Acquired resistance to isoniazid during isoniazid monotherapy in a subject with latent infection following household rifampicin-resistant tuberculosis contact: A case report

Tsung Lun Li, Tai Hua Chan, Cheng Hui Wang, Ruwen Jou, Ming Chih Yu, Denise Utami Putri, Chih Hsin Lee, Yi Hsien Lin

研究成果: 雜誌貢獻文章同行評審

摘要

Appropriate treatment is the key element in eliminating tuberculosis (TB), and requires prompt diagnosis. We presented a case of a household contact of rifampicin-resistant TB revealing reactive IFN-gamma release assay with unsuspicious clinical and radiologic examinations. She was diagnosed with latent tuberculosis infection (LTBI) and treated with isoniazid monotherapy. On the ninth month, she developed a progressive cough and was found to harbor active TB disease with added resistance to isoniazid. An individualized anti-TB regimen consisting of moxifloxacin, kanamycin, prothionamide, ethambutol, and pyr-azinamide was prescribed for 20 months, leading to sputum culture conversion and improve-ment of the reported symptom. No recurrence was observed on one-year follow-up. Assuming high compliance to therapy, we propose that the patient may have been under-diagnosed and received sub-optimal treatment leading to acquired-drug resistance. Conventional diagnosis methods based on immunological assay and radiographical findings may be insufficient to distinguish the incipient and subclinical states of TB from LTBI.
原文英語
頁(從 - 到)1505-1509
頁數5
期刊Infection and Drug Resistance
14
DOIs
出版狀態已發佈 - 2021

ASJC Scopus subject areas

  • 藥理
  • 傳染性疾病
  • 藥學(醫學)

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