To describe a group of patients with septic shock caused by M. Tuberculosis and compare their outcomes to those of patients with septic shock caused by other microorganisms.
Data was extracted from a multicenter database with information from the records of 2731 patients with septic shock. Patients with septic shock caused by M. Tuberculosis were identified by positive blood or multi-site cultures.
A total of 2731 patients with septic shock were studied. Eleven patients (0.4%) had septic shock caused by M.Tuberculosis (MTB group). In the MTB group, the mean age was 44.2 (±19.5) years, mean APACHE II score was 26 (±8), 36% were males and 64% were females. Comorbid conditions included; alcohol use 54%, non-HIV immunosupresive diseases 36.4%, and diabetes mellitus 18.2%. None of these patients had documented HIV. Overall mortality in the MTB group was 81.8 %, and mean length of stay in the ICU was 12.7(± 17.1) days. Inapropriate initial antimicrobial coverage based on culture results was given to five patients (45.5%) in the MTB group. When compared to patients with septic shock caused by other microorganism (OTH group), patients in MTB group were younger (44.27(±19.5) years vs 62.66 (±16.4)) years p = 0.0002), and more likely to have alcohol use as a comorbidity (54.4% vs 13.8 %, p= 0.0013). Patients in the MTB group were more likely to receive inappropriate initial antimicrobial therapy than patients in the OTH group (45.5% vs 18.6%, p=0.0039). Patients in the MTB group had a higher mean ICU LOS (12.21 days vs 8.1 days ), had a higher overall mortality (81.8% vs 56.2% , p = 0.12 ), and were more likely to develop hepatic failure (p 0.0039).
M. Tuberculosis is an uncommon cause of septic shock. However, when it occurs it is associated with increased morbidity and mortality and a significant delay in institution of appropriate antituberculous treatment.
Mycobacterium Tuberculosis should be thought of as a possible cause for septic shock in apropriate clinical situations.
Raquel Nahra, None.