Infect Chemother.  2016 Mar;48(1):41-46. 10.3947/ic.2016.48.1.41.

A Case of Disseminated Multidrug-Resistant Tuberculosis involving the Brain

• Jung EK
• Chang JY
• Lee YP
• Chung MK
• Seo EK
• Koo HS
• Choi HJ

• KMID: 2170516
• DOI: http://doi.org/10.3947/ic.2016.48.1.41

Abstract

We report a case of a 23-year-old female immigrant from China who was diagnosed with multidrug-resistant tuberculosis affecting her lung and brain, resistant to the standard first-line therapeutics and streptomycin. She was treated with prothionamide, moxifloxacin, cycloserine, and kanamycin. However, her headache and brain lesion worsened. After the brain biopsy, the patient was confirmed with intracranial tuberculoma. Linezolid was added to intensify the treatment regimen, and steroid was added for the possibility of paradoxical response. Kanamycin was discontinued 6 months after initiation of the treatment; she was treated for 18 months with susceptible drugs and completely recovered. To our knowledge, this case is the first multidrug-resistant tuberculosis that disseminated to the brain in Korea.

Keyword

Mycobacterium tuberculosis; Tuberculosis, multidrug-resistant; Tuberculosis, central nervous system; Tuberculosis, pulmonary

MeSH Terms

Biopsy
Brain*
China
Cycloserine
Emigrants and Immigrants
Female
Headache
Humans
Kanamycin
Korea
Linezolid
Lung
Mycobacterium tuberculosis
Prothionamide
Streptomycin
Tuberculoma, Intracranial
Tuberculosis, Central Nervous System
Tuberculosis, Multidrug-Resistant*
Tuberculosis, Pulmonary
Young Adult
Cycloserine
Kanamycin
Prothionamide
Streptomycin