Tubercular empyema thoracic: An acute presentation with COVID-19 co-infection

ABSTRACT

COVID-19 (Coronavirus Disease 2019) pandemic is caused by a novel Coronavirus, SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2, which has received worldwide attention and most COVID-19 patients have respiratory symptoms and develop a mild disease. In addition, co-infection of SARS-CoV-2 with other respiratory infections of bacterial, other viral and fungal origin needs to be validated. The clinical features, course and treatment of TB patients with COVID-19 are unclear and understudied. There is paucity of literature on this co-infection. Here, authors present a case report of a young diabetic Asian male patient who presented to the emergency department as COVID-19 positive with acute exacerbation of symptoms, who later developed respiratory distress and was eventually found to have a lung abscess with subsequent tubercular empyema thoracic on contrary to a severe COVID-19 pneumonia or a fungal infection, as thought of. Contrast Enhanced Computed Tomography (CECT) chest along with Cartridge-Based Nuclei Acid Amplification Test (CBNAAT) of pleural fluid pus confirmed the tubercular lesion timely to aid the diagnosis and further course of management.