Disseminated Multidrug-Resistant Tuberculosis in a Young Patient: A Rare Case Report

Abstract

Drug resistance is a persistent threat to tuberculosis (TB) control program worldwide. Patients infected with multiple drug-resistant strains are less likely to become cured. Management of resistant cases is complex and presents therapeutic limitations. Patients with multidrug-resistant strains are more prone to treatment failure and progress to more chronic forms of the disease and death. According to the Global Tuberculosis Report 2018, about 3.5% of newly diagnosed patients had multidrug-resistant tuberculosis (MDR-TB) and 18% of previously treated TB cases were estimated to have MDR-TB. This case presented a rare occurrence of disseminated MDR-TB in a diabetic patient. A case of a 14-year-old female, who was an old-treated case of abdominal TB, presented with 5 months of history of fever, breathlessness, and pain in the abdomen with diabetes mellitus, in whom disseminated MDR-TB was documented with fine-needle aspiration cytology of abdominal lymph nodes and bronchoalveolar lavage fluid that showed drug-resistant TB. So this case emphasizes the importance of screening all extrapulmonary TB patients for drug resistance especially if the patient also has associated comorbid conditions.