Bilateral Foot-Drop Secondary to Axonal Neuropathy in a Tuberculosis Patient With Co-Infection of COVID-19: A Case Report

Abstract

Tuberculosis (TB) is a global pandemic and is one of the top 10 causes of death worldwide as well as the leading cause of death from a single infectious agent. It can cause a wide array of complications including peripheral neuropathy. In addition to TB pandemic the recent pandemic of coronavirus disease 2019 (COVID-19) has led to an increased interest in the co-infection of TB patients and COVID-19 and whether TB increases risk for COVID-19 and its role in causing severity of disease and vice-versa. This case report discusses about a young cachectic man who was found to have bilateral foot-drop under the setting of TB with co-infection of COVID-19 later confirmed to be axonal neuropathy on nerve conduction study. The report highlights the importance of differential diagnosis of TB in COVID-19 patients as well as the consideration of TB in a patient with peripheral neuropathy after nutritional causes have been ruled out.

Keywords: covid-19; foot drop; novel coronavirus; peripheral neuropathy; sars-cov-2 infection; tuberculosis.

Figure 1. Bilateral foot-drop.

Figure 2. Chest X-ray showing bilateral multiple small nodules scattered in the lung fields giving the military shadow with blunting left costophrenic angle.

Figure 3. High resolution CT-scan showing diffuse innumerable miliary nodules. A. Cystic bronchiectatic changes in upper lobes (arrowhead). B. Left side mild pleural effusion with multiple air fluid level (arrow).