Tuberculous ARDS is associated with worse outcome when compared with non-tuberculous infectious ARDS

Sudarsan, Thomas Isaiah; Thomas, Lovely; Samprathi, Abhishek; Chacko, Binila; Mathuram, Alice Joan; George, Tina; Gunasekaran, Karthik; Rajan, Sudha Jasmine; Carey, Ronald Albert Benton; Mahasampath, Gowri; Peter, John Victor

doi:10.1016/j.jcrc.2020.10.015

Cited by 5 publications

(5 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Invasive fungal infections and parasites, such as P. jirovecii and S. Mansoni , may be responsible for ARDS/ALI in immunocompromised patients 17. ARDS was also described as a complication in critical cases of tuberculosis,20 meningococcemia,21 rickettsial diseases,22 hantavirus pulmonary syndrome,23 and leptospirosis 18. Given that these are uncommon causes of ARDS, it is also intriguing to note that some of these agents, along with the 3 carcinomas, 1 neuroendocrine tumor, and 1 case of meningoencephalitis, might not have been identified without histopathologic analysis and IHC confirmation.…”

Section: Discussionmentioning

confidence: 99%

Histopathologic and Immunohistochemical Assessment of Acute Respiratory Distress Syndrome (ARDS): Challenges and Complexities of Postmortem Diagnosis

Araújo

Louzado²,

Cirqueira³

et al. 2023

Applied Immunohistochemistry &Amp; Molecular Morphology

View full text Add to dashboard Cite

Acute respiratory distress syndrome (ARDS) is a life-threatening condition due to acute lung injury (ALI), characterized by rapid-onset respiratory failure, leading to the clinical manifestations of poor lung compliance, severe hypoxemia, and dyspnea. ARDS/ALI has many causes, most commonly related to infections (sepsis, pneumonia), traumas, and multiple transfusions. The objective of this study is to assess the performance of postmortem anatomopathological examination in identifying etiological agents associated with ARDS or ALI in deceased patients from the State of São Paulo from 2017 to 2018. A retrospective cross-sectional study was performed based on the final outcome obtained by histopathology, histochemical, and immunohistochemical examination for ARDS/ALI differential diagnosis at the Pathology Center of the Adolfo Lutz Institute in São Paulo, Brazil. Of the 154 patients clinically diagnosed with ARDS or ALI, 57% tested positive for infectious agents, and the most frequent outcome was influenza A/H1N1 virus infection. In 43% of cases, no etiologic agent was identified. The opportunity to establish a diagnosis, identify particular infections, confirm a microbiological diagnosis, and uncover unanticipated etiologies is provided by postmortem pathologic analysis of ARDS. A molecular assessment could improve the diagnosis accuracy and lead to research into host responses and public health measures.

show abstract

Section: Discussionmentioning

confidence: 99%

Histopathologic and Immunohistochemical Assessment of Acute Respiratory Distress Syndrome (ARDS): Challenges and Complexities of Postmortem Diagnosis

Araújo

Louzado²,

Cirqueira³

et al. 2023

Applied Immunohistochemistry &Amp; Molecular Morphology

View full text Add to dashboard Cite

show abstract

“…Having that said, almost any bodily organ could be a site for the disease. It commonly affects people living in crowded conditions such as institutionalized patients, immigrants from countries with a high prevalence of tuberculosis, immunocompromised such as patients with HIV, and health care workers [25][26][27][28][29][30][31].…”

Section: Discussionmentioning

confidence: 99%

Progressive Primary Pulmonary Tuberculosis in Current Times: Are we really heading Towards ‘End of TB’ or Still, Many Miles to go for ‘Dream Come True’?

