Miliary tuberculosis complicated with acute respiratory distress syndrome and hemophagocytic lymphohistiocytosis syndrome in an immunocompetent patient

2021 ◽  
Author(s):  
Antonio Rosales-Castillo ◽  
Miguel Ángel López-Ruz
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Distress Syndrome ◽  
Miliary Tuberculosis ◽  
Immunocompetent Patient

scholarly journals Miliary Tuberculosis-Related Acute Respiratory Distress Syndrome Complicated with Hemophagocytic Lymphohistiocytosis Syndrome

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Sz-Jiun Shiu ◽  
Ting-Ting Li ◽  
Bor-Jen Lee ◽  
Pin-Kuei Fu ◽  
Chen-Yu Wang ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Distress Syndrome ◽  
Case Reports ◽  
Multiorgan Failure ◽  
Miliary Tuberculosis ◽  
Bone Marrow Aspiration ◽  
Underlying Disease

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.

scholarly journals SARS-CoV-2 Triggering Severe Acute Respiratory Distress Syndrome and Secondary Hemophagocytic Lymphohistiocytosis in a 3-Year-Old Child With Down Syndrome

2020 ◽  
Author(s):  
Sarah Kim-Hellmuth ◽  
Matthias Hermann ◽  
Julia Eilenberger ◽  
Julia Ley-Zaporozhan ◽  
Marcus Fischer ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Intravenous Immunoglobulin ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Distress Syndrome ◽  
Pediatric Intensive Care ◽  
Down Syndrome Patient ◽  
Secondary Hemophagocytic Lymphohistiocytosis

Abstract Down syndrome (DS) predisposes to severe immunologic reaction secondary to infectious triggers. Here, we report a pediatric DS patient with coronavirus disease 2019 (COVID-19) who developed a hyperinflammatory syndrome, severe acute respiratory distress syndrome, and secondary hemophagocytic lymphohistiocytosis requiring pediatric intensive care unit admission and treatment with steroids, intravenous immunoglobulin, and remdesivir. Investigations into genetic susceptibilities for COVID-19 and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-associated complications warrant systematic clinical and scientific studies. We report a pediatric Down syndrome patient with coronavirus disease 2019 (COVID-19) who developed secondary hemophagocytic lymphohistiocytosis requiring treatment with steroids, intravenous immunoglobulin, and remdesivir. Investigations into genetic susceptibilities for COVID-19-associated complications warrant systematic clinical and scientific studies.

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