Septic Shock From Mycobacterium tuberculosis After Therapy for Pneumocystis carinii

Clark, Timothy M.; Burman, William J.; Cohn, David L.; Mehler, Philip S.

doi:10.1001/archinte.158.9.1033

Cited by 13 publications

(8 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although most cases of sepsis syndrome have a bacterial or toxic cause, TB presenting with septic shock in patients with HIV has already been recognized [2-5]. However, to the best of our knowledge, none of these patients had a polymorphonuclear effusion upon diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Disseminated tuberculosis presenting with polymorphonuclear effusion and septic shock in an HIV-seropositive patient: a case report

et al. 2010

View full text Add to dashboard Cite

IntroductionBecause a substantial number of patients present with few or atypical symptoms, the recognition of tuberculosis remains challenging. Disseminated tuberculosis presenting with septic shock has already been described in some case reports, but, to the best of our knowledge, it has never been associated with polymorphonuclear effusion.Case presentationWe describe the case of a 27-year-old man from western Africa who was seropositive for human immunodeficiency virus. He presented with pleural and abdominal polymorphonuclear effusions and quickly developed septic shock due to disseminated Mycobacterium tuberculosis infection leading to multiple organ failure and death.ConclusionIn high-risk patients, Mycobacterium tuberculosis infection should be considered even in exceptional clinical presentations, such as septic shock and polymorphonuclear effusions.

show abstract

Section: Discussionmentioning

confidence: 99%

Disseminated tuberculosis presenting with polymorphonuclear effusion and septic shock in an HIV-seropositive patient: a case report

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Bacterial infections are the most common complication of corticosteroid use (3). However, long-term treatment induces a significant defect in cell-mediated immunity that results in infections with opportunistic pathogens, including Pneumocystis (4,5), mycobacteria (6) (including Mycobacterium tuberculosis septic shock (7)), Candida (8), Aspergillus (9), Cryptococcus (10), Legionella (11), Nocardia (12), and Strongyloides (13). Corticosteroids are associated with increased infection, even in previously immunocompetent hosts (14), and they increase the risk of infection of any baseline immunocompromised state (15,16).…”

Section: Corticosteroidsmentioning

confidence: 99%

“…Respiratory viral infections, like parainfluenza, can be associated with other pathogens (142); legionella has also been reported as part of mixed infections (143). Sometimes, a second infection occurs after the first is resolving (144). A high level of suspicion should be maintained at all times for mixed or sequential infections.…”

Section: Co-existing Infections Should Be Soughtmentioning

confidence: 99%

Sepsis associated with immunosuppressive medications: An evidence-based review

Gea-Banacloche

Opal

Jorgensen

et al. 2004

Critical Care Medicine

View full text Add to dashboard Cite

Immunosuppressed patients, by definition, are susceptible to a wider spectrum of infectious agents than immunologically normal patients and, thus, require a broader spectrum antimicrobial regimen when they present with sepsis or septic shock. Special expertise managing immunosuppressed patient populations is needed to predict and establish the correct diagnosis and to choose appropriate empiric and specific agents and maximize the likelihood that patients will survive these microbial challenges.

show abstract

“…[8][9][10][11][12][13] The clinical picture is characterized by septic shock, without specific signs of tuberculosis, which frequently evolves towards multi-organ failure and death.…”

Section: Discussionmentioning

confidence: 99%

Septic shock and multi-organ failure in HIV infection-'sepsis tuberculosa gravissima'

et al. 2006

View full text Add to dashboard Cite

A profoundly immunosuppressed HIV-infected man developed sepsis syndrome with multi-organ failure. A septic screen failed to identify a bacterial or fungal cause and despite empirical treatment for these pathogens the patient remained unwell. Investigations revealed disseminated tuberculosis. With specific anti-tuberculosis therapy the patient rapidly recovered. Although most cases of sepsis syndrome in HIV-infected patients are due to bacteria, tuberculosis should be added to the differential diagnosis of this presentation.

show abstract

Septic Shock From Mycobacterium tuberculosis After Therapy for Pneumocystis carinii

Cited by 13 publications

References 11 publications

Disseminated tuberculosis presenting with polymorphonuclear effusion and septic shock in an HIV-seropositive patient: a case report

Disseminated tuberculosis presenting with polymorphonuclear effusion and septic shock in an HIV-seropositive patient: a case report

Sepsis associated with immunosuppressive medications: An evidence-based review

Septic shock and multi-organ failure in HIV infection-'sepsis tuberculosa gravissima'

Contact Info

Product

Resources

About