Acute respiratory distress syndrome caused by miliary tuberculosis: a multicentre survey in South Korea

Lee, K.; Kim, J. H.; Lee, J. H.; Lee, W. Y.; Park, Moo Suk; Kim, J. Y.; Kim, K. C.; Lee, M. G.; Jung, KS; Kim, Y. S.; Shin, Yong Moon; Koh, Younsuck

doi:10.5588/ijtld.10.0557

Cited by 45 publications

(68 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although there are a few reports suggesting that the administration of corticosteroid drugs is effective for the treatment of ARDS complicated with miliary TB [15] [16] [17], they were not effective for case 6 in this study. Therefore, we have some doubts regarding the effectiveness of corticosteroid drugs administration for miliary TB.…”

Section: Discussioncontrasting

confidence: 46%

Clinical Analysis of Miliary Tuberculosis Patients in Our Tertiary Hospital

Kobashi¹,

Kittaka²,

Mouri³

et al. 2017

JTR

View full text Add to dashboard Cite

Objective: To investigate the clinical characteristics of miliary tuberculosis experienced in our tertiary hospital without a tuberculosis isolation room. Materials and Methods: We obtained a definite diagnosis of tuberculosis for 72 patients in our tertiary hospital between January 2010 and September 2016. There were six patients (8.3%) who were diagnosed with miliary tuberculosis following the isolation of Mycobacterium tuberculosis from several organs, and we analyzed the clinical findings. Results: The average age of the six patients with miliary tuberculosis was 74 years old (3 males and 3 females). All patients had underlying diseases and immunosuppressive treatment was performed for three patients. The detection methods were based on clinical symptoms such as high fever in all patients. Concerning the laboratory findings, three patients showed a negative or indeterminate response for interferon-gamma release assays (IGRAs). Bronchoscopic examinations were performed for five of six patients soon after admission and a definite diagnosis was obtained. Although treatment according to the American Thoracic Society (ATS) guidelines was performed for all patients, three of the six died due to complications or worsening of miliary tuberculosis. Conclusions: Patients with miliary tuberculosis experienced in a tertiary hospital were frequently detected among patients receiving immunosuppressive treatment for a long time. Because these patients showed a rapid progressive clinical course, it is thought to be important to perform bronchoscopic examination proactively for patients suspected of miliary tuberculosis on radiological findings to make an appropriate early diagnosis and start treatment.

show abstract

Section: Discussioncontrasting

confidence: 46%

Clinical Analysis of Miliary Tuberculosis Patients in Our Tertiary Hospital

Kobashi¹,

Kittaka²,

Mouri³

et al. 2017

JTR

View full text Add to dashboard Cite

show abstract

“…In a multicenter study conducted in South Korea, (35) the APACHE II score was not a predictor of survival. In that study, the characteristics and outcomes of patients with ARDS caused by miliary tuberculosis were evaluated.…”

Section: Mortality and Prognostic Factorsmentioning

confidence: 85%

Tuberculose grave com necessidade de internação em UTI

2012

View full text Add to dashboard Cite

Tuberculosis is a curable disease that can evolve to severe forms, requiring the treatment of the patients in an ICU, especially if there is a delay in the diagnosis or if it affects elderly patients, those on dialysis, or those with HIV infection or other states of immunosuppression, as well as in cases of multidrug resistant disease. Knowledge of the radiological presentation of the cases can help diagnose these severe forms, as can the introduction of new tests, such as the early detection of the etiological agent by PCR and chest CT, which favors the early initiation of treatment. In addition, the use of regimens without isoniazid and rifampin, as well as uncertain enteral absorption and low serum concentrations of antituberculosis drugs, can reduce the efficacy of treatment. For such patients, the prognosis is generally poor and mortality rates are high.Keywords: Tuberculosis; Respiratory insufficiency; Respiration, artificial; Hospitalization. ResumoA tuberculose é uma doença curável que pode evoluir para formas graves com necessidade de tratamento dos pacientes em UTI, especialmente se essa não for diagnosticada em tempo ou se afetar pacientes idosos, aqueles em diálise e aqueles com infecção pelo HIV ou outros estados de imunossupressão, assim como nos casos de doença multirresistente. O conhecimento da apresentação radiológica dos casos pode auxiliar no diagnóstico dessas formas graves, assim como a introdução de novos testes, como a detecção rápida do agente por PCR e a TC de tórax, favorecendo o início precoce do tratamento. Além disso, o uso de esquemas sem isoniazida e rifampicina, a absorção entérica incerta e as baixas concentrações séricas das drogas antituberculose podem contribuir para a diminuição da eficácia do tratamento. O prognóstico desses pacientes geralmente é ruim, com elevadas taxas de mortalidade.

show abstract

“…Multiorgan failure has been shown to be associated with mortality in a few studies. (3,5) Although ICU scoring systems of APACHE and SOFA scores have been validated for use for predicting individual patient outcomes during ICU admissions, (26) both of these scoring systems have only been shown to be associated with mortality in patients with PTB requiring ICU care in a few studies, (6,14) with many others not reporting such an association. (4,5,13,15) APACHE II scores may severely underestimate the mortality risk of patients with TB who have septic shock.…”

Section: Discussionmentioning

confidence: 99%

“…(3)(4)(5)(6)(7)(8)(9)(10)(11)(12) Identified risk factors for mortality include acute respiratory distress syndrome, (4,5) need for mechanical ventilation, (4) HIV infection, (7) multiple organ failure, (3,5) consolidation on chest radiograph, (3,5) acute renal failure, (4) early ICU admission, (13) Acute Physiology and Chronic Health Evaluation (APACHE) II score, (6) Sequential Organ Failure Assessment (SOFA) score, (14) sepsis, (4,6) low albumin, (7) age (15) and nosocomial-or ventilator-associated pneumonia. (4,8,13) Besides these factors, treating PTB in the ICU is challenging because of poor absorption of antituberculous treatment among the critically ill and the paradoxical deterioration of TB during treatment.…”

Section: Introductionmentioning

confidence: 99%