结核病(TB)是全球发展中地区最主要的传染病之一。正如世界卫生组织(世卫组织)所指出的那样,耐药结核病(DR-TB)的病例数最近有所增加.该病例报告描述了原发性肺外多药耐药结核性胸腔积液的有效诊断和定制治疗。一种由于细菌计数相对较低以及抗酸杆菌(AFB)的ZiehlNeelsen(ZN)染色通常为阴性而难以鉴定的疾病。导致耐多药结核病(MDR-TB)的细菌对至少两种药物具有抗药性,异烟肼和利福平,最有效的结核病药物。我们将介绍一个60岁的男性抱怨呼吸困难的案例,咳嗽,体重减轻一个月,胸痛和发烧12天。对患者进行了胸腔积液检查,显示渗出液(根据Light's标准),腺苷脱氨酶(ADA)阳性。进行了基于药筒的核酸扩增测试(CBNAAT)和线探针测定(LPAs),提示结核分枝杆菌(MTB)对利福平和异烟肼耐药。患者根据WHO标准开始口服bedaquiline,导致显著改善。这一病例揭示了为了及时诊断和治疗DR-TB,胸腔积液,和胸膜活检需要早期暴露于调查,如Xpert(MTB)/对利福平测定的抗性,培养,和基因型药物敏感性测试(DST)。
Tuberculosis (TB) is among the most predominant infectious illnesses in developing areas around the globe. As stated by the World Health Organization (WHO), the number of instances of drug-resistant tuberculosis (DR-TB) has increased lately. This
case report describes the effective diagnosis and customized treatment for primary extra-pulmonary multidrug-resistant tubercular pleural effusion, a disease which is difficult to identify due to relatively low bacterial count as well as frequently negative staining on Ziehl Neelsen (ZN) for acid-fast bacilli (AFB). The bacteria causing multidrug-resistant tuberculosis (MDR-TB) is resistant to a minimum of two drugs, isoniazid and rifampicin, the most effective TB medications. We are going to present the
case of a 60-year-old male who complained of breathlessness, cough, and loss of weight for one month and chest pain and fever for 12 days. The patient\'s pleural fluid examination was carried out, which showed exudative fluid (according to Light\'s criteria) with adenosine deaminase (ADA) positive. Cartridge-based nucleic acid amplification test (CBNAAT) and line probe assays (LPAs) were carried out, which suggested mycobacterium tuberculosis (MTB) with rifampicin and isoniazid resistance. The patient was started an oral regimen with bedaquiline in accordance with WHO standards, leading to significant improvement. This
case reveals that to promptly diagnose and treat DR-TB, pleural effusions, and pleural biopsies need to be exposed early to investigations such as Xpert (MTB)/resistance to rifampicin assay, culturing, and genotype drug sensitivity testing (DST).