Complicated Silicosis Associated with Mycobacterium tuberculosis Infection

Romania is recognized as the European country with the highest tuberculosis rate in Europe. The association of tuberculosis with silicosis determines synergistic immunosuppression of the alveolar macrophages resulting in a higher grade of pulmonary parenchymal destruction and consequently respiratory failure. The case report approaches a patient with third stage of silicosis and associated active secondary pulmonary tuberculosis disease with positive smears. The impact of the Mycobacterium tuberculosis (MTB) infection’s activation is known to be severe, worsening the prognosis of silicosis and reducing the patient’s quality of life. Regarding the high morbidity rate of tuberculosis, an early diagnosis of tuberculosis in patients with silicosis is paramount, and sometimes cannot be achieved by usual bacteriological tests. Therefore, a better strategy is to be considered in silicotuberculosis, namely to prevent the progression of the latent tuberculosis foci by testing the positive predictive value of up-to-date tests such as IFN-γ inducible protein 10 biomarker, which may allow early detection and treatment.