Managing a case of extensively drug-resistant (XDR) pulmonary tuberculosis in Singapore
Phua, C.K.; Chee, C.B.E.; Chua, A.P.G.; Gan, S.H.; Ahmed, A.D.B.; Wang, Y.T.
Annals of the Academy of Medicine Singapore 40(3): 132-135
2011
ISSN/ISBN: 0304-4602 PMID: 21603731 Document Number: 652017
Extensively drug-resistant tuberculosis (XDR-TB) is an emerging global health risk. We present the first case report of XDR-TB in Singapore. A 41-year-old Indonesian lady with previously treated pulmonary tuberculosis presented with chronic cough. Her sputum was strongly acid-fast bacilli positive and grew Mycobacterium tuberculosis complex resistant to first and second-line TB medications. She received 5 months of intensive multidrug treatment without sputum smear conversion. She then underwent resection of the diseased lung. The total cost incurred amounted to over S$100,000. She achieved sputum smear/culture conversion post-surgery, but will require further medical therapy for at least 18 months. XDRTB is poorly responsive to therapy and extremely expensive to manage. Its prevention by strict compliance to therapy is paramount.