Rifampicin-Resistant Pulmonary Tuberculosis in an Immunocompetent Adult Without Prior Antituberculous Treatment: A Case Report

Rifampicin-resistant tuberculosis (RR-TB) represents a growing public health concern, particularly in high-burden countries. It is most commonly observed in patients with a history of tuberculosis (TB) treatment or immunosuppressive conditions. We report a case of rifampicin-resistant pulmonary TB in a 48-year-old immunocompetent Moroccan male with no History of antituberculous treatment, recent exposure, or known comorbidities. He presented with chronic cough, night sweats, and weight loss. Clinical examination revealed bilateral cervical and supraclavicular lymphadenopathy accompanied by bronchial rales. Imaging and molecular diagnostics confirmed active pulmonary TB with rifampicin resistance. This case underscores the importance of considering drug-resistant TB even in immunocompetent individuals without prior exposure. Early molecular diagnosis is critical for timely referral and initiation of appropriate therapy.