A 21-year-old South American woman came to the emergency department complaining of cough with hemoptoic sputum, fever, night sweats and weight loss.
She had two episodes of tuberculosis as her relevant personal history.
The first episode was two years before in the country of origin, receiving treatment although with poor pharmacological adherence.
The second, also in its country of origin, was a year before and in the antibiogram of a sputum sample was isolated Mycobacterium tuberculosis resistant to rifampin and isoniazid.
The patient was treated in her country, although it is unknown which drugs and for how long.
He did not come to the follow-up appointment for symptomatic improvement.
Examination revealed tachypnea with thick crackles at the end of inspiration in both lung fields.
The Microbiology Department reports positive sputum smear microscopy (++).
Chest X-ray shows radiopacity in the apex and reticular interstitial pattern.
Negative result for HIV/AIDS.
The diagnosis is active pulmonary tuberculosis with a history of multiresistance.
She was admitted to Internal Medicine ward and underwent respiratory isolation.
Treatment was initiated with moxifloxacin, 400 mg/24 hours a.o.; amikacin, 1 g/24 hours i.v. (discharge from hospital); prothionamide, 1 g/24 hours a.v. medication.
The patient was discharged after 53 days of hospitalization due to a high risk of treatment abandonment with the consequent risk to the community, after obtaining negative sputum culture for Mycobacterium.
She is currently being followed up by the Internal Medicine Department.
