What are the possible complications of advanced tuberculosis in a 17-year-old with severe symptoms and family history of TB?
Asking about a case: 17 year old male came referred to ER 9 days ago (23/6/2026) with complain of diarrhea more or less 3 days, weakness in the legs (patient is not strong enough to walk), fatigue, coughing for since 8 months ago (initially dry, then with phlegm since 3 days before coming into ER), dyspnea since 8 months ago as well. Patient was active before coughing and dyspnea started (8 months ago), walked to school independently, played sports. Approx. 3 months ago, coughing and dyspnea started getting worse, and weight loss was noticed. No fever, hemoptisis, pain reported. Patient was brought to local medical centre and referred with suspicion of intestinal TB. Patient has history of gastritis since middle schools and an unspecified intestinal infection when 8 months old. Patient's father died of Drug Resistant TB 8 months ago when symptoms started, patient's younger sibling died 2 years ago due to meningitis TB. Patient physical evaluation and blood test revealed BMI of 13.3, hypotension (90/60), tachypnea (RR 30x/minute), hyponatremia, hypokalemia, hypocalcemia, and hypochloremia. Patient was treated for natrium, kalium, and chloride correction, antibiotics (Ceftriaxone), Omeprazole, and Ambroxol. TCM test revealed MTB DETECTED HIGH, Rif Resistance Not Detected, Patient was given 4 FDC 1x3 DOTS. On 24/6/2026, Patient still had symptoms and was referred to pulmonologist and nutritionist and underwent a GenXpert test.Nutritionist recommended Vitamin B1 2x50 mg Vitamin B complex 3x1 tab Zinc 1x20 mg Folic Acid 1x400 mcg and food totalin in 1400 kkal 25/6/2026 Patient still had symptoms and test was found positive for TB (MTB DETECTED HIGH, Rif Resistance Not Detect). Patient was given 4 FDC 1x3 DOTS. 26/6/2026 Patient still had symptoms and new complaint of edema in lower legs. Test shows hypoalbuminemia and given albumin 25% transfusion of 100cc. 27/8/2026 Patient still has symptoms and new complaint of distended abdomen with suspected Ileus. Patient was consulted to surgery specialist who found distension, hypertymphany, and low peristaltic sounds. Patient was put NGT (for decompression), fasting, and scheduled for CT Scan. 28/6/2026 Patient was fasted and even Anti-TB meds was stopped. At this point electrolytes are corrected except for calcium. Hand edema along with legs still. 29/6/2026 Patient reported cough, dyspnea, and diarrhea was better. Weakness of extremity still reported. Abdomen was slightly less distended, pain when moving extremities reported. Patient continued therapy, Anti-TB through NGT. NGT reported at 100ml/24 hours. Patient was CT scanned. 30/6/2026 Patient went unconscous at 07.50 with blood pressure of 70/-, tachycardic, tachypneic. Patient treated with Loading RL 500 cc. 09.17 Patient had seizure 1x less than 30 seconds, eyes rolled back, stiff extremities 09.26 patient arrest, no pulse or BP found, EKG revealed asystole. No CPR (DNR)
How long did the patient experience symptoms before seeking medical help?:
- More than 3 monthsWhat was the patient's weight loss over the past few months?:
- More than 15 kgHas the patient experienced any other symptoms like fever or night sweats?:
- Occasional feverWhat was the patient's nutritional intake prior to hospitalization?:
- Adequate and balancedWhat treatments has the patient received for TB before this hospitalization?:
- No prior treatmentHow has the patient's energy level been since the onset of symptoms?:
- Severe fatigue, unable to perform daily activitiesWas there any history of contact with other TB patients?:
- Yes, close contactHow would you describe the patient's overall mental state during this period?:
- Very anxious or depressedHas the patient had any previous surgeries or hospitalizations?:
- No, none100% Anonymously
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Doctors' responses
Hello dear See tb is very dreadful disease It is characterized by Weakness Malaise High grade fever Cough Haemoptysis It is associated with Gastric issues Respiratory issues Neurological impacts Cardiac issues May cause cancer ( very rare) I suggest you to please Donot skip medication and complete dots course Take good priteinacous diet Avoid fried food Avoid exertion Have regular follow up Take immunity boosters as per recommendation by concerned physician only Regards
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