1 / 10

Case Study: MDR-TB in an 18-Year-Old Woman with No Prior Medical History

This case study follows an 18-year-old woman with no medical history who presents with several months of cough, weight loss, and fatigue. Initially suspected of having tuberculosis (TB) due to her symptoms, her sputum testing revealed smear-positive results. Despite adherence to the first-line TB treatment, she experienced worsening symptoms and underwent bronchoscopy, revealing endobronchial TB. Subsequent sputum culture showed resistance to isoniazid (INH) and rifampicin, leading to a diagnosis of multidrug-resistant TB (MDR-TB). The patient was switched to a second-line treatment, resulting in steady improvement.

tamah
Télécharger la présentation

Case Study: MDR-TB in an 18-Year-Old Woman with No Prior Medical History

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. LEARNING MODULE TITLE SUBTITLE

  2. HISTORY OF PRESENT ILLNESS An 18 year-old woman with no past medical history and no known risks for TB presents with several months of cough, weight loss, and fatigue. • She had no underlying medical problems • No known contacts with MDR-TB patients.

  3. INITIAL CXR

  4. DIAGNOSIS • She was determined to be at risk for TB based on her symptoms and underwent testing. • Her sputum was found to be smear positive with 3+ AFB.

  5. CLINICAL COURSE • Two months after starting therapy, the patient had worsening shortness of breath and cough. • She was compliant with her TB treatment. • She came to the hospital and had sputum that was smear + and an CXR that showed the following findings.

  6. FOLLOW-UP CXR The CXR showed a collapsed left lung. The patient underwent a bronchoscopy to visualize the airway to determine the problem in the left lung.

  7. Bronchoscopy showed tuberculosis at the end of the airway (endobronchial TB) in the left airway. The patient underwent dilation of the airway and was continued on first-line drugs. BRONCHOSCOPY

  8. CLINICAL COURSE • The patient continued her first line drug regimen with good adherence and compliance • After 5 months on therapy, her sputum smear remained positive (1+/2+). • Sputum culture and drug susceptibility testing showed resistance to INH and Rifampicin, meeting the diagnosis for MDR-TB.

  9. MDR-TB DIAGNOSIS • The patient was switched to second-line drugs for MDR regimen, and she has steadily improved while on treatment. • Her last CXR was *** • Her last sputum smear/culture was *** • She has *** months left on treatment

  10. TEACHING POINTS • What are the classic risk factors for MDR-TB? • In patients without these classic risk factors, when would you think of testing for MDR-TB? • What are the symptoms and signs of collapsed lobes of the lung? • What is the treatment and follow-up for endobronchial TB?

More Related