Case- Report of Tuberculosis in a Tanzanian Male Sickle Cell Disease Patient

Sickle cell disease is a group of inherited disorders that affect hemoglobin. Normally red blood cells are disc- shaped and flexible so they can move easily through the blood vessels. In sickle cell red blood cells are misshaped, typically crescent or Ì sickleÌ‹ -shaped due to a gene mutation that affects the hemoglobin molecule. Tuberculosis is an infectious disease caused by bacteria that most often affects the lungs. It spreads through infected droplets when people with TB cough, sneeze or spit. Patients with sickle cell disease frequently suffer from recurrent crises, in particular affecting the lungs, skeletal system and the abdominal organs. Tuberculosis has rarely been reported in patients with sickle cell disease. Since there is an overlap of the possible presenting symptoms of SCD complications and TB, a low index for suspicion of TB in these patients is recommended hence it is difficult to diagnose TB in sickle cell patients especially when they present with dry cough. Here we present a case of TB infection in a 25 years old male sickle cell anemia patient who presented mainly with chronic cough that was initially dry in nature and later became productive and was associated with fever which was more marked during the evenings and later developed difficulty in breathing, shortness of breath and hypoxia in room air. He had no known history of TB contact and no history of smoking. He was first diagnosed and treated as severe pneumonia but did not respond to treatment and later was treated with Rifampicin, Isoniazid, Pyrazinamide and Ethambutol in the intensive phase and continue with Rifampicin and isoniazid in the continuation phase resulted to marked improvement.