Alveolar Proteinosis Secondary to M. tuberculosis, in a Patient with Transient CD4 Lymphocytopenia Due to Cryptococcus neoformans Infection: First Case in the Literature

Transient CD4 lymphocytopenia is defined as the transitory presence of CD4+ T lymphocyte fewer than 300 cells/mm3 or less than 20% of T cells without HIV infection. It can occur due to multiple causes; however, it is rare for it to occur due to opportunistic infections. Few cases have been described in the literature where antimicrobial treatment normalizes the CD4 count, being more frequent in Mycobacterium tuberculosis infections. To date, this phenomenon has not been described in Cryptococcus neoformans infections. This would be the first reported case according to our knowledge, of a patient who normalizes CD4 count after antifungal treatment, later developing alveolar proteinosis due to M. Tuberculosis

<i>Pandoraea pnomenusa</i> Superinfection in a Patient with SARS-CoV-2 Pneumonia: First Case in the Literature

Pandoraea pnomenusa is a Gram-negative bacterium of the Pandoraea genus and is mainly associated with the colonization of structurally abnormal airways. During the COVID-19 pandemic, many microorganisms have been associated with coinfection and superinfection in SARS-CoV-2 pneumonia, but so far, no coinfection or superinfection by P. pnomenusa has been reported. We present the first case describing this association in a previously healthy patient. Clinical manifestations, treatment, and outcomes are shown

Alveolar Proteinosis Secondary to <i>M. tuberculosis</i>, in a Patient with Transient CD4 Lymphocytopenia Due to <i>Cryptococcus neoformans</i> Infection: First Case in the Literature

Transient CD4 lymphocytopenia is defined as the transitory presence of CD4+ T lymphocyte fewer than 300 cells/mm3 or less than 20% of T cells without HIV infection. It can occur due to multiple causes; however, it is rare for it to occur due to opportunistic infections. Few cases have been described in the literature where antimicrobial treatment normalizes the CD4 count, being more frequent in Mycobacterium tuberculosis infections. To date, this phenomenon has not been described in Cryptococcus neoformans infections. This would be the first reported case according to our knowledge, of a patient who normalizes CD4 count after antifungal treatment, later developing alveolar proteinosis due to M. Tuberculosis.</i

Sobrevida en una cohorte con diagnóstico de tuberculosis en Colombia

7 páginasBackground: Tuberculosis is a chronic infectious pathology whose incidence is high in developing countries, however, information and studies that analyze mortality and long-term survival are limited. Methodology: retrospective cohort study, in patients with a diagnosis of tuberculosis older than 18 years, admission was consecutive until completing the study period. Survival and mortality were analyzed using the Kaplan-Meier estimator by the log Rank test. Results: 329 subjects were admitted, mortality at 30 days was 11.9% and at one year 24.6%, pulmonary tuberculosis was the most frequent type with 70.2%. Physical examination findings related to mortality were cachexia (p<0.001) and extremity edema (p<0.001). Overall survival was 87.2% at 30 days and 72.9% at one year. In patients with pulmonary tuberculosis, survival was 85.8% at 30 days and 72.8% at one year. Conclusion: The one-year survival rate in patients hospitalized for tuberculosis is low, advanced age, malnutrition, PaO2/FiO2 less than 300, c-reactive protein greater than 45 mg/dL, cerebrovascular disease and peripheral vascular disease were variables that were associated with higher mortalityIntroducción: La tuberculosis es una patología infecciosa crónica cuya incidencia es elevada en países en vía de desarrollo, sin embargo, es limitada la información y los estudios que analizan la mortalidad y sobrevida a largo plazo. Metodología: estudio de cohorte retrospectivo, en pacientes con diagnóstico de tuberculosis mayores de 18 años, el ingreso fue de manera consecutiva hasta completar el periodo de estudio. Se analizó la sobrevida y mortalidad a través del estimador Kaplan – Meier por la prueba de log Rank. Resultados: ingresaron 329 sujetos, la mortalidad a los 30 días fue de 11,9% y al año del 24,6%, la tuberculosis pulmonar fue el tipo más frecuente con en el 70,2%. Los hallazgos al examen físico relacionados con mortalidad fueron la caquexia (p<0,001) y el edema en extremidades (p<0,001). La sobrevida general fue del 87,2% a los 30 días y del 72,9% al año. En los pacientes con tuberculosis pulmonar la sobrevida fue del 85,8% a los 30 días y del 72,8% al año. Conclusión: La tasa de sobrevida a un año en pacientes hospitalizados por tuberculosis es baja, la edad avanzada, desnutrición, PaO2/FiO2 menor de 300, proteína c reactiva mayor de 45 mg/dL, enfermedad cerebrovascular y enfermedad vascular periférica fueron variables que se asociaron con una mayor mortalidad