Acquired Resistance to Isoniazid During Isoniazid Monotherapy in a Subject with Latent Infection Following Household Rifampicin-Resistant Tuberculosis Contact: A Case Report
| Autor: | Tai-Hua Chan, Denise Utami Putri, Ming-Chih Yu, Cheng-Hui Wang, Yi-Hsien Lin, Tsung-Lun Li, Chih Hsin Lee, Ruwen Jou |
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| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Tuberculosis latent tuberculosis infection 030106 microbiology Sputum culture acquired drug resistance 03 medical and health sciences 0302 clinical medicine Internal medicine medicine case report subclinical TB Pharmacology (medical) 030212 general & internal medicine Ethambutol Pharmacology treatment medicine.diagnostic_test Latent tuberculosis business.industry drug-resistant TB Isoniazid Pyrazinamide bacterial infections and mycoses medicine.disease LTBI Regimen Infectious Diseases Prothionamide business medicine.drug |
| Zdroj: | Infection and Drug Resistance |
| ISSN: | 1178-6973 |
| Popis: | Appropriate treatment is the key element in eliminating tuberculosis (TB), and requires prompt diagnosis. We presented a case of a household contact of rifampicin-resistant TB revealing reactive IFN-gamma release assay with unsuspicious clinical and radiologic examinations. She was diagnosed with latent tuberculosis infection (LTBI) and treated with isoniazid monotherapy. On the ninth month, she developed a progressive cough and was found to harbor active TB disease with added resistance to isoniazid. An individualized anti-TB regimen consisting of moxifloxacin, kanamycin, prothionamide, ethambutol, and pyrazinamide was prescribed for 20 months, leading to sputum culture conversion and improvement of the reported symptom. No recurrence was observed on one-year follow-up. Assuming high compliance to therapy, we propose that the patient may have been underdiagnosed and received sub-optimal treatment leading to acquired-drug resistance. Conventional diagnosis methods based on immunological assay and radiographical findings may be insufficient to distinguish the incipient and subclinical states of TB from LTBI. |
| Databáze: | OpenAIRE |
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