Familial outbreak of disseminated multidrug-resistant tuberculosis and meningitis.
Int J Tuberc Lung Dis
; 5(6): 551-8, 2001 Jun.
Article
em En
| MEDLINE
| ID: mdl-11409583
ABSTRACT
Rapidly progressive multidrug-resistant tuberculosis (MDR-TB) is well documented in human immunodeficiency virus (HIV) positive subjects, but it is not fully recognised in HIV-negative subjects in the familial environment. We report three cases of MDR-TB in three young HIV-negative subjects from the same family. All the patients showed signs of meningitis during the course of their disease, and in two cases a resistant strain of Mycobacterium tuberculosis was isolated in cerebrospinal fluid. Two of the three subjects died from neurological complications; the other was successful treated utilising both systemic and intrathecal therapy for tuberculous meningitis. By a retrospective analysis of DNA obtained from Lowenstein-Jensen cultures, the strains were confirmed as M. tuberculosis resistant to rifampicin and isoniazid, and were closely related in the two cases where specimens were available for analysis. The resistance was acquired in two patients initially infected with a susceptible strain; in the other patient, the resistance was present on the first sensitivity test for which results were available. This report demonstrates the high risk of fatality from MDR-TB for HIV-negative subjects in the absence of reliable early diagnostic and preventive tools. It also reinforces the concept that genetic susceptibility to M. tuberculosis may be an important factor in the clinical presentation and outcome of MDR-TB.
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Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
/
3_ND
/
4_TD
Base de dados:
MEDLINE
Assunto principal:
Rifampina
/
Tuberculose Meníngea
/
Tuberculose Resistente a Múltiplos Medicamentos
/
Isoniazida
/
Mycobacterium tuberculosis
/
Antituberculosos
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Int J Tuberc Lung Dis
Ano de publicação:
2001
Tipo de documento:
Article