Miliary Tuberculosis-Related Acute Respiratory Distress Syndrome Complicated with Hemophagocytic Lymphohistiocytosis Syndrome
Acute respiratory distress syndrome (ARDS) and hemophagocytic lymphohistiocytosis (HLH) are accompanied with poor outcome and high mortality when miliary tuberculosis is a causative pathogen for both of them. A patient complicated with ARDS and HLH is unusual in critical care, and few case reports a...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2019/9501610 |
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| author | Sz-Jiun Shiu Ting-Ting Li Bor-Jen Lee Pin-Kuei Fu Chen-Yu Wang Sz-Iuan Shiu |
| author_facet | Sz-Jiun Shiu Ting-Ting Li Bor-Jen Lee Pin-Kuei Fu Chen-Yu Wang Sz-Iuan Shiu |
| author_sort | Sz-Jiun Shiu |
| collection | DOAJ |
| description | Acute respiratory distress syndrome (ARDS) and hemophagocytic lymphohistiocytosis (HLH) are accompanied with poor outcome and high mortality when miliary tuberculosis is a causative pathogen for both of them. A patient complicated with ARDS and HLH is unusual in critical care, and few case reports are present in PudMed. Besides, the relationship between HLH and ARDS is still unknown and has not been reviewed in the literature. In this report, we present the case of a 74-year-old Taiwanese woman suffering from pulmonary tuberculosis and miliary tuberculosis, and she developed ARDS and HLH on the 3rd day after admission. We arranged serial laboratory examination, various serum markers, bone marrow aspiration, and bronchoscopy with alveolar lavage for survey; we prescribed empirical antibiotics and antituberculosis medication soon after alveolar lavage showing positive acid-fast stain. She was extubated on hospital day 31 and discharged on hospital day 73. In conclusion, early diagnosis and intervention for underlying disease and intensive bundle care for multiorgan failure are crucial for both ARDS and HLH. |
| format | Article |
| id | doaj-art-3f2f1c05c277492d85f0d76746e8563b |
| institution | Kabale University |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-3f2f1c05c277492d85f0d76746e8563b2025-02-03T06:00:35ZengWileyCase Reports in Infectious Diseases2090-66252090-66332019-01-01201910.1155/2019/95016109501610Miliary Tuberculosis-Related Acute Respiratory Distress Syndrome Complicated with Hemophagocytic Lymphohistiocytosis SyndromeSz-Jiun Shiu0Ting-Ting Li1Bor-Jen Lee2Pin-Kuei Fu3Chen-Yu Wang4Sz-Iuan Shiu5Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, TaiwanDivision of Cardiovascular Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, TaiwanDepartment of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, TaiwanAcute respiratory distress syndrome (ARDS) and hemophagocytic lymphohistiocytosis (HLH) are accompanied with poor outcome and high mortality when miliary tuberculosis is a causative pathogen for both of them. A patient complicated with ARDS and HLH is unusual in critical care, and few case reports are present in PudMed. Besides, the relationship between HLH and ARDS is still unknown and has not been reviewed in the literature. In this report, we present the case of a 74-year-old Taiwanese woman suffering from pulmonary tuberculosis and miliary tuberculosis, and she developed ARDS and HLH on the 3rd day after admission. We arranged serial laboratory examination, various serum markers, bone marrow aspiration, and bronchoscopy with alveolar lavage for survey; we prescribed empirical antibiotics and antituberculosis medication soon after alveolar lavage showing positive acid-fast stain. She was extubated on hospital day 31 and discharged on hospital day 73. In conclusion, early diagnosis and intervention for underlying disease and intensive bundle care for multiorgan failure are crucial for both ARDS and HLH.http://dx.doi.org/10.1155/2019/9501610 |
| spellingShingle | Sz-Jiun Shiu Ting-Ting Li Bor-Jen Lee Pin-Kuei Fu Chen-Yu Wang Sz-Iuan Shiu Miliary Tuberculosis-Related Acute Respiratory Distress Syndrome Complicated with Hemophagocytic Lymphohistiocytosis Syndrome Case Reports in Infectious Diseases |
| title | Miliary Tuberculosis-Related Acute Respiratory Distress Syndrome Complicated with Hemophagocytic Lymphohistiocytosis Syndrome |
| title_full | Miliary Tuberculosis-Related Acute Respiratory Distress Syndrome Complicated with Hemophagocytic Lymphohistiocytosis Syndrome |
| title_fullStr | Miliary Tuberculosis-Related Acute Respiratory Distress Syndrome Complicated with Hemophagocytic Lymphohistiocytosis Syndrome |
| title_full_unstemmed | Miliary Tuberculosis-Related Acute Respiratory Distress Syndrome Complicated with Hemophagocytic Lymphohistiocytosis Syndrome |
| title_short | Miliary Tuberculosis-Related Acute Respiratory Distress Syndrome Complicated with Hemophagocytic Lymphohistiocytosis Syndrome |
| title_sort | miliary tuberculosis related acute respiratory distress syndrome complicated with hemophagocytic lymphohistiocytosis syndrome |
| url | http://dx.doi.org/10.1155/2019/9501610 |
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