Patil¹,

Gondhali²,

Choudhari³

et al. 2023

SAR J Med

View full text Add to dashboard Cite

Tuberculosis is a more prevalent disease and the leading cause of death from an infectious agent in India. Tuberculosis in India accounts for the highest number of cases and deaths annually in the world. In spite of an efficient National tuberculosis control program for five decades, Tuberculosis is still the number one cause of death due to infectious agents in India and one third of total global deaths occurs in India due to this disease. Burden of drug sensitive and drug resistant cases is highest in the south east Asian region with maximum cases in India and China. India has launched a National strategic plan to end TB in 2017 with a target to eliminate TB by 2025. Main theme of the national strategic plan is ‘TB Free India’ with the vision of zero TB disease, zero deaths due to TB and decreasing poverty due to TB. Tuberculosis is an ancient disease and history traced before the evolution of mankind on this planet. Tuberculosis primarily affects the lung and is classified pathologically as primary, post-primary and progressive primary tuberculosis. In this case report, a 62-year male, presented with constitutional symptoms for six-month duration with partial response to medical treatment. He was having low grade fever, cough, shortness of breath, weight loss and anorexia for 6 months. His symptoms were progressive and empirically treated as enteric or typhoid fever for four to five occasions with oral and intravenous antibiotics with steroids with general physicians and family physicians. Additionally, he received empirical treatment as jaundice, viral fever, bronchitis, asthma, and generalised debilitating disease. Relatives brought to our center worsened general health with increased shortness of breath. Clinically he was having bilateral crepitations with decreased breath sounds right lower axillary and infrascapular area. Chest x-ray showed right pleural effusion with miliary opacities bilateral lung field. HRCT thorax showed typical miliary opacities with conglomerated pattern and pleural effusion on the right side of thorax. Pleural fluid analysis revealed exudative effusion with raised ADA level. He was unable to produce sputum, we have done bronchoscopy and BAL evaluation confirmed pulmonary tuberculosis and sensitivity pattern. BAL cytology documented acid-fast bacilli in smear and MTB genome with rifampicin sensitivity in cartridge based nucleic acid amplification test. Treatment initiated with anti-tuberculosis (ATT). We have recorded near complete radiological resolution, bacteriological cure after eight months of ATT with good compliance. More awareness is required regarding symptoms, diagnosis and treatment of tuberculosis to family physicians and general practitioners as the majority of the rural population receives treatment from these health professionals.

show abstract

“…In TB/HIV co-infected patients, ICU related complications were also common, with nosocomial pneumonia in 67.2% patients, pneumothorax in 13.8%, ARDS in 12.1%, acute renal failure in 12.1% and multi-organ failure (MOF) in 3.4% [22] . The mortality for ARDS secondary due to TB has not changed significantly over time, despite advances in new treatment regimens and ventilatory strategies in ICU [11] , [21] . Canadian study found a significantly higher in-hospital mortality of 69% for patients requiring mechanical ventilation for TB in comparison to ARDS of any cause (56%) and nontuberculous pneumonia (36%) requiring mechanical ventilation [11] .…”

Section: Discussionmentioning

confidence: 99%

“…The mortality for ARDS secondary due to TB has not changed significantly over time, despite advances in new treatment regimens and ventilatory strategies in ICU [11] , [21] . Canadian study found a significantly higher in-hospital mortality of 69% for patients requiring mechanical ventilation for TB in comparison to ARDS of any cause (56%) and nontuberculous pneumonia (36%) requiring mechanical ventilation [11] .…”

Section: Discussionmentioning

confidence: 99%

“…Mortality rates range between 47 and 80 percent. Patients with Milliary or disseminated TB were significantly more likely to develop respiratory failure requiring mechanical ventilation despite the availability of effective antituberculous therapy [11] . Furthermore, TB can cause ARDS from sepsis and septic shock that behaves similarly to bacterial septic shock.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary tuberculosis complicated by pneumothorax, and acute respiratory distress syndrome (ARDS) in the settings of advanced HIV disease: A case report

Haile,

Tema,

Anjulo

et al. 2023

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

View full text Add to dashboard Cite

Tuberculous ARDS is associated with worse outcome when compared with non-tuberculous infectious ARDS

Cited by 5 publications

References 20 publications

Histopathologic and Immunohistochemical Assessment of Acute Respiratory Distress Syndrome (ARDS): Challenges and Complexities of Postmortem Diagnosis

Histopathologic and Immunohistochemical Assessment of Acute Respiratory Distress Syndrome (ARDS): Challenges and Complexities of Postmortem Diagnosis

Progressive Primary Pulmonary Tuberculosis in Current Times: Are we really heading Towards ‘End of TB’ or Still, Many Miles to go for ‘Dream Come True’?

Pulmonary tuberculosis complicated by pneumothorax, and acute respiratory distress syndrome (ARDS) in the settings of advanced HIV disease: A case report

Contact Info

Product

Resources

About