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VOLUME 19 , ISSUE 1 ( 2015 ) > List of Articles


Severe Mycobacterium tuberculosis-related immune reconstitution syndrome in an immunocompetent patient

Sujatha Chandrasekharan

Keywords : Immune reconstitution, pneumothorax, respiratory failure, tuberculosis, Vitamin D

Citation Information : Chandrasekharan S. Severe Mycobacterium tuberculosis-related immune reconstitution syndrome in an immunocompetent patient. Indian J Crit Care Med 2015; 19 (1):50-52.

DOI: 10.4103/0972-5229.148650

License: CC BY-ND 3.0

Published Online: 01-12-2015

Copyright Statement:  Copyright © 2015; The Author(s).


We present a young immunocompetent male with diagnosed sputum culture-positive tuberculosis on intensive phase with observed daily four-drug antituberculosis therapy. He presented at 1-month of treatment with sequential bilateral pneumothoraces, increase in cavitation and consolidation and respiratory failure. Repeat smears for acid-fast bacilli had downgraded, and cultures were negative. Quantiferon-GOLD (initially negative) was now strongly positive. A diagnosis of possible immune reconstitution syndrome was considered and 0.25 mg/kg/day oral steroids administered. We also discuss an approach to differential diagnosis of a patient worsening on treatment for microbiologically confirmed tuberculosis in this manuscript.

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