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Tuberculosis as a primary cause of respiratory failure is an uncommon occurrence1 with an incidence of 1.5% in patients hospitalized with pulmonary TB2. Patients with miliary or disseminated disease are especially prone to develop respiratory failure. Tuberculous Pneumonia has rarely been identified as a cause of ARF3-4. Acute tuberculous pneumonia presents as parenchymal consolidation with or without endobronchial spread mimicking bacterial pneumonia. It probably represents an exudative hypersensitivity reaction to tuberculoprotein, rather than actual inflammation caused by the Mycobacterium tuberculosis organism per se. These infiltrates can appear within a matter of days and can clinically simulate acute bacterial pneumonia. Anti-tubercular treatment has been considered to be an important factor affecting patient’s outcome. In this report, we describe. | Case Report TUBERCULOSIS PNEUMONIA AS A PRIMARY CAUSE OF RESPIRATORY FAILURE-REPORT OF TWO CASES M.M. Puri1 Subodh Kumar2 Brahma Prakash3 K. Lokender4 A . Jaiswal1 and D. Behera5 Received on 20.10.2009 Accepted on 29.10.2009 Summary Tuberculosis TB is one of the treatable diseases rarely causing Acute Respiratory Failure ARF . Hypoxic respiratory failure is often fatal in miliary tuberculosis and acute tuberculous bronchopneumonia. We describe two patients of tuberculous pneumonia with ARF who were successfully treated with early appropriate anti-tuberculosis therapy. Indian J Tuberc 2010 57 41-47 Key words Tuberculosis Pneumonia Acute Respiratory Failure Miliary Tuberculosis INTRODUCTION Tuberculosis as a primary cause of respiratory failure is an uncommon occurrence1 with an incidence of 1.5 in patients hospitalized with pulmonary TB2. Patients with miliary or disseminated disease are especially prone to develop respiratory failure. Tuberculous Pneumonia has rarely been identified as a cause of ARF3-4. Acute tuberculous pneumonia presents as parenchymal consolidation with or without endobronchial spread mimicking bacterial pneumonia. It probably represents an exudative hypersensitivity reaction to tuberculoprotein rather than actual inflammation caused by the Mycobacterium tuberculosis organism per se. These infiltrates can appear within a matter of days and can clinically simulate acute bacterial pneumonia. Anti-tubercular treatment has been considered to be an important factor affecting patient s outcome. In this report we describe two patients with tuberculosis who developed ARF and were successfully treated with early appropriate antituberculosis therapy. The experience with these cases serves to re-emphasize the importance of quality sputum examination routinely for AFB in patients at risk of TB with respiratory failure and pneumonic infiltrates particularly in endemic areas since specific and effective therapy for tuberculosis is available in contrast to .
