Latent tuberculosis reactivation in the setting of SARS-Cov-2 infection: The analysis of the radiologic features that help the diagnosis

Abstract

In Italy tuberculosis is a relatively rare disease and people coming from developing nations are usually affected. The radiological findings are variable and depend on the tuberculosis activity, if primary or post-primary. In literature, few data are reported about the co-existence of COVID-19 and lung tuberculosis. In this case report, authors describe the imaging features of latent lung tuberculosis in a patient with SARS-CoV-2 disease. The important role of CT imaging in identifying and diagnosing other infectious lung diseases presenting in the setting of the polymorphism and severity of SARS-CoV-2 disease is also discussed.

Keywords: Co-infection; Computed tomography; SARS-CoV-2; Tuberculosis.

Fig. 1

Chest x-ray performed at emergency department admission. Few and small airspace opacities are visible in the lower zones bilaterally associated with scissural thickening in the right lung.

Fig. 2

Chest CT scans. Images are reported in axial views (A and B) and in coronal view obtained with multiplanar reformation (C). Several ground glass opacities are present bilaterally associated with small air space consolidation in the median lobe (B and C).

Fig 3

Axial chest CT scans. Some small excavated pseudo-nodular areas (A), partially excavated consolidations in the right lower lobe and in the median lobe (B and C), multiple micronodules and branching lesions resembling tree in bud appearance (B).