Treatment of multiple drug resistant pulmonary tuberculosis in a diabetic patient with renal allograft
https://doi.org/10.21292/2075-1230-2021-99-2-52-57
Abstract
The article describes a clinical case of treatment of multiple drug resistant tuberculosis in the patient with type 1 diabetes mellitus who had received a kidney transplant (from his mother) 3 years before tuberculosis was diagnosed due to diabetic nephroangiosclerosis and the development of end-stage chronic renal disease. Pulmonary tuberculosis developed while taking immunosuppressive drugs, it manifested by an infiltrate with destruction of lung tissue in the upper lobe of the left lung, infiltrative tuberculosis of the left upper lobe and segmental bronchi, bacterial excretion confirmed by microscopy and culture. The strain of tuberculosis was resistant to 5 drugs including isoniazid and rifampicin. The chemotherapy regimen included pyrazinamide, capreomycin, levofloxacin, ethionamide, cycloserine, and paraaminosalicylic acid. Glomerular filtration rate was monitored every month. The full course of anti-tuberculosis chemotherapy (556 doses) was effectively completed, glomerular filtration by that time was 77.0 ml/min. Stable sputum conversion was achieved (confirmed by sputum culture), the cavity was healed, and some areas of pneumosclerosis and single solid foci persisted.
About the Authors
E. V. Korzh
M. Gorky Donetsky National Medical University
Ukraine
Elena V. Korzh, Doctor of Medical Sciences, Professor, Professor of Phthisiology and Pulmonology Department
Ukraine
Elena V. Korzh, Doctor of Medical Sciences, Professor, Professor of Phthisiology and Pulmonology Department
16, Iliicha Ave., Donetsk, 283003
N. A. Podchos
Republican Clinical Tuberculosis Hospital
Ukraine
Ukraine
Nina A. Podchos, Head of Pulmonary Tuberculosis Department for Adults
104-a, Iliicha Ave., Donetsk, 283003
T. V. Ivanitskaya
Republican Clinical Tuberculosis Hospital
Ukraine
Ukraine
Tatiana V. Ivanitskaya, Head of Council on Drug Resistant Tuberculosis
104-a, Iliicha Ave., Donetsk, 283003
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Review
For citations:
Korzh E.V., Podchos N.A., Ivanitskaya T.V. Treatment of multiple drug resistant pulmonary tuberculosis in a diabetic patient with renal allograft. Tuberculosis and Lung Diseases. 2021;99(2):52-57. (In Russ.) https://doi.org/10.21292/2075-1230-2021-99-2-52-57
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