Co-infection Pulmonary Tuberculosis and Severe COVID-19 in a Pregnant Woman at the University Hospital of Kinshasa: A Case Report

Frederick Tshibasu Tshienda,Tresor Mputsu,Cynthia Minouche Bukumba,Jean Marie Kayembe Ntumba,Benjamin Longo Mbenza,Joseph Bodi Mabiala,Ben Bepouka Izizag,Damien Mbanzulu Pita Nsonizau,Roger Mbungu Mwimba ,Madone Mandina Ndona ,Daddy Mata‐Mbemba ,Jean Robert Makulo Risasi ,Angèle Mbongo Tansia

doi:10.11648/j.ijmi.20210903.13

Frederick Tshibasu Tshienda, Tresor Mputsu + Show 11 more

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https://doi.org/10.11648/j.ijmi.20210903.13

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Abstract

Background: To date, world widely, only a couple of papers have reported the association between pulmonary tuberculosis, Coronavirus disease 2019 (COVID-19) and pregnancy, and none of these reports was from sub-Saharan Africa where tuberculosis is endemic. Objective: the main objective of this study is to describe the co-infection Pulmonary Tuberculosis and Severe COVID-19 in pregnant young Woman at the University Hospital of Kinshasa. Method: The report case is of a pregnant woman aged 19 (Pare 2, Gesture 2, Abortion 0) with no known significant medical history, at 32 weeks of gestation based last menstrual period She has benefited from clinic examination, biological examinations (Ziehl’s on sputum), a chest CT scan and a morphological ultrasound. Result: On admission, COVID-19 was the only working diagnosis. However, the persistent coughing prompted clinicians to request a Ziehl-Neelsen staining of sputum that revealed the diagnosis of pulmonary TB. The reverse-transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 infection and HIV serology negative. A contrast-enhanced chest computed tomography (CT) showed airspace disease involving the right upper lobar, right medial basal segment and left upper lobe in the background of diffuse micro-nodular opacities favored to represent military pulmonary tuberculosis. There were associated cystic bronchiectasis in bilateral upper lobe and bilateral small amount of pleural effusion. Aforementioned findings were favored to represent a secondary or reactivation tuberculosis. The obstetrical ultrasound showed a single live intrauterine pregnancy in breech presentation, estimated at 34 weeks 3 days of gestation without usual features including detectable congenital malformation. Conclusion: The outcome of a pregnant woman with simultaneous COVID-19 and pulmonary tuberculosis is improved when the diagnosis is made early and management is promptly initiated. This attitude also improves the fetal prognosis. In the context of the COVID-19, the association of COVID-19 and pulmonary tuberculosis, especially in immunocompromised patients should be considered.

Highlights

The emergence of the new coronavirus 2 in China in late 2019 (COVID-19) caused a pandemic with a global health crisis
This study report an association between COVID-19 infection, pulmonary tuberculosis and pregnancy, which not been described in Sub-Saharan Africa where tuberculosis is endemic
In a study of 70 patients with COVID-19 pneumonia, serial computed tomography (CT) scans revealed that the majority (94%) of patients had mild to significant residual pulmonary abnormalities including some fibrotic changes on their last CT chest scan performed just prior to a median of 24 days from the onset of symptoms

Summary

Introduction

The emergence of the new coronavirus 2 (sars-cov-2) in China in late 2019 (COVID-19) caused a pandemic with a global health crisis. Pregnancy is a physiological condition that leads to a relative decrease in immunity and makes pregnant women vulnerable to viral infections for this purpose. In China, all studies of COVID-19 positive pregnant women have reported no maternal deaths [3]. Despite the resurgence of tuberculosis disease in many countries, its association with pregnancy is still relatively rare but it should still be considered in differential diagnosis in pregnant women showing recurrent fevers or apical pneumonitis. World widely, only a couple of papers have reported the association between pulmonary tuberculosis, Coronavirus disease 2019 (COVID-19) and pregnancy, and none of these reports was from sub-Saharan Africa where tuberculosis is endemic. Objective: the main objective of this study is to describe the co-infection Pulmonary Tuberculosis and Severe COVID-19 in pregnant young Woman at the University Hospital of Kinshasa. The reverse-transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 infection and HIV

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