PMID- 37182005
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230516
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 4
DP  - 2023 Apr
TI  - Pulmonary Tuberculosis Presenting As Septic Shock in an Immunocompetent Patient: 
      Revisiting an Old Disease With New Perspectives.
PG  - e37362
LID - 10.7759/cureus.37362 [doi]
LID - e37362
AB  - Septic shock due to Mycobacterium tuberculosis (M. tuberculosis) in 
      immunocompromised patients (particularly HIV) is a well-recognized clinical 
      entity. However, tubercular sepsis in the immunocompetent is still underdiagnosed 
      and under-discussed. Moreover, sepsis is usually associated with gram-negative 
      and other gram-positive microorganisms that can cause similar pulmonary and 
      disseminated disease and can further convolute the diagnosis. We herein discuss a 
      case of an elderly female who presented with acute onset fever, cough, and 
      altered talk from the last seven days. Her initial clinical and laboratory 
      examination revealed features of lower respiratory tract infection with septic 
      shock. She was started on broad-spectrum antibiotics based on severe 
      community-acquired pneumonia management guidelines. Her blood and urine cultures 
      were sterile. She did not respond to initial antibiotics. Furthermore, sputum 
      production was not possible, which compelled us for gastric aspirate analysis, 
      which came positive for cartridge-based nucleic acid amplification test (CBNAAT). 
      In repeated blood cultures, M. tuberculosis was also isolated. She was started on 
      antitubercular treatment; on the 12th day of antitubercular treatment, she 
      developed acute respiratory distress and eventually succumbed to her illness on 
      the 19th day of hospitalization. We highlighted the importance of early diagnosis 
      and prompt antitubercular therapy in tubercular septic shock. We also discuss the 
      possibility of tubercular-immune reconstitution inflammatory syndrome (IRIS) in 
      such patients, which could be a contributing factor to mortality.
CI  - Copyright (c) 2023, Malik et al.
FAU - Malik, Manika
AU  - Malik M
AD  - Internal Medicine, All India Institute of Medical Sciences, Jodhpur, IND.
FAU - Lodha, Naman
AU  - Lodha N
AD  - Internal Medicine, All India Institute of Medical Sciences, Jodhpur, IND.
FAU - Meena, Durga S
AU  - Meena DS
AD  - Internal Medicine, All India Institute of Medical Sciences, Jodhpur, IND.
FAU - Sureka, Binit
AU  - Sureka B
AD  - Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, 
      Jodhpur, IND.
LA  - eng
PT  - Case Reports
DEP - 20230410
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10170580
OTO - NOTNLM
OT  - immunocompetent
OT  - pulmonary
OT  - sepsis
OT  - septic shock
OT  - tuberculosis
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/05/14 19:13
MHDA- 2023/05/14 19:14
PMCR- 2023/04/10
CRDT- 2023/05/14 12:26
PHST- 2023/04/09 00:00 [accepted]
PHST- 2023/05/14 19:14 [medline]
PHST- 2023/05/14 19:13 [pubmed]
PHST- 2023/05/14 12:26 [entrez]
PHST- 2023/04/10 00:00 [pmc-release]
AID - 10.7759/cureus.37362 [doi]
PST - epublish
SO  - Cureus. 2023 Apr 10;15(4):e37362. doi: 10.7759/cureus.37362. eCollection 2023 
      Apr.