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Updated: Jun 1, 2026

Diagnosing Pulmonary Tuberculosis with the Xpert MTB/RIF Test
Published on: April 9, 2012
Managing a case of extensively drug-resistant (XDR) pulmonary tuberculosis in Singapore
Chee Kiang Phua1, Cynthia B E Chee, Angeline P G Chua
1Tuberculosis Control Unit, Tan Tock Seng Hospital, Singapore.
Introduction:
Extensively drug-resistant tuberculosis (XDR-TB) is an emerging global health risk. We present the first case report of XDR-TB in Singapore.
Clinical Picture:
A 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.
Treatment:
She 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.
Outcome:
She achieved sputum smear/culture conversion post-surgery, but will require further medical therapy for at least 18 months.
Conclusion:
XDRTB is poorly responsive to therapy and extremely expensive to manage. Its prevention by strict compliance to therapy is paramount.
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