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Volume 26, Number 11—November 2020
Research Letter

Four Patients with COVID-19 and Tuberculosis, Singapore, April–May 2020

Sai Meng Tham, Wei Yang Lim, Chun Kiat Lee, Jerold Loh, Arthi Premkumar, Benedict Yan, Adrian Kee, Louis Chai, Paul Anantharajah Tambyah, and Gabriel YanComments to Author 
Author affiliation: National University Health System, Singapore

Main Article

Table

Epidemiologic and clinical features for 4 patients with coronavirus disease and tuberculosis, Singapore*

Pt no. Age, y/sex, nationality Initial signs/symptoms Radiologic findings Pleural fluid analysis Sputum analysis Microbiological findings IGRA for TB Outcome
1†
32/M, India
Fever, productive cough
CXR: right upper zone and left lower zone cavitary lesions;
chest CT: irregular opacifications with central cavitation
NA
AFB smear negative; molecular TB analysis negative
Sputum AFB culture negative
+
Symptoms resolved; repeat CXR after starting ATT demonstrated resolution of cavitary lesions at 2 mo of treatment
2
33/M, India
Fever, nonproductive cough; 3-kg weight loss over 1 mo
CXR: right-sided pleural effusion;
chest CT: loculated right-sided effusion with adjacent collapse/consolidation
Lymphocytic exudative effusion; ADA 130 U/L;
SARS-CoV-2 PCR negative
AFB smear negative; 
molecular TB analysis negative
Sputum and pleural fluid AFB cultures pending
+
Symptoms resolved with interval improvement of CXR
3†
22/M, India
Fever, nonproductive cough; exertional dyspnea, pleuritic chest pain
CXR: right-sided pleural effusion with adjacent compressive atelectasis
Lymphocytic exudative effusion; ADA 112 U/L;
SARS-CoV-2 PCR negative
AFB smear negative;
molecular TB analysis negative
Sputum and pleural fluid AFB cultures pending
+
Symptoms resolved with interval improvement of CXR
4 40/M, Bangladesh Fever, productive cough; reduced effort tolerance CXR: large left-sided pleural effusion;
Chest CT: left-sided pleural effusion, bilateral patchy consolidative changes with ground-glass opacities and interlobular septal thickening Lymphocytic exudative effusion; ADA 69 U/L;
SARS-CoV-2 PCR negative AFB smear negative; molecular TB analysis negative Sputum AFB culture negative; pleural fluid AFB culture positive for Mycobacterium tuberculosis complex + Symptoms resolved with interval improvement of CXR

*ADA, adenosine deaminase; AFB, acid-fast bacilli; ATT, anti-TB therapy; CT, computed tomography image; CXR, plain chest radiograph; IGRA, interferon gamma release assay; NA, not applicable; Pt, patient; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; TB, tuberculosis; +, positive.
†These patients reside in the same dormitory.

Main Article

Page created: July 15, 2020
Page updated: October 19, 2020 1:40 PM EDT
Page reviewed: October 19, 2020 1:40 PM EDT
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