Pulmonary tuberculosis in an immunocompromised patient: is it AIDS-related, COVID-19-associated, or both? A Case report.

BACKGROUND AND IMPORTANCE: Patients who are immunocompromised due to the HIV may be more vulnerable to a severe coronavirus disease 2019 (COVID-19) infection and tuberculosis (TB) lung disease. The COVID-19 pandemic poses a serious hazard to TB sufferers.

CASE PRESENTATION: A 67-year-old black African homewife woman with an HIV/AIDS diagnosis arrived at the emergency room on 28 September 2022. The admitted woman had significant complaints, including muscle weakness, a loss of weight of about 33 pounds during the preceding week, headaches, and a cough. Reduced breath sounds were audible on chest auscultation in the right lower and upper lungs. She had two nasopharyngeal swabs for COVID-19 testing, which were positive. For the first five days of her stay in the hospital, she received continuous oxygen delivered through a nasal cannula at a rate of four liters per minute, and she is still taking her antiretroviral therapy (ART) regimen. For TB treatment, she took rifampicin 300 mg, isoniazid 600 mg, pyrazinamide 1600 mg, and ethambutol 1100 mg during a 2-month intensive phase, then rifampicin 225 mg and isoniazid 450 mg for a 4-month continuous phase.

CLINICAL DISCUSSION: COVID-19 may have a negative influence on TB control in a number of ways, including by accelerating the spread of the disease at the home, delaying TB diagnosis and treatment, worsening treatment outcomes, and raising the chance of acquiring drug-resistant TB. HIV-positive individuals are more likely to develop a TB infection. HIV impairs immunity, making it more difficult for the body to fight off mycobacterial TB germs.

CONCLUSION: According to the WHO Clinical Staging System Stage III of HIV/AIDS, the patient's COVID-19 infection and immunological impairment from HIV/AIDS both played a role in the development of pulmonary TB.