Extrapulmonary Drug Resistant Tuberculosis in Zambia: Case Reports on the First Two Recorded Cases

A CASE OF TUBERCULOSIS MENINGITIS AND A CASE OF A COLD ABSCESS

  • Webster Chewe Kitwe Teaching Hospital
  • Abidan Chansa Kitwe Teaching Hospital
  • Patrick Lungu University Teaching Hospital/National Tuberculosis & Leprosy   Programme
  • Namakando Liusha Kitwe Teaching Hospital
Keywords: cold abscess, drug resistance, extrapulmonary, meningitis, tuberculosis

Abstract

Extrapulmonary drug resistant tuberculosis (DR-TB) is a rare manifestation of disseminated tuberculosis which carries high mortality more so if the central nervous system (CNS) is affected. This paper reviews two cases of extrapulmonary DR-TB, involving two males both aged 32 years and human immunodeficiency virus (HIV) positive. The first case presented with fever and had meningeal signs while the second case was a prisoner who presented with recurrent anterior chest wall abscesses respectively. The cerebrospinal fluid (CSF) from the first patient and aspirate of the abscess from the second patient were subjected to nucleic acid amplification assays with Xpert® MTB/RIF assay (Cepheid, CA, USA) and both results showed mycobacterium positive, with rifampicin resistance detected in low titers. Both patients were initiated on all oral long regimen containing bedaquiline (BDQ) and linezolid (LZD) as core drugs. Both patients showed tremendous improvement and were almost symptom free at month three of treatment and had returned to full functional status with no apparent adverse effects. This shows the importance of high clinical inquisition and the need for clinicians to subject various bodily fluids to culture and molecular testing including GeneXpert analysis.

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Author Biographies

Abidan Chansa, Kitwe Teaching Hospital

Department of Internal Medicine

Patrick Lungu, University Teaching Hospital/National Tuberculosis & Leprosy   Programme

Department of Internal Medicine

Namakando Liusha, Kitwe Teaching Hospital

Department of Internal Medicine

Published
2020-07-15
How to Cite
Chewe, W., Chansa, A., Lungu, P., & Liusha, N. (2020). Extrapulmonary Drug Resistant Tuberculosis in Zambia: Case Reports on the First Two Recorded Cases. Medical Journal of Zambia, 47(2), 154 - 159. Retrieved from https://mjz.co.zm/index.php/mjz/article/view/658
Section
Case Reports