A Survival Case Of Extensively Drug Resistance Tuberculosis

Trabalho de Projeto do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaOs casos de Tuberculose extensivamente resistente (XDR-TB) são raros, embora esta situação se possa alterar drasticamente, devido à capacidade cada vez mais comum, que os microorganismo têm para adquirir resistências.A importância de selecionarmos sempre esquemas terapêuticos compostos pela associação de vários fármacos é a melhor e mais eficaz forma de tratarmos a doença, dado reduzir o aparecimento de resistências futuras. A Tuberculose, é ainda a doença infecciosa com maior taxa de prevalência e incidência no mundo.A divulgação destes casos raros, assumiu grande utilidade na abordagem e realização de tratamento eficaz destas situações pelos médicos que lidam com esses casos, de modo a que possam obter o diagnóstico precoce e o sucesso terapêutico. A XDR-TB apresenta altas taxas de mortalidade em parte por existir pouca informação fidedigna.O Sr. J.M.C.S.M. 48 anos, esteve internado na enfermaria de Pneumologia durante 281 dias, tendo dado entrada com sintomas constitucionais inespecíficos, mas que o seu histórico médico de antecedentes de tuberculose há doze anos, com má adesão à terapêutica, o que provavelmente muito contribuiu para a resistência actual, fizeram logo suspeitar desta doença. O doente estava desempregado e numa família disfuncional. Tinha antecedentes de consumo excessivo de álcool e tabaco.Há muita informação importante que podemos reter com este trabalho, mas duas são fundamentais: é fulcral tratar sempre a Tuberculose com mais de dois antibacilares e os esquemas terapêuticos devem ser feitos até ao fim e com os fármacos correctos.XDR-TB is still rare but this scenario might drastically change because of the natural capacity of microorganisms in acquiring resistance being more common. Although the choice to prescribe associations of antibiotics as a better way to treat the disease is one of the strategies to diminishes it, Tuberculosis is still the most prevalent and infectious disease with the highest incidence in the world. It is important to share XDR-TB cases so doctors can be able to diagnose and treat it earlier as it has a huge mortality rate and the background literature is too poor. Mr. J.M.C.S.M. 48y, was in our Pneumology ward for 281 days as he entered with such general symptoms but his past medical history of Tuberculosis with suboptimal treatment adherence, which contribute to existence of resistance made us diagnosed it very promptly. The patient was unemployed, with dysfunctional family and heavy consume of alcohol and tobacco.We can conclude too many important things from here, but two are essential about resistance: it is important to treat always a TB with more than two antibiotics and that the therapeutically regimen should always be completed without failures and with the right drugs.XDR-TB is still rare but this scenario might drastically change because of the natural capacity of microorganisms in acquiring resistance being more common. Although the choice to prescribe associations of antibiotics as a better way to treat the disease is one of the strategies to diminishes it, Tuberculosis is still the most prevalent and infectious disease with the highest incidence in the world. It is important to share XDR-TB cases so doctors can be able to diagnose and treat it earlier as it has a huge mortality rate and the background literature is too poor. Mr. J.M.C.S.M. 48y, was in our Pneumology ward for 281 days as he entered with such general symptoms but his past medical history of Tuberculosis with suboptimal treatment adherence, which contribute to existence of resistance made us diagnosed it very promptly. The patient was unemployed, with dysfunctional family and heavy consume of alcohol and tobacco.We can conclude too many important things from here, but two are essential about resistance: it is important to treat always a TB with more than two antibiotics and that the therapeutically regimen should always be completed without failures and with the right drugs