Doctor Nguyen Thanh Thuy, a First-Degree Specialist in the Department of General Internal Medicine at Tam Anh General Hospital TP HCM, reported that the patient's lungs were consolidated. They showed numerous small nodules, approximately 1-2 mm in size, resembling millet seeds. An MRI also suggested a prostate abscess. Biopsy and culture results confirmed AFB positive, indicating that tuberculosis bacteria had spread from the lungs to other organs.

Phongsay had been living with systemic lupus erythematosus for over two years, which had caused multi-organ damage to his kidneys, hematological system, and joints. Doctors diagnosed him with multi-organ tuberculosis on a background of systemic lupus erythematosus. He received treatment with anti-tuberculosis drugs according to a specific regimen, antibiotics to control infection, and adjusted corticosteroids to manage his underlying lupus condition. He was isolated in a specialized room for his treatment.

After one week, the patient's fever subsided, his shortness of breath resolved, and his appetite improved significantly, making him fit for discharge.

According to Doctor Thuy, tuberculosis bacteria commonly spread to the prostate via the bloodstream or through retrograde spread from other organs. The disease often progresses silently, potentially causing symptoms such as painful urination, difficulty urinating, perineal pain, pain during ejaculation, or prolonged fever. However, many cases present with almost no specific symptoms. The spread of tuberculosis bacteria through the bloodstream also increases the risk of the disease affecting many other organs, including lymph nodes, meninges, liver, spleen, bones and joints, and kidneys.

Doctor Thuy noted that miliary tuberculosis is often overlooked because its initial symptoms are usually non-specific. Patients primarily experience prolonged fever, fatigue, loss of appetite, weight loss, a cough or slight cough, sometimes only presenting like a common infection. In the early stage, chest X-ray images may also be unclear, while clinical manifestations are easily confused with pneumonia or autoimmune diseases.

Doctor Thuy advises a patient during outpatient treatment. Photo: Tam Anh General Hospital

Doctor Thuy advises a patient during outpatient treatment. Photo: Tam Anh General Hospital

Systemic lupus erythematosus and the use of immunosuppressants are factors that can increase the risk of opportunistic infections, including tuberculosis. Therefore, individuals with autoimmune diseases undergoing immunosuppressive therapy are often closely monitored to detect early signs of infection.

Doctor Thuy advises individuals undergoing treatment for chronic diseases with immunosuppressants to attend follow-up appointments as scheduled and complete all prescribed monitoring tests. If symptoms such as fever lasting over two weeks, persistent cough, fatigue, unexplained weight loss, or night sweats appear, patients should seek medical examination.

Nhat Thanh

*Patient's name has been changed