Activation of tuberculosis in recovered COVID-19 patients: a case report.

Currently, coronavirus disease 2019 (COVID-19) and tuberculosis (TB) are among the most important causes of respiratory infections around the world. Both of them are sources of concern for human health and life safety. COVID-19 caused the deaths of millions of people, and many of them suffered from what has become known as 'post-COVID squeal'. Immunosuppression is one of the most important of these symptoms that leave patients susceptible to severe infections like TB. Case Presentation: In these two cases, the authors observed the development of active TB after a period of COVID recovery. Two patients who were admitted to the hospital complained mainly, among other symptoms, of fever and a continuous cough after a period of COVID-19 recovery. Clinical Discussion: Radiological examination revealed a caving density in the two cases, and the Gene-Xpert test proved the presence of Mycobacterium tuberculosis bacteria despite the negative result of the Ziehl-Neelsen stain. The two patients were improved after standard TB treatment. Conclusion: Patients with post-COVID-19 chronic respiratory symptoms should be screened for TB, especially in TB-endemic areas, even though the result of the Ziehl-Neelsen stain was negative.

Synergistic effect of Thymbra spicata L. extracts with antibiotics against multidrug- resistant Staphylococcus aureus and Klebsiella pneumoniae strains.

OBJECTIVES: To evaluate the in vitro interaction between different extracts of Thymbra spicata L. and certain antimicrobial drugs of different mechanisms, including ampicillin, cefotaxime, amikacin and ciprofloxacin. This study was performed against multidrug-resistant strains of Staphylococcus aureus and Klebsiella pneumoniae. MATERIALS AND METHODS: Evaluation of antibacterial activity and synergy interaction between plant extracts and antimicrobial agents was carried out using checkerboard microdilution. RESULTS: Different interactions (synergistic, additive and indifference) were observed between plant crude extracts and used antibiotics depending on the strain. The fractional inhibitory concentration (FIC) index ranged from 0.02 to 1.5 for S. aureus and 0.25 to 2 for K. pneumoniae strains. The best synergistic capacity appeared with cefotaxime against S. aureus strains, where the activity of cefotaxime was increased from 8- to 128-fold. CONCLUSION: These results may indicate that T. spicata extracts potentiates the antimicrobial action of antibiotics, suggesting a possible utilization of this herb in combination therapy against emerging multidrug-resistance S. aureus and K. pneumoniae.