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Lung India Official publication of Indian Chest Society  
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CASE REPORT
Year : 2007  |  Volume : 24  |  Issue : 3  |  Page : 97-99

Primary multidrug resistant tuberculosis


1 Department of Chest Medicine, Nil ratan sircar Medicla College ,Kolkatta 14, West Bengal., India
2 Department of Orthopedic Surgery, Nil Ratan Sircar Medicla College, Kolkatta 14, West Bengal., India

Correspondence Address:
Supriya Sarkar
Department of Chest Medicine, Nil ratan sircar Medicla College ,Kolkatta 14, West Bengal.
India
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Source of Support: None, Conflict of Interest: None


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A 37-year old man presented at our institution with back pain, low-grade fever and weight-loss. X-ray of chest (postero-anterior view) showed multiple opacities with erosion of right 2nd and left 6th ribs. CT-scan of thorax and CT-guided FNAC con­firmed the diagnosis of tuberculosis of ribs. Even after 5-months of treatment with four first line drugs, the patient developed a cold abscess at the back. Mycobacterial culture and drug sensitivity of material aspirated by Radiometric method from the cold abscess showed growth of Mycobacterium tuberculosis, and those bacilli were resistant to both isoniazide and rifampicin. The patient did not have anti-tubercu­lar medication in the past, and that established the diagnosis of primary multidrug resistant tuberculosis of ribs. Patient was treated successfully with 2nd line drugs at the cost of moderate degree of hearing loss. After one and half years of treatment X-ray of chest (PA view) showed complete healing of rib erosions with new bone formation.


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