AUTHOR=Shang Xiuling , Zhang Hongxuan , Chen Sheng , Wang Chen , Lin Meifu , Yu Rongguo TITLE=Diagnosis and ECMO Treatment of a Critically Ill Patient With Disseminated Mycobacterium tuberculosis: A Case Report JOURNAL=Frontiers in Public Health VOLUME=10 YEAR=2022 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.938913 DOI=10.3389/fpubh.2022.938913 ISSN=2296-2565 ABSTRACT=Background

Mycobacterium tuberculosis infection remains a public health concern worldwide. The diagnosis and treatment of disseminated M. tuberculosis is very difficult, so we shared our experiences and lessons learned in this case report.

Case Presentation

A 36-year-old female with a history of epilepsy presented to our hospital with fever, upper abdominal pain, muscle soreness in limbs for 7 days, and shortness of breath for 4 days. On admission, she presented with acute respiratory distress syndrome (ARDS) and liver dysfunction. Due to the critical nature of her clinical presentation, the patient was admitted directly to the Intensive Care Unit (ICU), received mechanical ventilation in prone position and VV-ECMO treatment. Her condition improved gradually, and the ECMO was removed after 7 days and she was weaned off the ventilator after 8 days. However, her fever recurred and she underwent PET-CT examination, liver contrast ultrasound, acid-fast staining and second-generation sequencing of cerebrospinal fluid, which confirmed M. tuberculosis infection.

Conclusion

This case report briefly described the treatment and diagnosis of a critically ill patient with intra and extra-pulmonary tuberculosis infection. Timely and appropriate treatment is crucial to save lives, but the timing of ECMO treatment needs to be carefully considered for patients with ARDS caused by tuberculosis.