A Case of Disseminated Extensively Drug Resistant Extrapulmonary Tuberculosis

Abstract

Tuberculosis (TB) strains with drug resistance are more difficult to treat than drug susceptible ones and jeopardise global progress towards the targets set by the World Health Organisation’s End TB Strategy. Although disseminated TB is well known as an opportunistic infection in HIV infected individuals, it is uncommon in HIV negative individuals. The present case is a rare case of Extensively Drug Resistant (XDR)-TB in disseminated TB involving the extrapulmonary sites in an immunocompetent adult. We report a case of a young man who has disseminated TB involving pleura and peritoneum. Prior to this, he had taken category II anti-TB treatment with no satisfactory response. Drug sensitivity test of pleural fluid revealed resistance to quinolones, kanamycin, isoniazid and rifampicin. Patient was administered second line anti-TB therapy with remarkable response. Therefore, this case highlights the importance of investigating aggressively for Drug Resistance (DR) in suspected cases of extrapulmonary TB.

Keywords

• disseminated tuberculosis
• extensively drug resistant tuberculosis
• extrapulmonary tuberculosis