Volume 26, Number 11—November 2020
Research Letter
Four Patients with COVID-19 and Tuberculosis, Singapore, April–May 2020
Sai Meng Tham, Wei Yang Lim, Chun Kiat Lee, Jerold Loh, Arthi Premkumar, Benedict Yan, Adrian Kee, Louis Chai, Paul Anantharajah Tambyah, and Gabriel Yan
Table
Epidemiologic and clinical features for 4 patients with coronavirus disease and tuberculosis, Singapore*
| Pt no. | Age, y/sex, nationality | Initial signs/symptoms | Radiologic findings | Pleural fluid analysis | Sputum analysis | Microbiological findings | IGRA for TB | Outcome |
|---|---|---|---|---|---|---|---|---|
| 1† |
32/M, India |
Fever, productive cough |
CXR: right upper zone and left lower zone cavitary lesions;
chest CT: irregular opacifications with central cavitation |
NA |
AFB smear negative; molecular TB analysis negative |
Sputum AFB culture negative |
+ |
Symptoms resolved; repeat CXR after starting ATT demonstrated resolution of cavitary lesions at 2 mo of treatment |
| 2 |
33/M, India |
Fever, nonproductive cough; 3-kg weight loss over 1 mo |
CXR: right-sided pleural effusion;
chest CT: loculated right-sided effusion with adjacent collapse/consolidation |
Lymphocytic exudative effusion; ADA 130 U/L;
SARS-CoV-2 PCR negative |
AFB smear negative;
molecular TB analysis negative |
Sputum and pleural fluid AFB cultures pending |
+ |
Symptoms resolved with interval improvement of CXR |
| 3† |
22/M, India |
Fever, nonproductive cough; exertional dyspnea, pleuritic chest pain |
CXR: right-sided pleural effusion with adjacent compressive atelectasis |
Lymphocytic exudative effusion; ADA 112 U/L;
SARS-CoV-2 PCR negative |
AFB smear negative;
molecular TB analysis negative |
Sputum and pleural fluid AFB cultures pending |
+ |
Symptoms resolved with interval improvement of CXR |
| 4 | 40/M, Bangladesh | Fever, productive cough; reduced effort tolerance | CXR: large left-sided pleural effusion; Chest CT: left-sided pleural effusion, bilateral patchy consolidative changes with ground-glass opacities and interlobular septal thickening | Lymphocytic exudative effusion; ADA 69 U/L; SARS-CoV-2 PCR negative | AFB smear negative; molecular TB analysis negative | Sputum AFB culture negative; pleural fluid AFB culture positive for Mycobacterium tuberculosis complex | + | Symptoms resolved with interval improvement of CXR |
*ADA, adenosine deaminase; AFB, acid-fast bacilli; ATT, anti-TB therapy; CT, computed tomography image; CXR, plain chest radiograph; IGRA, interferon gamma release assay; NA, not applicable; Pt, patient; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; TB, tuberculosis; +, positive. †These patients reside in the same dormitory.
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Page updated: October 19, 2020
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