Saffar Homina, Sobhanian Pooria, Alian Shahriar, Darvishnia David, Baradaran Mansoureh
Student Research Committee, Faculty of Medicine Mazandaran University of Medical Sciences Sari Mazandaran Iran.
Department of Infectious Diseases, School of Medicine, Antimicrobial Resistance Research Center, Communicable Diseases Institute, Ghaem Shahr Razi Hospital Mazandaran University of Medical Sciences Sari Mazandaran Iran.
Clin Case Rep. 2024 Dec 12;12(12):e9614. doi: 10.1002/ccr3.9614. eCollection 2024 Dec.
Tuberculosis (TB) is an infectious disease caused by bacteria, which is more prevalent among immunocompromised individuals. According to the distribution of affected organs, this infection can be categorized as either pulmonary or extrapulmonary TB. Immunodeficiency states resulting from rheumatological disorders and the use of immunosuppressive medications, such as in Behçet's disease (BD), are potential predisposing factors for TB, particularly in cases involving multiple organs. These situations can introduce challenges in both the diagnosis and treatment of patients. We describe a 43-year-old man with a history of BD who presented with symptoms of weight loss, abdominal pain, and shortness of breath. His chest X-ray revealed cavities and calcifications, while an abdominal X-ray demonstrated signs of intestinal obstruction and adhesions. Subsequent TB diagnosis led to a 6-month course of a TB treatment regimen. Despite treatment initiation, the patient developed a brain abscess 1 year later, necessitating surgical intervention. Following the procedure, he received another 1-year course of a TB treatment regimen and experienced full recovery without any complications during a 2-year follow-up period. Notably, the patient recently received a Sinopharm COVID-19 vaccine and subsequently developed seizures that are currently being managed with anticonvulsant therapy. This case report emphasizes the significance of including pulmonary TB in complex medical cases, especially in individuals with autoimmune diseases. Early diagnosis and treatment are crucial for improving outcomes and reducing the risk of complications. Furthermore, it highlights the possible correlation between TB and BD, along with the potential adverse reactions to COVID-19 vaccines in this population, which necessitate special consideration by healthcare professionals.
结核病(TB)是一种由细菌引起的传染病,在免疫功能低下的个体中更为普遍。根据受影响器官的分布,这种感染可分为肺结核或肺外结核。由风湿性疾病和使用免疫抑制药物(如白塞病(BD))导致的免疫缺陷状态是结核病的潜在易感因素,特别是在涉及多个器官的病例中。这些情况会给患者的诊断和治疗带来挑战。我们描述了一名43岁有白塞病病史的男性,他出现了体重减轻、腹痛和呼吸急促的症状。他的胸部X光显示有空洞和钙化,而腹部X光显示有肠梗阻和粘连的迹象。随后的结核病诊断导致了为期6个月的结核病治疗方案。尽管开始了治疗,但患者在1年后出现了脑脓肿,需要进行手术干预。手术后,他又接受了为期1年的结核病治疗方案,在2年的随访期内完全康复,没有任何并发症。值得注意的是,该患者最近接种了国药新冠疫苗,随后出现了癫痫发作,目前正在接受抗惊厥治疗。本病例报告强调了在复杂医疗病例中纳入肺结核的重要性,特别是在自身免疫性疾病患者中。早期诊断和治疗对于改善预后和降低并发症风险至关重要。此外,它突出了结核病与白塞病之间可能的相关性,以及该人群对新冠疫苗可能的不良反应,这需要医护人员特别关注。