Resumen

MONTIEL ALFONSO, Miguel Angel; ALFONSO VIVEROS, Karina  y  CHAVES OCAMPOS, Jimena María José. Cavitary pulmonary coinfection caused by carbapenemase-producing Enterobacteriaceae and Mycobacterium tuberculosis in an immunocompetent host. Rev. virtual Soc. Parag. Med. Int. [online]. 2026, vol.13, n.1, e13142601.  Epub 29-Dic-2025. ISSN 2312-3893.  https://doi.org/10.18004/rvspmi/2312-3893/2026.e13142601.

Cavitated lung infections are usually associated with anaerobic pathogens in patients with predisposing factors. Coinfection with multidrug-resistant Enterobacteriaceae and Mycobacterium tuberculosis in immunocompetent hosts is rare and poses significant diagnostic and therapeutic challenges.

We present the case of a 77-year-old man with no known immunosuppression, presenting with subacute respiratory symptoms and imaging findings of pulmonary cavitation. Pseudomonas sp., Stenotrophomonas maltophilia, and carbapenemase-producing Escherichia coli were sequentially isolated. Molecular testing by GeneXpert confirmed coinfection with M. tuberculosis. The patient responded favorably to targeted antibiotic treatment followed by an antituberculosis regimen.

The coexistence of multidrug-resistant pathogens and tuberculosis in an immunocompetent host suggests local alterations in pulmonary immunity. Expanded clinical suspicion and the use of molecular tools were key to timely diagnosis and individualized therapeutic approach. This case highlights the importance of considering coinfections in persistent cavitary pulmonary conditions, even in patients without immunosuppression, and of integrating advanced microbiological studies in contexts of high bacterial resistance.

Palabras clave : pulmonary tuberculosis; Enterobacteriaceae; coinfection; molecular diagnostic techniques; immune system.

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