Tuberculosis in the ICU
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Tuberculosis remains a significant public health problem worldwide. Patients with suspected or definite tuberculosis may require intensive care for a variety of reasons. The majority of patients with pulmonary tuberculosis required intensive care for treating acute respiratory failure. High mortality was observed among patients with active tuberculosis and respiratory failure that required mechanical ventilation. The second most frequent reason for admission to intensive care was severe sepsis/septic shock; most of these patients presented with multiple organ failure, and they displayed higher mortality than patients admitted to intensive care for other reasons. Tuberculosis is a treatable disease, and an active approach with immediate intervention is required for treating patients that are critically ill. Delays in starting therapy can be associated with worse survival. This review describes the reasons that patients with tuberculosis may need intensive care, and we discuss the diagnosis and management of these patients in an intensive care environment.
KeywordsTuberculosis Intensive care Miliary tuberculosis Pulmonary tuberculosis Tuberculosis meningitis Tuberculosis outcome Tuberculosis diagnosis
- 1.Centers for Disease Control and Prevention (CDC). Tuberculosis. Data and Statistics. http://www.cdc.gov/tb/statistics/. Accessed 5 June 2017.
- 2.WHO, Global tuberculosis report 2016. http://www.who.int/tb/publications/global_report/en/. Accessed 5 June 2017.
- 9.Cavallazzi R, Wiemken T, Christensen D, Peyrani P, Blasi F, Levy G, Aliberti S, Kelley R, Ramirez J, Community-Acquired Pneumonia Organization (CAPO) Investigators. Predicting Mycobacterium tuberculosis in patients with community-acquired pneumonia. Eur Respir J. 2014;43(1):178–84.CrossRefGoogle Scholar
- 11.Chakravarty C, Burman S. VA-ECMO in Landouzy sepsis or tubercular septic shock. J Anesth Crit Care Open Access. 2017;8(1):00289.Google Scholar
- 20.Nahid P, Dorman SE, Alipanah N, Barry PM, Brozek JL, Cattamanchi A, Chaisson LH, Chaisson RE, Daley CL, Grzemska M, Higashi JM, Ho CS, Hopewell PC, Keshavjee SA, Lienhardt C, Menzies R, Merrifield C, Narita M, O'Brien R, Peloquin CA, Raftery A, Saukkonen J, Schaaf HS, Sotgiu G, Starke JR, Migliori GB, Vernon A. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: treatment of drug-susceptible tuberculosis. Clin Infect Dis. 2016;63(7):e147–95.CrossRefGoogle Scholar