Managing a case of extensively drug-resistant (XDR) pulmonary tuberculosis in Singapore.
- Author:
Chee Kiang PHUA
1
;
Cynthia B E CHEE
;
Angeline P G CHUA
;
Suay Hong GAN
;
Aneez D B AHMED
;
Yee Tang WANG
Author Information
- Publication Type:Case Reports
- MeSH: Adult; Antitubercular Agents; therapeutic use; Delirium; drug therapy; etiology; Directly Observed Therapy; Drug Resistance, Multiple, Bacterial; drug effects; Drug Therapy, Combination; Extensively Drug-Resistant Tuberculosis; drug therapy; Female; Humans; Microbial Sensitivity Tests; Mycobacterium tuberculosis; drug effects; isolation & purification; Singapore; Sputum; microbiology; Tuberculosis, Pulmonary; drug therapy
- From:Annals of the Academy of Medicine, Singapore 2011;40(3):132-135
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTIONExtensively drug-resistant tuberculosis (XDR-TB) is an emerging global health risk. We present the first case report of XDR-TB in Singapore.
CLINICAL PICTUREA 41-year-old Indonesian lady with previously treated pulmonary tuberculosis presented with chronic cough. Her sputum was strongly acid-fast bacilli positive and grew Mycobacterium tuberculosis complex resistant to first and second-line TB medications.
TREATMENTShe received 5 months of intensive multidrug treatment without sputum smear conversion. She then underwent resection of the diseased lung. The total cost incurred amounted to over S$100,000.
OUTCOMEShe achieved sputum smear/culture conversion post-surgery, but will require further medical therapy for at least 18 months.
CONCLUSIONXDRTB is poorly responsive to therapy and extremely expensive to manage. Its prevention by strict compliance to therapy is paramount.
