Khayat Mohammed, Fan Hanan, Vali Yusuf
Department of Pulmonology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.
Respir Med Case Rep. 2021;32:101344. doi: 10.1016/j.rmcr.2021.101344. Epub 2021 Jan 20.
We report the case of a 40-year-old female diagnosed with COVID-19 after presenting to our institution with fever, cough and myalgia for three days. Her nasopharyngeal swab tested positive for SARS COV-2 by real time PCR and her plain chest radiograph was reported as normal. She did not require hospitalization and at telephone follow up she confirmed her illness lasted 11 days. Seven weeks later she presented with chest pain, dyspnea and fever for two days. Her repeat chest imaging showed right upper zone consolidation and this culminated in a microbiological diagnosis of pulmonary tuberculosis. The patient's daughter had been treated for tuberculosis two years earlier and unfortunately family screening for latent TB was not undertaken. This case appears to confirm the concerns that the CD4 T-cell depletion associated with COVID-19 may promote the development of active tuberculosis from latent infection much like HIV does. If this effect is widespread it may have a significant impact on the worldwide TB burden. We suggest vigilance to ensure patients are diagnosed early and meticulous contact tracing is undertaken to treat those with latent tuberculosis.
我们报告了一例40岁女性病例，该患者因发热、咳嗽和肌痛三天前来我院就诊，后被诊断为新冠肺炎。她的鼻咽拭子经实时聚合酶链反应检测，结果显示严重急性呼吸综合征冠状病毒2（SARS-CoV-2）呈阳性，其胸部X光平片报告显示正常。她无需住院治疗，通过电话随访，她确认自己的病情持续了11天。七周后，她出现胸痛、呼吸困难和发热症状，持续了两天。她再次进行胸部影像学检查显示右上肺叶实变，最终微生物学诊断为肺结核。该患者的女儿两年前曾接受过结核病治疗，不幸的是，未对其家人进行潜伏性结核筛查。该病例似乎证实了人们的担忧，即与新冠肺炎相关的CD4 T细胞耗竭可能会像艾滋病毒那样，促使潜伏感染发展为活动性结核病。如果这种影响广泛存在，可能会对全球结核病负担产生重大影响。我们建议提高警惕，以确保患者得到早期诊断，并进行细致的接触者追踪，以治疗那些患有潜伏性结核病的患者。
