Multidrug-resistant Tuberculosis and COVID-19 Coinfection with Diabetes Mellitus in Medan, Indonesia: A Case Report

Bintang Yinke Magdalena Sinaga; Joshua Princeman Sinaga; Parluhutan Siagian

doi:10.3889/oamjms.2022.8817

Authors

Bintang Yinke Magdalena Sinaga Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Adam Malik General Hospital, Medan, Sumatera Utara, Indonesia https://orcid.org/0000-0003-1447-3266
Joshua Princeman Sinaga Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Adam Malik General Hospital, Medan, Sumatera Utara, Indonesia https://orcid.org/0000-0002-1198-0687
Parluhutan Siagian Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Adam Malik General Hospital, Medan, Sumatera Utara, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.8817

Keywords:

COVID-19, Multidrug-resistant tuberculosis, Diabetes mellitus

Abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19) has distracted the global health system due to significant morbidity and mortality. There are increasing mortality rates related to the existence of comorbidities. Due to immunologic conditions, other infectious diseases, such as multidrug-resistant tuberculosis (MDR-TB), might coinfect with COVID-19. We describe a case of MDR-TB with diabetes mellitus and critical COVID-19 patient with fatal outcome.

CASE REPORT: A 60-year-old man was admitted to our hospital with shortness of breath for 2 days. A history of recurrent shortness of breath has had developed for about 7 months. Room air oxygen saturation was at 66%. RT-PCR SARS-CoV-2 nasopharynx swab result was positive. The chest X-ray series result showed destroyed left lung with increasing infiltrate in the lower right lung. The patient was diagnosed with pulmonary MDR-TB based on GeneXpert and LPA (Line Probe Assay) test 6 months prior and also has had history of diabetes mellitus for 7 years. Then, the patient was diagnosed with COVID-19, pulmonary MDR-TB, and diabetes mellitus. MDR-TB regimen, anti-diabetic medication, and management of COVID-19 were carried out. On the 6^thday, the patient’s condition worsened to the point, where he needed intubation. The patient eventually passed away.

CONCLUSION: The treatment outcome was highly related to the severity of COVID-19 symptoms and complications of comorbidities when patients are admitted to the hospital. The early screening and treatment of COVID-19 are important to prevent deteriorating clinical conditions caused by comorbidities.

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