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All Journal Jurnal Kedokteran Brawijaya Jurnal Respirologi Indonesia Jurnal Respirasi (JR) Medica Hospitalia Malang Respiratory Journal Jurnal Klinik dan Riset Kesehatan Asian Journal of Health Research
Tantular, Rezki
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Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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Primary Pre-Extensively Drug-Resistant (Pre-XDR) Tuberculosis with Meningoencephalitis in Nineteen Years Old Young Woman : A Case Report Sugiri, Yani Jane Rosihaningsih; Tantular, Rezki; Falyani, Silvy Amalia; Maulana, Uray Riki Arif
Malang Respiratory Journal Vol. 6 No. 2 (2024): September 2024
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.02.02

Abstract

Introduction. Mycobacterium tuberculosis (MTB) is continually evolving in order to resist treatment. This has resulted in drug-resistant tuberculosis, which has a greater rate of therapy failure and mortality, as well as the necessity for other ways of disease transmission prevention. Pre-extensively drug-resistant tuberculosis (Pre-XDR TB) is caused by MTB strains that are resistant to isoniazid, rifampicin, and any fluoroquinolone medicines. Case Report. A 19-year-old HIV-negative immunocompetent female presented to our emergency department with dyspnea and severe headache. She also complained of a cough, a low-grade temperature, and weight loss. She has no relevant medical history and has never been exposed to tuberculosis. A chest X-ray revealed infiltrates with cavities and fibrosis in both lungs, while a brain CT suggested meningoencephalitis. We performed a sputum drug sensitivity test and discovered that this patient was resistant to rifampin, isoniazid, levofloxacin, and moxifloxacin. She was later diagnosed with Pre-XDR TB and was given a tailored lengthier regimen that included Bedaquiline, Cycloserin, Linezolide, Clofazimine, and Etambutol. Her symptoms improved significantly as a result of this program. Discussion. Primary pre-XDR TB in an immunocompetent patient is uncommon, and our case is even more unusual due to meningoencephalitis involvement. The treatment of pre-XDR TB requires a personalized regimen that is tailored to the patient's clinical status and comorbidities. The possibility of transmission via a positive contact was raised in this patient, prompting us to conduct a more thorough contact inquiry to prevent future spread. Conclusion. In our region, there is a risk of'silent' drug resistant tuberculosis. Early detection and treatment of such patients are critical to preventing uncontrollable pan-resistant TB. Successful management with cautious contact investigation will minimize the mortality rate and spread rate of drug-resistant TB. Keywords. Drug-Resistant Lung Tuberculosis, Drug-Resistant Meningoencephalitis Tuberculosis
Co-Authors Abdul, Haris Andreas, Santoso Aprilen, Nisa Arinto Yudi Ponco Wardoyo Asyari, Claudia Herda Binharyanto, Adlan Pratama Chozin, Iin Noor Delfianto, Dwiroza Dini, Zata Djajalaksana, Susanthy Eka Pratiwi Fadli, M Luqman Falyani, Silvy Amalia I MADE SUARDANA I Wayan Agung Indrawan Iqbal Muhammad Jane, Sugiri Kristo, Kurniawan Listyoko, Aditya Sri Lyono, Albert Mafisah, Saidah Maulana, Uray Riki Arif Murti Dewi, Dian Ayu Nanik Setijowati Permana, Deden Prabowo, Adityo Pratama, Anugerah Justi Primaputri, Cindy Carissa R Sugiri, Yani Jane R. Sugiri, Yani Jane Rachma Erawati, Dini Rahayu Sartono, Teguh Sartono, Teguh Rahayu Setyawan, Ungky Agus Setyo Yudhanto, Hendy Sugiri, Yani Jane Rosihaningsih Susanti, Lia Syahrul Chilmi, Syahrul Tanuwijaya, Hendra Widowati, Ayu Rizky Wikamto, Rifka Yusdianto, Adrian Yusuf, Mustofa