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Diagnosis and ECMO Treatment of a Critically Ill Patient With Disseminated Mycobacterium tuberculosis: A Case Report

BACKGROUND: Mycobacterium tuberculosis infection remains a public health concern worldwide. The diagnosis and treatment of disseminated M. tuberculosis is very difficult, so we shared our experiences and lessons learned in this case report. CASE PRESENTATION: A 36-year-old female with a history of e...

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Autores principales: Shang, Xiuling, Zhang, Hongxuan, Chen, Sheng, Wang, Chen, Lin, Meifu, Yu, Rongguo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9330379/
https://www.ncbi.nlm.nih.gov/pubmed/35910925
http://dx.doi.org/10.3389/fpubh.2022.938913
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author Shang, Xiuling
Zhang, Hongxuan
Chen, Sheng
Wang, Chen
Lin, Meifu
Yu, Rongguo
author_facet Shang, Xiuling
Zhang, Hongxuan
Chen, Sheng
Wang, Chen
Lin, Meifu
Yu, Rongguo
author_sort Shang, Xiuling
collection PubMed
description BACKGROUND: Mycobacterium tuberculosis infection remains a public health concern worldwide. The diagnosis and treatment of disseminated M. tuberculosis is very difficult, so we shared our experiences and lessons learned in this case report. CASE PRESENTATION: A 36-year-old female with a history of epilepsy presented to our hospital with fever, upper abdominal pain, muscle soreness in limbs for 7 days, and shortness of breath for 4 days. On admission, she presented with acute respiratory distress syndrome (ARDS) and liver dysfunction. Due to the critical nature of her clinical presentation, the patient was admitted directly to the Intensive Care Unit (ICU), received mechanical ventilation in prone position and VV-ECMO treatment. Her condition improved gradually, and the ECMO was removed after 7 days and she was weaned off the ventilator after 8 days. However, her fever recurred and she underwent PET-CT examination, liver contrast ultrasound, acid-fast staining and second-generation sequencing of cerebrospinal fluid, which confirmed M. tuberculosis infection. CONCLUSION: This case report briefly described the treatment and diagnosis of a critically ill patient with intra and extra-pulmonary tuberculosis infection. Timely and appropriate treatment is crucial to save lives, but the timing of ECMO treatment needs to be carefully considered for patients with ARDS caused by tuberculosis.
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spelling pubmed-93303792022-07-29 Diagnosis and ECMO Treatment of a Critically Ill Patient With Disseminated Mycobacterium tuberculosis: A Case Report Shang, Xiuling Zhang, Hongxuan Chen, Sheng Wang, Chen Lin, Meifu Yu, Rongguo Front Public Health Public Health BACKGROUND: Mycobacterium tuberculosis infection remains a public health concern worldwide. The diagnosis and treatment of disseminated M. tuberculosis is very difficult, so we shared our experiences and lessons learned in this case report. CASE PRESENTATION: A 36-year-old female with a history of epilepsy presented to our hospital with fever, upper abdominal pain, muscle soreness in limbs for 7 days, and shortness of breath for 4 days. On admission, she presented with acute respiratory distress syndrome (ARDS) and liver dysfunction. Due to the critical nature of her clinical presentation, the patient was admitted directly to the Intensive Care Unit (ICU), received mechanical ventilation in prone position and VV-ECMO treatment. Her condition improved gradually, and the ECMO was removed after 7 days and she was weaned off the ventilator after 8 days. However, her fever recurred and she underwent PET-CT examination, liver contrast ultrasound, acid-fast staining and second-generation sequencing of cerebrospinal fluid, which confirmed M. tuberculosis infection. CONCLUSION: This case report briefly described the treatment and diagnosis of a critically ill patient with intra and extra-pulmonary tuberculosis infection. Timely and appropriate treatment is crucial to save lives, but the timing of ECMO treatment needs to be carefully considered for patients with ARDS caused by tuberculosis. Frontiers Media S.A. 2022-07-14 /pmc/articles/PMC9330379/ /pubmed/35910925 http://dx.doi.org/10.3389/fpubh.2022.938913 Text en Copyright © 2022 Shang, Zhang, Chen, Wang, Lin and Yu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Shang, Xiuling
Zhang, Hongxuan
Chen, Sheng
Wang, Chen
Lin, Meifu
Yu, Rongguo
Diagnosis and ECMO Treatment of a Critically Ill Patient With Disseminated Mycobacterium tuberculosis: A Case Report
title Diagnosis and ECMO Treatment of a Critically Ill Patient With Disseminated Mycobacterium tuberculosis: A Case Report
title_full Diagnosis and ECMO Treatment of a Critically Ill Patient With Disseminated Mycobacterium tuberculosis: A Case Report
title_fullStr Diagnosis and ECMO Treatment of a Critically Ill Patient With Disseminated Mycobacterium tuberculosis: A Case Report
title_full_unstemmed Diagnosis and ECMO Treatment of a Critically Ill Patient With Disseminated Mycobacterium tuberculosis: A Case Report
title_short Diagnosis and ECMO Treatment of a Critically Ill Patient With Disseminated Mycobacterium tuberculosis: A Case Report
title_sort diagnosis and ecmo treatment of a critically ill patient with disseminated mycobacterium tuberculosis: a case report
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9330379/
https://www.ncbi.nlm.nih.gov/pubmed/35910925
http://dx.doi.org/10.3389/fpubh.2022.938913
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