On March 2, 2023, Dr. Manoon Leechawengwong, head of the ICU specialized in respiratory diseases, intensive care units and elderly diseases at Vichaiyut Hospital Post a message via Facebook “Doctor Manoon Leechawengwong FC” stating that…
The patient was diagnosed with miliary tuberculosis spreading through the lungs through the bloodstream. Causing patients to have fever, chronic cough, weight loss, fatigue, difficulty breathing after being infected with the COVID-19 virus
A 70-year-old female patient with rheumatoid arthritis for 6 years took multiple immunosuppressive drugs. get vaccinated against covid 3 injections of AstraZeneca and 1 injection of Pfizer, sick with COVID-19, fever, cough, tired, went to bed in a hospital near the house between 12-26 December 2022, received Remdesivir intravenously for 10 days and sedatives Steroids A month after leaving the hospital, still having a fever, coughing with a little bit of phlegm, going up one flight of stairs, tired, weight loss of 5 kg, came to Vichaiyut Hospital on January 30, 2023.
On physical examination, there was a high fever, temperature 38.9 degrees Celsius, lung auscultation was normal, chest X-ray showed small granules, not more than 2 mm in size, scattered throughout the lungs. Confirmed by computerization of the lungs (see picture). Miliary TB is suspected. Prodded nasal RT-PCR examination did not detect the COVID-19 virus. due to inability to collect sputum Therefore, an endoscopy was performed to look into the trachea. Nothing wrong was found. send water to wash the trachea Tuberculosis was not found. Examination of the genetic code of bronchial lavage found tuberculosis. not resistant to rifampicin Waiting for results of TB culture
Diagnosed with disseminated tuberculosis (Miliary TB), four treatment regimens were initiated: isoniazid, rifampicin, pyracinamide. (Pyrazinamide) and Ethambutol (Ethambutol) by giving 4 types of separate tablets from February 2, 2023, because the hospital does not have a combined tuberculosis drug. After taking TB medicine for 3 weeks, the patient’s symptoms improved, fever decreased, cough less, not tired, eating better.
This patient must have been infected with TB for a long time. Tuberculosis hides in itself. Come relapse spread into the bloodstream throughout the lungs after being infected with the COVID virus and taking steroids.
