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Extra-pulmonary primary multidrug-resistant tubercular lymphadenitis in an HIV negative patient
Surya Kant1, S Saheer, Ghulam Hassan
1Department of Pulmonary Medicine, CSMMU, Lucknow, India. dr.kantskt@rediffmail.com
BMJ Case Reports
|May 19, 2012
Summary
Primary multidrug-resistant tuberculosis (MDR-TB) in extrapulmonary sites can be successfully treated. This case study shows effective treatment of a patient with MDR-TB affecting lymph nodes and the clavicle using second-line drugs.
Area of Science:
- Infectious Diseases
- Microbiology
- Pulmonology
Background:
- Tuberculosis (TB) remains a significant global health challenge.
- Multidrug-resistant tuberculosis (MDR-TB) poses a complex treatment obstacle.
- Extrapulmonary TB presentations require careful diagnosis and management.
Observation:
- A 28-year-old woman presented with cervical lymphadenopathy and a clavicular cold abscess.
- Pus culture identified Mycobacterium tuberculosis resistant to rifampicin and isoniazid.
- This indicated primary multidrug-resistant tuberculosis without prior treatment history.
Findings:
- The patient was diagnosed with primary MDR-TB affecting extrapulmonary sites.
- Treatment with second-line drugs was guided by culture susceptibility testing.
- Successful clinical response was observed upon completion of therapy.
Implications:
- This case demonstrates the successful management of primary extrapulmonary MDR-TB.
- Current second-line anti-TB drugs can be effective for complex MDR-TB cases.
- Highlights the importance of susceptibility testing for tailored MDR-TB treatment.
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