Bilateral Foot-Drop Secondary to Axonal Neuropathy in a Tuberculosis Patient With Co-Infection of COVID-19: A Case Report.

Mohammad H Alkhateeb,Mugahid Eltahir,Afia Aziz,Abdulnasser Elzouki

doi:10.7759/cureus.11734

Abstract

Tuberculosis (TB) is a global pandemic and is one of the top 10 causes of death worldwide as well as the leading cause of death from a single infectious agent. It can cause a wide array of complications including peripheral neuropathy. In addition to TB pandemic the recent pandemic of coronavirus disease 2019 (COVID-19) has led to an increased interest in the co-infection of TB patients and COVID-19 and whether TB increases risk for COVID-19 and its role in causing severity of disease and vice-versa. This case report discusses about a young cachectic man who was found to have bilateral foot-drop under the setting of TB with co-infection of COVID-19 later confirmed to be axonal neuropathy on nerve conduction study. The report highlights the importance of differential diagnosis of TB in COVID-19 patients as well as the consideration of TB in a patient with peripheral neuropathy after nutritional causes have been ruled out.

Highlights

Tuberculosis (TB) has been a slow pandemic causing major infection-related morbidity and mortality [1]
With the recent pandemic of COVID-19, several studies have come forth regarding the coinfection of TB with COVID-19 with the first set of studies suggesting the synergistic potential of COVID-19 with TB worsening prognosis of TB patients [4,5]
We present a case of a 28-year-old male diagnosed with miliary TB after developing peripheral neuropathy in the setting of COVID-19

Summary

Introduction

Tuberculosis (TB) has been a slow pandemic causing major infection-related morbidity and mortality [1]. It had worsened dramatically with shortness of breath on mild exertion and fever with chills 15 days prior to the patient seeking medical attention He noticed difficulty in taking steps around one month ago that progressively worsened to involve weakness in lower limbs around the same time his cough worsened. The patient was admitted to an isolation unit; first set of COVID testing was positive detected by reverse transcription-polymerase chain reaction (RT-PCR), his chest X-ray showed miliary shadowing (Figure 2). He had hypochromic microcytic anemia and lymphocytopenia (Table 1). He was lost to follow-up at eight weeks as he had left the country for good

Discussion

Conclusions

Disclosures