Pulmonary tuberculosis in a case of acute myeloid leukemia during consolidation chemotherapy

Abstract

Tuberculosis in acute myeloid leukemia (AML) has rarely been reported. Herein, we report the diagnosis and treatment of a patient with AML who was finally diagnosed with pulmonary tuberculosis following consolidation chemotherapy. In this case, chest CT showed space-occupying lesions near the right pulmonary hilum after the second cycle of consolidation chemotherapy. Initially, extramedullary infiltration of AML and lung cancer were considered. After consolidation chemotherapy, antibiotics were simultaneously administered, but persistent fever continued. Later, based on the positive acid-fast staining of the tissue puncture following tracheoscopy and the sputum, the patient was diagnosed to have pulmonary tuberculosis and immediately transferred to a dedicated tuberculosis hospital for anti-tuberculosis treatment. Unfortunately, the patient died of respiratory failure 3 months later. In conclusion, in cases wherein AML patients have persistent fever or pulmonary space-occupying lesions of unknown causes during chemotherapy, the possibility of tuberculosis should be considered. Early diagnosis and targeted anti-tuberculosis treatment may significantly improve the prognosis of patients.