Multidrug-resistant tuberculosis—Prolonged course of disease

SummaryThe study describes treatment for multidrug-resistant tuberculosis with individual drug regimen adjusted according to the results of susceptibility tests. The patient tolerated all drugs used very well. Although smear and culture negativity was reached, course of disease was changed in the 7th year of the individual regimen, the disease progressed and the patient died. Management of patients suffering from multidrug-resistant tuberculosis is complicated and successful in 60–70% only. Therapy is performed either on the recommendation for the resistant forms of tuberculosis or on the results of susceptibility tests for antituberculous drugs of the second or third classes. In this case, even 7-year long individual treatment regimen did not prevent patient from the exitus letalis

Situation of multidrug-resistant tuberculosis in the Czech Republic, unusual case study

AbstractMultidrug-resistant tuberculosis has been a serious medical and epidemic problem all over the world. Management of patients suffering from multidrug-resistant tuberculosis is complicated and therapy is successful in 60–70% of cases only. Therapeutic strategies recommend the application of standardized or an individual treatment regimen based on the results of susceptibility drug tests for second-line antituberculous drugs. The case study describes treatment for multidrug-resistant tuberculosis with individual drug regimen adjusted according to the results of susceptibility tests. Although smear and culture negativity was reached, course of disease was changed in the seventh year of the individual regimen, the disease progressed and the patient died

The incidence of subclinical forms of urogenital tuberculosis in patients with pulmonary tuberculosis

The aim of our study was to determine whether patients with pulmonary tuberculosis may have subclinical forms of urogenital tuberculosis.Between 2011 and 2012, a prospective study was conducted. Basic demographic parameters were recorded and the following investigations were performed: direct bacilloscopy of sputum, evaluation of affected lung fields and presence of cavities on chest X-ray, Mantoux tuberculin skin test II, and interferon gamma release assay. Culture and molecular methods for Mycobacterium tuberculosis in urine were performed. In cases with a positive urine test, an ultrasound examination, computed tomography scan of the abdomen, and endoscopy of the urinary tract were performed.A total of 102 patients (75 men and 27 women) were included in the study, with a median age of 46.8 years. Subclinical forms of urogenital TB were detected in 7 patients; 5 by molecular methods, 1 by urine culture, and 1 with both methods The presence of subclinical forms of genitourinary TB was found in 4 patients without and 3 patients with findings on imaging methods corresponding to TB.A significant number of patients with pulmonary tuberculosis may simultaneously have subclinical forms of urogenital TB. Keywords: Urogenital, Pulmonary, Tuberculosis, Subclinical, Urin