”

A middle-aged lady with near-fatal respiratory failure

“…Bronchogenic pulmonary tuberculosis (TB) simulating a diffuse interstitial lung disease is a less recognized and rare cause of acute respiratory failure. The incidence of bronchogenic TB is reported between 1.5-1.9%, with a 50-75% mortality rate in undiagnosed cases [9]. Causes of hypoxemia in non-military pulmonary tuberculosis result from direct injury to alveolar epithelial cells from tubercular antigens.…”