A rare case of isoniazid mono-resistant tuberculosis presenting as cardiac tamponade along with an anterior mediastinal mass in a 15-year-old immunocompetent patient.

IF 1.3 Q4 RESPIRATORY SYSTEM Lung India Pub Date : 2024-03-01 Epub Date: 2024-02-27 DOI:10.4103/lungindia.lungindia_221_23

Richa Mishra, Ashima Jamwal, Bishal Gupta, Sudeep Kumar, Abhijeet Bharali, Parijat Das, Alok Nath, Manoj Jain, Zafar Neyaz

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Abstract

Abstract: A 15-year-old boy presented with a sudden onset of breathlessness for 7 days, gradual loss of weight of 17.6 lbs over the last month and progressive hoarseness of voice for 7 months. The contrast-enhanced computed tomography (CECT) scan revealed a heterogeneously enhancing lesion in the anterior mediastinum with multiple discrete lymph nodes in the cervical and mediastinal locations. The GeneXpert MTB/RIF assay performed on the CT-guided biopsy of the mass was negative, but the culture for Mycobacterium tuberculosis was positive at 7 weeks of incubation. There was a suboptimal radiological response after 6 months of treatment. First-line drug susceptibility testing (DST) performed by line probe assay (LPA) on the positive culture detected high-level resistance to isoniazid. The treatment was modified as per DST results to which the patient responded well.

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一例罕见的单耐药异烟肼结核病病例，患者 15 岁，免疫功能正常，表现为心脏填塞和前纵隔肿块。

摘要：一名15岁男孩突然出现呼吸困难7天，近一个月来体重逐渐减轻17.6磅，声音逐渐嘶哑7个月。造影剂增强计算机断层扫描（CECT）显示，前纵隔有异质性增强病灶，颈部和纵隔位置有多个离散淋巴结。在CT引导下对肿块进行活检时，基因Xpert MTB/RIF检测结果为阴性，但经7周培养后，结核分枝杆菌培养结果呈阳性。治疗 6 个月后，放射学反应不理想。用线探针检测法（LPA）对阳性培养物进行了一线药敏试验（DST），检测出了对异烟肼的高度耐药性。根据 DST 结果对治疗进行了调整，患者反应良好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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