A Coronavirus Disease 2019 (COVID-19) Mystery: Persistent Fevers and Leukocytosis in a Patient With Severe COVID-19. (18th December 2020)

• Record Type: Journal Article
• Authors: Sasson, Arielle; Aijaz, Amna; Chernyavsky, Svetlana; Salomon, Nadim
• Is Part Of: Open forum infectious diseases. Volume 7:Number 12(2020)
• Publication Date: 2020-12-18
• Subjects: cavitary TB -- COVID-19 -- respiratory infections -- SARS CoV-2 -- tuberculosis; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofaa558
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Short-course glucocorticosteroids are being used and tocilizumab (TCZ) had been used to treat patients with severe coronavirus disease 2019 (COVID-19) disease. These agents, when administered individually, have been associated with tuberculosis (TB) during chronic use. We report a case of TB in a 44-year-old male with diabetes and severe COVID-19 who received high-dose short-course glucocorticosteroids and a single dose of TCZ. The clinical presentation was atypical with unresolving fevers and leukocytosis, progressive lower lobe cavities, and hilar adenopathy. Delayed diagnosis led to prolonged hospitalization and extensive antibiotic use.