The characteristics of patients with mycobacterium tuberculosis blood stream infections in Beijing, China: a retrospective study

Mycobacterium tuberculosis bacteremia in a human immunodeficiency virus-negative patient with liver cirrhosis: A case report

BACKGROUND

With the increasing prevalence of human immunodeficiency virus (HIV), the incidence of Mycobacterium tuberculosis (M. tuberculosis) bacteremia has also increased. As a common affliction of acquired immunodeficiency syndrome patients, M. tuberculosis infection is associated in these patients with severe sepsis and high mortality. In contrast, M. tuberculosis bacteremia is rarely seen in HIV-negative patients, and M. tuberculosis has never been reported from the blood of patients with liver cirrhosis.

CASE SUMMARY

We evaluated a 55-year-old Chinese male patient who had been admitted to the hospital with abdominal distension of unknown cause of one-week duration, accompanied by diarrhea, shortness of breath, and occasional fever. Based on these indicators of abnormal inflammation and fever, we suspected the presence of an infection. Although evidence of microbial infection was not found in routine clinical tests and the patient did not show typical clinical symptoms of infection with M. tuberculosis, next-generation sequencing of blood samples nevertheless demonstrated the presence of M. tuberculosis, which was subsequently isolated from blood samples grown in conventional BacT/ALERT FA blood culture bottles.

CONCLUSION

Our findings demonstrate that HIV-negative liver cirrhosis patients can also be infected with M. tuberculosis.

What is the true face of evidence-based medicine?

Evidence-based medicine (EBM) is a scientific approach to help doctors to make right care decisions based on research evidence integrating clinical state and circumstance as well as patient's preference and actions. At present, EBM has been abused and misunderstood in some cases. In this paper, I discuss the evolution of the concept of EBM, the relationship between translational medicine and precision medicine, and the debate on EBM, with an aim to help doctors correctly understand EBM and use EBM methods to make right care decisions.