Rare Presentation of Disseminated Tuberculosis in the Present Era of Modern Tuberculosis Management

A. Anilkumar, S. Manikandan, V. Sreenivasan
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Abstract

Background: Disseminated tuberculosis (TB) is defined as two or more noncontiguous sites resulting from lymphohematogenous dissemination of Mycobacterium tuberculosis. In an immunocompetent host, it is uncommon. The presentation varies, and non-specific early infection symptoms can be noted on chest radiography. Early medication beginning is linked to significantly better outcomes in cases of disseminated tuberculosis. The current case report describes the series of incidents that resulted from a 50-year-old man's excessive usage of the corticosteroid medication tablet Betamethasone, which he was taking for a cough and cold related to his chronic obstructive pulmonary disease (COPD). Case Presentation: A 50-year-old Indian male patient with osteoporosis, drug-induced adrenal insufficiency, and bilateral pleural effusion who is receiving anti-tuberculosis therapy which he is on now is presented to the outpatient department of a tertiary hospital with complaints of fever associated with shivering on & off for 4 months, generalized tiredness. He had a history of loose stools for 2-3 days, small joint pain, left knee joint pain and swelling, loss of weight, and loss of appetite. Conclusion: The right diagnosis, treatment, patient counseling, diet, and family support helped him recover despite his turbulent recovery phase. As far as steroid therapy is concerned, it is a double-edged sword, meaning that taking (OTC) over-the-counter steroid drugs without first seeking adequate medical advice could have serious negative effects.
现代结核病管理时代弥散性结核病的罕见表现
背景:播散性结核(TB)被定义为结核分枝杆菌淋巴血液传播引起的两个或多个不连续的部位。在免疫能力强的宿主中,不常见。表现各异,胸片上可发现非特异性早期感染症状。在播散性结核病病例中,早期开始用药可显著改善预后。目前的病例报告描述了一名50岁男子因慢性阻塞性肺疾病(COPD)引起的咳嗽和感冒而过量使用皮质类固醇药物片剂倍他米松(Betamethasone)引起的一系列事件。病例介绍:一名50岁印度男性患者,患有骨质疏松、药物性肾上腺功能不全和双侧胸腔积液,正在接受抗结核治疗,现以发热伴寒战4个月,全身乏力就诊于某三级医院门诊部。患者有稀便2-3天、小关节痛、左膝关节痛、肿胀、体重减轻、食欲不振病史。结论:正确的诊断、治疗、患者咨询、饮食和家庭支持帮助他度过了动荡的康复期。就类固醇治疗而言,这是一把双刃剑,这意味着在没有事先征求充分医疗建议的情况下服用(OTC)非处方类固醇药物可能会产生严重的负面影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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