©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Sep 11, 2019; 8(5): 72-81
Published online Sep 11, 2019. doi: 10.5492/wjccm.v8.i5.72
Published online Sep 11, 2019. doi: 10.5492/wjccm.v8.i5.72
Tuberculosis septic shock, an elusive pathophysiology and hurdles in management: A case report and review of literature
Rashmi Mishra, Pulmonary and Critical Care, Penn Highlands Healthcare, Dubois, PA 15801, United States
Harish K Patel, Division of Gastroenterology, Department of Medicine, Bronx Care Health system, Bronx, NY 10457, United States
Rakesh Singasani, Department of Medicine, SBH Health System, Bronx, NY 10457, United States
Trupti Vakde, Division of Pulmonary and Critical Care, Department of Medicine, Bronx Care Health System, Bronx, NY 10457, United States
Author contributions: All authors have reviewed the literature and contributed to manuscript drafting; Vakde T, Mishra R and Patel HK were responsible for the revision of the manuscript for important intellectual content; All authors issued final approval for the version to be submitted.
Informed consent statement: All patients have deceased, as per the recommendation of the editorial office, the initial consent for the treatment and hospitalization have been uploaded.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2013), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Trupti Vakde, MD, Attending Doctor, Attending Physician, Division of Pulmonary and Critical Care, Department of Medicine, Bronx Care Health System, 1650 Grand concourse, Bronx, NY 10457, United States. tvakde@bronxcare.org
Telephone: +1-718-9601234 Fax: +1-917-7780876
Received: April 6, 2019
Peer-review started: April 8, 2019
First decision: August 2, 2019
Revised: August 13, 2019
Accepted: August 21, 2019
Article in press: August 21, 2019
Published online: September 11, 2019
Processing time: 160 Days and 22.2 Hours
Peer-review started: April 8, 2019
First decision: August 2, 2019
Revised: August 13, 2019
Accepted: August 21, 2019
Article in press: August 21, 2019
Published online: September 11, 2019
Processing time: 160 Days and 22.2 Hours
Core Tip
Core tip: Tuberculosis septic shock is a rare entity. We present three cases of tuberculosis septic shock with varied clinical manifestations. Mycobacterium tuberculosis culture or nucleic acid amplification testing confirmed diagnosis of tuberculosis. All of our presented cases had poor outcome despite timely administration of appropriate anti-tuberculosis regimen. There was clinical and radiological deterioration after administration of anti-microbial agents. This deteriorating clinical course raises a concern for immune reconstitution as possible pathogenesis for tuberculosis septic shock.