YE Sheng # , TANG Xiaomiao # , MENG Shen , LEI Wei
  • The Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P. R. China;
LEI Wei, Email: leiweilw@suda.edu.cn
Severe pulmonary tuberculosis; septic shock; multiple organ dysfunction syndrome; next-generation sequencing; death
10.7507/1671-6205.202202043
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Objective  To summarize and explore the clinical features, diagnosis and treatment of severe pulmonary tuberculosis (TB). Methods  One death case of pulmonary TB in The First Affiliated Hospital of Soochow University was analyzed, related publications of case reports and articles relevant on the analysis and study of pulmonary tuberculosis deaths from Pubmed between January 2012 and March 2022 were also reviewed. Results  A 25-year-old female patient was admitted for "intermittent cough with sputum for more than 1 year, aggravated with chest tightness and shortness of breath for 5 days". She had no underlying disease. Pulmonary TB was diagnosed by TB bacterium smear and next-generation sequencing of bronchoalveolar lavage fluid. The patient was in shock compensation period and developed acute respiratory distress syndrome immediately after admission. Through active anti-tuberculosis, invasive mechanical ventilation, intra-aortic balloon counterpulsation and continuous renal replacement therapy, the disease continued to deteriorate and she died on the third day after admission. A total of 269 pulmonary TB deaths were retrieved. An analysis of 244 patients' past medical history showed that human immunodeficiency virus co-infection was the most common among young people and chronic diseases were the most common among the elderly. All 269 patients died of septic shock, respiratory failure and multiple organ dysfunction syndrome (MODS), among which hyponatremia was also a significant complication. The shortest time from admission to death was 7 days, while the longest average time was only 35 days. Conclusions  Pulmonary TB could develop into septic shock and MODS with poor prognosis and high mortality. Health education on TB should be strengthened.

Citation： YE Sheng, TANG Xiaomiao, MENG Shen, LEI Wei. Tuberculosis death in a young woman without underlying disease: a case report and literature review. Chinese Journal of Respiratory and Critical Care Medicine, 2022, 21(3): 153-157. doi: 10.7507/1671-6205.202202043 Copy

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