Tuberculosis Development In A Patient With Chronic History Of Steroid Abuse: A Case Report

Saraswathi, S., and Noorizan Abdul Aziz, and Yahaya Hassan, and Jahizah Hassan, (2004) Tuberculosis Development In A Patient With Chronic History Of Steroid Abuse: A Case Report. Malaysian Journal of Pharmaceutical Sciences, 2 (2). pp. 34-34. ISSN 16575-7319

Abstract

OBJECTIVE: To discuss a case of a patient who developed TB after using steroid for more than 10 years. CASE SUMMARY: A 60 years old Chinese male was referred from Seberang Jaya Hospital for septic shock management. He had developed Cushing's syndrome due to extensive steroid therapy. He had a history of chronic abuse of steroid (topical, oral and injection) for his skin problem. He stopped steroid six months ago when he developed lower limbs weakness. Patient also had cough for about six months. He had been managed in General Intensive Care Unit (GICU), Penang Hospital for septic shock, acute renal failure, ischemic heart disease, multiple skin problems,coagulopathy and hypoalbuminemia. Patient was ventilated. On examination, air entry into lungs was found to be reduced bilaterally and presence of crept at lower lobes of both lungs. CXR revealed patchy opacities over the right upper lobe. Tracheal aspiration was confirmed positive for AFB on September 3, 2004. On September 4, 2004, patient was started on TB therapy. DISCUSSION: Extensive corticosteroid therapy can compromise the immune system and predispose to development of active TB. As TB had made its come back in Malaysia, it is very important for medical professionals to justify the use of
steroid and monitor patients who are on extensive corticosteroid therapy besides explaining this risk factor to the patients. Patients should be advised to avoid exposure to TB patients. Patients should be also advised on steroid usage and traditional medicines, which contain steroid. CONCLUSION: TB can develop in patients who are immunocompromised due to chronic steroid therapy. Medical professionals should avoid unnecessary steroid use in patients and educate patients on the risks of steroid

Tuberculosis Development In A Patient With Chronic History Of Steroid Abuse: A Case Report

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Abstract