A Case of Multiple-drug Resistant Pulmonary Tuberculosis Treated by Cavernostomies.

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The treatment of multiple drug resistant tuberculosis is difficult even today. We report here a case of multiple drug resistant pulmonary tuberculosis in whom cavernostomies were effective. The patient is a 34 year-old female with a cavitary pulmonary tuberculosis in the right lobe who was admitted because of persistent fever of more than two months duration. Because the bacilli isolated were multiple drug resistant, the patient was still young, and the lesion was located close to the chest wall, we performed cavernostomy which is less invasive than the other surgical approaches such as thracoplasties or lobectomies. In two months after the initial surgery the fever subsided and the sputum became negative. However, about a year and a half later the patient developed another cavities in the middle lobe and then in the left upper lobe. Both were treated successfully by cavernostomies and chemotherapies. Cavernostomy is still a treatment of choice in some patients with multiple drug resistant pulmonary tuberculosis if the lesion is limited and located close to the chest wall because it is relatively easy to perform, safer, and less invasive.
一般社団法人国立医療学会の論文