{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:52:19Z","timestamp":1791305539734,"version":"4.3.1"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:p>Tuberculosis (TB) remains a major global health concern, particularly among immunologically and nutritionally vulnerable individuals. Although celiac disease (CD) has been associated with an increased risk of TB, extensive and complicated forms remain rarely reported. We report the case of a 27-year-old man with CD, poor adherence to a gluten-free- diet (GFD), schizophrenia, and substance use disorders, who presented with extensive cavitary pulmonary TB (PT) complicated by pyopneumothorax and severe undernutrition. Concerns were raised regarding anti-TB drug absorption. In the absence of injectable anti-TB agents, standard oral treatment was initiated alongside a strict GFD, nutritional rehabilitation, and cessation of substance use. The patient showed very gradual general health improvement and required prolonged chest drainage, ultimately resulting in clinical recovery with residual pleuroparenchymal sequelae. This case highlights that PT in active CD can achieve recovery with oral anti-TB therapy when associated malabsorption is strictly managed.<\/jats:p>","DOI":"10.4103\/ijmy.ijmy_99_26","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T03:00:19Z","timestamp":1790823619000},"page":"328-332","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Extensive Pulmonary Tuberculosis Complicated by Pyopneumothorax in a Patient with Active Celiac Disease: A Management Challenge"],"prefix":"10.4103","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9955-9202","authenticated-orcid":false,"given":"Sabrina","family":"Abderrahim","sequence":"first","affiliation":[{"name":"Department of Pulmonology, Faculty of Medicine, Mustapha University Hospital Centre, Youcef El Khatib University of Health Sciences, Algiers, Algeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Laouar","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Faculty of Medicine, Mustapha University Hospital Centre, Youcef El Khatib University of Health Sciences, Algiers, Algeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"R2-20261006","first-page":"CD015890","article-title":"Undernutrition as a risk factor for tuberculosis disease","volume":"6","author":"Franco","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"key":"R3-20261006","doi-asserted-by":"crossref","first-page":"E1258","DOI":"10.1503\/cmaj.230091","article-title":"Diagnosis and management of celiac disease","volume":"197","author":"Blom","year":"2025","journal-title":"CMAJ"},{"key":"R4-20261006","doi-asserted-by":"crossref","first-page":"5107","DOI":"10.3390\/jcm12155107","article-title":"Nutritional status and metabolism in celiac disease: Narrative review","volume":"12","author":"M\u0119dza","year":"2023","journal-title":"J Clin Med"},{"key":"R5-20261006","doi-asserted-by":"crossref","first-page":"120","DOI":"10.3390\/medicina62010120","article-title":"Unraveling the complexity of celiac disease: A narrative review of its multisystem nature","volume":"62","author":"Rogalidou","year":"2026","journal-title":"Medicina (Kaunas)"},{"key":"R6-20261006","first-page":"252","article-title":"Coeliac disease: Complications and comorbidities","volume":"22","author":"Ludvigsson","year":"2025","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"R8-20261006","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1111\/j.1365-2036.2010.04572.x","article-title":"Risk of tuberculosis in a large sample of patients with coeliac disease \u2013 A nationwide cohort study","volume":"33","author":"Ludvigsson","year":"2011","journal-title":"Aliment Pharmacol Ther"},{"key":"R9-20261006","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1136\/thx.2006.059451","article-title":"Coeliac disease and risk of tuberculosis: A population based cohort study","volume":"62","author":"Ludvigsson","year":"2007","journal-title":"Thorax"},{"key":"R10-20261006","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1080\/17425255.2021.1836158","article-title":"Therapeutic drug monitoring in patients with tuberculosis and concurrent medical problems","volume":"17","author":"M\u00e4rtson","year":"2021","journal-title":"Expert Opin Drug Metab Toxicol"},{"key":"R11-20261006","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1007\/s40262-025-01537-w","article-title":"rifampicin exposure in tuberculosis patients with comorbidities in Sub-Saharan Africa: Prioritising populations for treatment-a systematic review and meta-analysis","volume":"64","author":"Said","year":"2025","journal-title":"Clin Pharmacokinet"},{"key":"R12-20261006","doi-asserted-by":"crossref","first-page":"1814","DOI":"10.3390\/nu16121814","article-title":"Associations between celiac disease, extra-gastrointestinal manifestations, and gluten-free diet: A narrative overview","volume":"16","author":"Santonicola","year":"2024","journal-title":"Nutrients"},{"key":"R13-20261006","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s12889-023-17495-6","article-title":"Global, regional and national trends in tuberculosis incidence and main risk factors: A study using data from 2000 to 2021","volume":"24","author":"Bai","year":"2024","journal-title":"BMC Public Health"},{"key":"R14-20261006","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.4103\/ijmy.ijmy_139_25","article-title":"Changes in the trends of tuberculosis incidence in Algeria from 1982 to 2024","volume":"15","author":"Selmane","year":"2026","journal-title":"Int J Mycobacteriol"},{"key":"R15-20261006","doi-asserted-by":"crossref","first-page":"268","DOI":"10.4103\/ijmy.ijmy_53_25","article-title":"Identifying high-risk tuberculosis cases: Implementation of a programmatic screening tool in Bengaluru","volume":"14","author":"Menon","year":"2025","journal-title":"Int J Mycobacteriol"},{"issue":"Suppl 1","key":"R16-20261006","first-page":"S49","article-title":"Review article: Follow-up of coeliac disease","volume":"56","author":"Tye-Din","year":"2022","journal-title":"Aliment Pharmacol Ther"},{"key":"R17-20261006","first-page":"214","article-title":"Relationship between coeliac disease and multifocal tuberculosis: About a case and literature review","volume":"27","author":"Sarghini","year":"2017","journal-title":"Pan Afr Med J"},{"key":"R18-20261006","doi-asserted-by":"crossref","first-page":"5144","DOI":"10.3390\/jcm14145144","article-title":"Outcomes in adults with celiac disease following a gluten-free diet","volume":"14","author":"Balaban","year":"2025","journal-title":"J Clin Med"},{"key":"R19-20261006","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1007\/s00228-024-03749-8","article-title":"Therapeutic drug monitoring in tuberculosis","volume":"80","author":"Sarkar","year":"2024","journal-title":"Eur J Clin Pharmacol"}],"container-title":["The International Journal of Mycobacteriology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijmy.ijmy_99_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:02:50Z","timestamp":1791302570000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijmy.ijmy_99_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijmy.ijmy_99_26","relation":{},"ISSN":["2212-5531","2212-554X"],"issn-type":[{"value":"2212-5531","type":"print"},{"value":"2212-554X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-04-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-28","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}