A CASE OF MULTI-DRUG RESISTANT PULMONARY TUBERCULOSIS WITH BILATERAL CAVITARY LESIONS SUCCESSFULLY TREATED BY SURGICAL TREATMENT

  • OKUMURA Masao
    Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA)
  • OGATA Hideo
    Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA)
  • YOSHIYAMA Takashi
    Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA)
  • KOKUTOH Hiroyuki
    Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA)
  • TADOKORO Eiji
    Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA)
  • KUBOTA Motoko
    Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA)
  • UEYAMA Masako
    Department of Respiratory Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA)
  • WADA Masako
    Research Institute of Tuberculosis, JATA
  • NAKAJIMA Yutsuki
    Thoracic Surgery, Fukujuji Hospital, JATA

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Other Title
  • 外科療法が有効であった両側空洞,初回重症多剤耐性肺結核症の1例
  • ゲカ リョウホウ ガ ユウコウ デ アッタ リョウガワ クウドウ ショカイ ジュウショウ タザイ タイセイ ハイ ケッカクショウ ノ 1レイ

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Abstract

A case was 38 years old male. He was pointed out abnormal shadow on chest X-ray and complained respiratory infection symptoms. He had not past history of tuberculosis. He was diagnosed as multi-drug resistant tuberculosis (MDR-TB) in a certain hospital and was referred to our hospital to undergo treatment. His drug sensitivity test by Ogawa medium was resistant to all anti-tuberculosis drugs except for kanamycin (KM) and enviomycin (EVM). His chest X-ray revealed large cavities in the right upper field and infiltrations in the right lower field and small cavitary lesions in the left lower field. The right pneumonectomy was done because he took anti-tuberculosis drugs but his sputum examinations continued to be smear and culture positive without improvement of the lesions. After the surgical treatment (right pneumonectomy), he continued anti-tuberculosis drugs therapy and the chest X-ray improved including the collapse of left lower cavitary lesions. This case was a difficult case to treat because of bilateral cavitary lesions. However he was successfully treated by the surgical treatment.

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