Pulmonary tuberculosis and secondary spontaneous tension pneumothorax in HIV patient: case report

Authors

  • Bernard Jonathan Christian Yong Department of Pulmonology, Wangaya Regional Hospital, Kota Denpasar, Bali, Indonesia
  • Ni Made Dwita Yaniswari Department of Pulmonology, Wangaya Regional Hospital, Kota Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.18203/2349-3933.ijam20242320

Keywords:

Tuberculosis, Pneumothorax, HIV

Abstract

Tuberculosis remains as one of the top 10 infectious diseases causing mortality worldwide. In year 2022, Tuberculosis has caused an estimated 1.30 million deaths with 1.13 million of death caused by tuberculosis alone, while 167000 cases in TB-HIV coinfection. Secondary Spontaneous Pneumothorax has been well known as a complication of Tuberculosis, although the incidence is quite rare, it could be life threatening especially if the pneumothorax progress to tension pneumothorax. Patient, male 19 years old came to the emergency room with a sudden shortness of breath for 3 hours prior to hospital admission. X-ray thorax examination showed collapse of the right lung with hyperlucent avascular findings on the right lung, which suggest secondary spontaneous tension pneumothorax. He was treated with chest tube insertion and WSD placement, 2 hours after WSD placement, he became pulseless. ACLS protocols were given and unfortunately, we were unable to achieve ROSC on him. Tuberculosis remains one of the deadliest infection diseases, but can still be treated with the DOTS regimen. Some condition can make tuberculosis difficult to treat, such as immunodeficiency patient like HIV/AIDS. Spontaneous Pneumothorax has been well known as a complication of tuberculosis, although the incidence rate of pneumothorax in tuberculosis are quite low, however it could be life-threatening if it develops into a tension pneumothorax, especially in the settings of advanced stage HIV patients. Spontaneous pneumothorax can be fatal especially when it develops to tension pneumothorax. Further research is needed to know what population who are at risk of developing pneumothorax.

References

WHO. Report 2020-2023. Available at. https://www.who.int/teams/global-tuberculosis. Accessed on 12th March 2024.

WHO. HIV Report. 2023. Available at. https://cdn.who.int/media/docs/default-source/hq-hiv-hepatitis-and-stis-library. Accessed on 10th March 2024.

Sadirova D, Grigoryan R, Parpieva N, Barotova V, Trubnikov A, Kalandarova L, et al. Incidence rate and risk factors for Tuberculosis among people living with hiv: a 2015–2017 cohort from Tashkent, Uzbekistan. Int J Environ Res Public Health. 2021;18(11):5746.

Aktogu S, Yorgancioglu A, Cirak K, Kose T, Dereli S. Clinical spectrum of pulmonary and pleural tuberculosis: a report of 5,480 cases. Eur Respir J. 1996;9(10):2031-5.

Smith S, Faris PD, Blackmore C, Ball CG, Robertson HL, et al. Clinical presentation of patients with tension pneumothorax. Ann Surg. 2015;261(6):1068-78.

Bruchfeld J, Correia-Neves M, Källenius G. Tuberculosis and HIV co-infection. Cold Spring Harb Perspect Med. 2015;5(7):17871.

Koenig SP, Kim A, Shepherd BE, Cesar C, Veloso V, Cortes CP, et al. Increased mortality after tuberculosis treatment completion in persons living with human immunodeficiency virus in latin America. Clin Infect Dis. 2020;71(1):215-7.

MV, Sakabe S, Waldman EA. Mortality and survival of tuberculosis coinfected patients living with AIDS in São Paulo, Brazil: a 12-year cohort study. BMC Infect Dis. 2022;22(1):223.

Wong K, Nguyen J, Blair L, Banjanin M, Grewal B, Bowman S, et al. Pathogenesis of human immunodeficiency virus-mycobacterium tuberculosis co-infection. J Clin Med. 2020;9(11):3575.

Noppen M. Spontaneous pneumothorax: epidemiology, pathophysiology and cause. Eur Respir Rev. 2010;19(117):217-9.

Onuki T, Ueda S, Yamaoka M, Sekiya Y, Yamada H, Kawakami N, et al. Primary and Secondary Spontaneous Pneumothorax: Prevalence, Clinical Features, and In-Hospital Mortality. Can Respir J. 2017;2017:1-8.

Puhalla S, Bhattacharya S, Davidson NE. Hormonal therapy in breast cancer: A model disease for the personalization of cancer care. Mol Oncol. 2012;6(2):222–36.

Shamaei M, Tabarsi P, Pojhan S, Ghorbani L, Baghaei P, Marjani M, et al. Tuberculosis-associated secondary pneumothorax: a retrospective study of 53 patients. Respir Care. 2011;56(3):298-302.

Hoechter DJ, Speck E, Siegl D, Laven H, Zwissler B, Kammerer T. Tension pneumothorax during one-lung ventilation-an underestimated complication? J cardiothorac vasc anesth. 2018;32(3):1398-402.

Freixinet JL, Caminero JA, Marchena J, Rodriguez PM, Casimiro JA, Hussein M. Spontaneous pneumothorax and tuberculosis: long-term follow-up. Eur Respir J. 2011;38(1):126-31.

Chen Z, Song T, Li Y, Luo L, Li Z, Zhao Q. The pulmonary infection risk factors in long-term bedridden patients: a meta-analysis. Am J Transl Res. 2021;13(10):11014-25.

Downloads

Published

2024-08-27