Severe Inflammatory Response and Moderate Acute Respiratory Distress Syndrome (ARDS) in an Immunocompetent Patient With Disseminated Tuberculosis: A Case Report
Year: 2026
Type: article
Study design: Case Report
Abstract: An acute exacerbation in some tuberculosis (TB) cases can lead to widespread infection; this disseminated disease may progress when the body's immune response becomes dysregulated.Although rare, certain patients without obvious immune compromise can develop severe organ dysfunction if inflammation escalates uncontrollably.Respiratory failure can develop rapidly once lung tissue becomes overwhelmed by excessive inflammatory signaling.This presentation is uncommon but severe and is frequently unrecognized in its early stages because symptoms mimic other critical conditions.Mortality increases substantially once acute respiratory distress syndrome (ARDS) develops in the setting of disseminated infection.A 40-year-old man, previously in good health, presented with severe respiratory distress.Oxygen saturation declined rapidly, requiring urgent endotracheal intubation.He subsequently required vasopressor support and prone positioning due to advanced respiratory failure.Laboratory evaluation revealed thrombocytopenia and elevated liver enzymes.Comprehensive microbiological testing did not identify common viral, bacterial, or fungal pathogens.A positive Mycobacterium tuberculosis (MTB) PCR result from bronchial fluid confirmed disseminated TB.His clinical course was complicated by moderate ARDS and a hyperinflammatory state, consistent with an exaggerated immune response to TB. Treatment was initiated with rifampin, isoniazid, pyrazinamide, and ethambutol (RIPE) therapy along with systemic corticosteroids (methylprednisolone 40 mg every eight hours).Clinical improvement was observed, and ventilatory support was discontinued following targeted treatment.The patient was discharged with a plan for prolonged anti-tubercular therapy.This case illustrates how disseminated TB can trigger a severe inflammatory response leading to moderate ARDS, even in the absence of underlying immunosuppression.Early recognition of this presentation is critical, and combined treatment with antimicrobial therapy and immunomodulation may improve outcomes.
Source: Cureus
Institutions: Ain Shams University, Broward Health
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7213983917