Severe Pulmonary Tuberculosis in Young HIV Negative Adults at Tanga Regional Referral Hospital, Tanzania

Tuberculosis (TB) remains a major public health challenge globally and particularly in high-burden countries like Tanzania. While TB is frequently associated with HIV co-infection, there is increasing number of reports from Tanzania and other sub-Saharan African countries indicating that young, HIV‐negative adults can present with aggressive and rapidly progressive forms of pulmonary TB. This case series highlights two young, HIV negative patients presenting with severe pulmonary TB at Tanga Regional Referral Hospital. Both cases were characterized by critical hypoxemia, extensive lung involvement, and rapid clinical deterioration despite standard anti-TB therapy, culminating in mortality. These cases underscore the importance of recognizing severe TB manifestations in diverse populations and the need for improved management strategies.