Mycobacterium tuberculosis sepsis with multiple intermuscular abscesses and respiratory failure as the main manifestations: a case report
Abstract Background Tuberculous sepsis is uncommon in individuals without human immunodeficiency virus (HIV) infection, and some patients may not exhibit clinical signs and symptoms of suspected sepsis upon admission, leading to delayed diagnosis and treatment. Case presentation This report present...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-03-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-024-09187-2 |
| _version_ | 1797247449051430912 |
|---|---|
| author | Yingzi Tang Ying Zhu Zhonglan You |
| author_facet | Yingzi Tang Ying Zhu Zhonglan You |
| author_sort | Yingzi Tang |
| collection | DOAJ |
| description | Abstract Background Tuberculous sepsis is uncommon in individuals without human immunodeficiency virus (HIV) infection, and some patients may not exhibit clinical signs and symptoms of suspected sepsis upon admission, leading to delayed diagnosis and treatment. Case presentation This report present the case of a 60-year-old female patient who presented with erythema, edema, and pain in her right upper limb accompanied by fever and chills. Further evaluation revealed multiple intermuscular abscesses caused by suspected gram-positive bacteria. Despite receiving anti-infection treatment, the patient rapidly progressed to septic shock and respiratory failure. Metagenomic next-generation sequencing (mNGS) analysis of blood samples detected Mycobacterium tuberculosis complex groups (11 reads). Additionally, mNGS analysis of fluid obtained from puncture of the abscess in the right upper extremity also suggested Mycobacterium tuberculosis complex groups (221 981 reads). Consequently, the patient was diagnosed with tuberculous sepsis resulting from hematogenous dissemination of Mycobacterium tuberculosis. Following the administration of anti-tuberculosis treatment, a gradual recovery was observed during the subsequent follow-up period. Conclusion It is noteworthy that atypical hematogenous disseminated tuberculosis can be prone to misdiagnosis or oversight, potentially leading to septic shock. This case illustrates the importance of early diagnosis and treatment of tuberculosis sepsis. Advanced diagnostic techniques such as mNGS can aid clinicians in the early identification of pathogens for definitive diagnosis. |
| first_indexed | 2024-04-24T19:58:52Z |
| format | Article |
| id | doaj.art-11657176fbb0418bb8344a345cb943aa |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-24T19:58:52Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-11657176fbb0418bb8344a345cb943aa2024-03-24T12:11:42ZengBMCBMC Infectious Diseases1471-23342024-03-012411610.1186/s12879-024-09187-2Mycobacterium tuberculosis sepsis with multiple intermuscular abscesses and respiratory failure as the main manifestations: a case reportYingzi Tang0Ying Zhu1Zhonglan You2Department of Infectious Diseases, First Affiliated Hospital, Army Medical UniversityDepartment of Infectious Diseases, First Affiliated Hospital, Army Medical UniversityDepartment of Infectious Diseases, First Affiliated Hospital, Army Medical UniversityAbstract Background Tuberculous sepsis is uncommon in individuals without human immunodeficiency virus (HIV) infection, and some patients may not exhibit clinical signs and symptoms of suspected sepsis upon admission, leading to delayed diagnosis and treatment. Case presentation This report present the case of a 60-year-old female patient who presented with erythema, edema, and pain in her right upper limb accompanied by fever and chills. Further evaluation revealed multiple intermuscular abscesses caused by suspected gram-positive bacteria. Despite receiving anti-infection treatment, the patient rapidly progressed to septic shock and respiratory failure. Metagenomic next-generation sequencing (mNGS) analysis of blood samples detected Mycobacterium tuberculosis complex groups (11 reads). Additionally, mNGS analysis of fluid obtained from puncture of the abscess in the right upper extremity also suggested Mycobacterium tuberculosis complex groups (221 981 reads). Consequently, the patient was diagnosed with tuberculous sepsis resulting from hematogenous dissemination of Mycobacterium tuberculosis. Following the administration of anti-tuberculosis treatment, a gradual recovery was observed during the subsequent follow-up period. Conclusion It is noteworthy that atypical hematogenous disseminated tuberculosis can be prone to misdiagnosis or oversight, potentially leading to septic shock. This case illustrates the importance of early diagnosis and treatment of tuberculosis sepsis. Advanced diagnostic techniques such as mNGS can aid clinicians in the early identification of pathogens for definitive diagnosis.https://doi.org/10.1186/s12879-024-09187-2Mycobacterium tuberculosisSepsisHematogenous disseminated tuberculosisMetagenomic next-generation sequencing |
| spellingShingle | Yingzi Tang Ying Zhu Zhonglan You Mycobacterium tuberculosis sepsis with multiple intermuscular abscesses and respiratory failure as the main manifestations: a case report BMC Infectious Diseases Mycobacterium tuberculosis Sepsis Hematogenous disseminated tuberculosis Metagenomic next-generation sequencing |
| title | Mycobacterium tuberculosis sepsis with multiple intermuscular abscesses and respiratory failure as the main manifestations: a case report |
| title_full | Mycobacterium tuberculosis sepsis with multiple intermuscular abscesses and respiratory failure as the main manifestations: a case report |
| title_fullStr | Mycobacterium tuberculosis sepsis with multiple intermuscular abscesses and respiratory failure as the main manifestations: a case report |
| title_full_unstemmed | Mycobacterium tuberculosis sepsis with multiple intermuscular abscesses and respiratory failure as the main manifestations: a case report |
| title_short | Mycobacterium tuberculosis sepsis with multiple intermuscular abscesses and respiratory failure as the main manifestations: a case report |
| title_sort | mycobacterium tuberculosis sepsis with multiple intermuscular abscesses and respiratory failure as the main manifestations a case report |
| topic | Mycobacterium tuberculosis Sepsis Hematogenous disseminated tuberculosis Metagenomic next-generation sequencing |
| url | https://doi.org/10.1186/s12879-024-09187-2 |
| work_keys_str_mv | AT yingzitang mycobacteriumtuberculosissepsiswithmultipleintermuscularabscessesandrespiratoryfailureasthemainmanifestationsacasereport AT yingzhu mycobacteriumtuberculosissepsiswithmultipleintermuscularabscessesandrespiratoryfailureasthemainmanifestationsacasereport AT zhonglanyou mycobacteriumtuberculosissepsiswithmultipleintermuscularabscessesandrespiratoryfailureasthemainmanifestationsacasereport |