Document 0676
 DOCN  M9650676
 TI    [Infection caused by Mycobacterium tuberculosis with primary resistance
       to multiple drugs: a case report of a patient with AIDS]
 DT    9605
 AU    Grinbaum RS; Daher M; Medeiros EA; de Mendonca JS; Beu MF; Kusano E;
       Telles MA; Ueki SY; Servico de Molestias Infecciosas, Hospital do
       Servidor Publico; Estadual de Sao Paulo (HSPE).
 SO    Rev Assoc Med Bras. 1995 May-Jun;41(3):255-6. Unique Identifier :
       AIDSLINE MED/96098905
 AB    Primary multidrug-resistant Mycobacterium tuberculosis is an important
       problem in the United States. There is no report in formal literature of
       this pathogen in Brazilian patients. CASE REPORT--We report a case of
       ganglionar tuberculosis diagnosed by acid-fast smears in a male, HIV
       positive patient. Mode of acquisition of HIV was not determined.
       Treatment was started, and isoniazid, rifampicin and pyrazinamide were
       prescribed. The patient and his family reported strict adherence to
       therapy, but no improvement was observed. After 75 days, the patient was
       admitted in our hospital because of clinical worsening. Clinical
       features were the presence of large submandibular and axillar lymph
       nodes, respiratory insufficiency and complains of abdominal pain. He
       died six days after admission. Culture obtained from the ganglionar
       aspirate disclosed M. tuberculosis susceptible to ethambutol, but
       resistant to isoniazid, rifampicin, pyrazinamide, ethionamide and
       streptomycin. DISCUSSION--Although this was a case of extrapulmonary
       tuberculosis, there is a concern about multidrug-resistant tuberculosis,
       that has been poorly evaluated in Brazil. Since high lethality and
       intrahospital transmission have been reported, we discuss the need of
       performing culture and antibiogram in suspected cases, and the
       prevention of the spread of M. tuberculosis to patients and health-care
       workers through the strict adherence to the isolation practices.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS  Adult  Case Report
       English Abstract  Human  Male  Tuberculosis, Lymph Node/*COMPLICATIONS
       Tuberculosis, Multidrug-Resistant/*COMPLICATIONS  JOURNAL ARTICLE

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