Fitness for Work in the Long Journey of Tuberculosis Infection to Chronic Posttuberculosis Disease Case Report and Literature Review

The long journey of tuberculosis (TB) from exposure to latent or progressive TB infection, from primary stage to second stage of illness with or without infectious status, and then to chronic post-TB sequelae is very complex and still unclear, including a various spectrum of stages and manifestations. A case report of a 55 year-old woman with personal history of pleural effusion, in her youth, 2 previous episodes of COVID-19 infections, having no exposure to active smoking but occupational exposure to wood dust, hot steam, barbeque smoke, was admitted to Constanta Clinical Pneumology Hospital in October 2022 for hemoptysis and fatigue. Clinical and paraclinical investigations highlighted an acute evolutive episode of Pulmonary TB with metastatic bilateral nodular pattern, negative smears, positive cultures and positive QuantiFERON TB Gold in Tube (QFT-GIT). TB standard regimen of therapy was started, based on QFT-GIT positivity, and after it ended, chronic obstructive pulmonary disease was detected by spirometry and small airways dysfunction by impulse oscillometry. TB illness does not stop after directly observed therapy ends. So, systematical screening of pulmonary, bronchial or pleural sequelae should be performed and identified syndromes need to be treated, as well as reintegration in the job process by a careful monitoring.