{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:43:01Z","timestamp":1793148181756,"version":"4.5.0"},"reference-count":19,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,3,4]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>We report a fatal case of SARS-CoV-2 and <jats:italic>Mycobacterium tuberculosis<\/jats:italic> coinfection in an infant, Botswana\u2019s first paediatric COVID-19-associated fatality. The patient, a 3-month-old HIV-unexposed boy, presented with fever and respiratory distress in the setting of failure to thrive. Both the patient and his mother tested positive for rifampin-sensitive <jats:italic>M. tuberculosis<\/jats:italic> (Xpert MTB\/Rif) and SARS-CoV-2 (real time-PCR). Initially stable on supplemental oxygen and antitubercular therapy, the patient experienced precipitous clinical decline 5\u2009days after presentation and subsequently died. Autopsy identified evidence of disseminated tuberculosis (TB) as well as histopathological findings similar to those described in recent reports of SARS-CoV-2 infections, including diffuse microthrombosis. TB remains a serious public health threat in hyperendemic regions like sub-Saharan Africa, and is often diagnosed late in infants. In addition to raising the question of additive\/synergistic pathophysiology and\/or immune reconstitution, this case of coinfection also highlights the importance of leveraging the COVID-19 pandemic response to strengthen efforts for TB prevention, screening and detection.<\/jats:p>","DOI":"10.1136\/bcr-2020-239701","type":"journal-article","created":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T12:46:58Z","timestamp":1619009218000},"page":"e239701","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Fatal SARS-CoV-2 and <i>Mycobacterium tuberculosis<\/i> coinfection in an infant: insights from Botswana"],"prefix":"10.1136","volume":"14","author":[{"given":"Unami Koolebogile","family":"Mulale","sequence":"first","affiliation":[{"name":"Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanolo","family":"Kashamba","sequence":"additional","affiliation":[{"name":"National Health Laboratory, Ministry of Health and Wellness Botswana, Gaborone, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5258-7654","authenticated-orcid":false,"given":"Jonathan","family":"Strysko","sequence":"additional","affiliation":[{"name":"Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana"},{"name":"Global Medicine, Botswana UPenn Partnership, Gaborone, Botswana"},{"name":"Global Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5464-8799","authenticated-orcid":false,"given":"Lynnette Tumwine","family":"Kyokunda","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Botswana, Gaborone, South-East District, Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,4,21]]},"reference":[{"key":"2025082703160550000_14.4.e239701.1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0b013e32832c7d61"},{"key":"2025082703160550000_14.4.e239701.2","unstructured":"World Health Organisation . 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