Background
The current case report presents acute hemorrhagic necrotizing encephalopathy (AHNE) as an example of a fatal complication, the etiology of which could be coronavirus disease 2019 (COVID-19) with multiple organ damage along with the existing respiratory tuberculosis.
Case presentation
A male in his 20s had severe symptoms of central nervous system lesion, which developed against the background of COVID-19 and respiratory tuberculosis, for which he was treated in the intensive care unit. Autopsy confirmed that he died from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) associated AHNE in adults with severe fatal endothelial dysfunction and respiratory tuberculosis. The main morphological signs of brain damage were desquamative endotheliitis, thrombosis, parenchymal hemorrhagic necrosis, encephalitis, severe necrobiotic neuronal damage.
Conclusion
The defeat of endothelial cells with the development of generalized endotheliitis in COVID-19, especially in conjunction with comorbid pathology, in particular tuberculosis, can lead to a fatal complication that affects the nervous system—AHNE. Therefore, it is worth paying close attention to the appearance of neurological symptoms in patients with a similar combination of diseases.
Analyzed 2 deaths from pathological and forensic practice in order to show that comorbid diseases in young patients in the context of the COVID-19 pandemic increase the risk of an adverse outcome due to the potentiation of the systemic damaging action of the viral agent, decompensation of chronic therapeutic pathology, the development of acute complications and status, possible drug interactions. The management of this category of patients requires knowledge of the characteristics of a viral infection, its clinical manifestations in combination with comorbid diseases.
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