UMEM Educational Pearls

Category: International EM

Title: XDR Tuberculosis

Keywords: XDR, tuberculosis, international, Eastern Europe, Russia (PubMed Search)

Posted: 8/14/2013 by Andrea Tenner, MD
Click here to contact Andrea Tenner, MD

 

General Information:

XDR TB is “extensively drug resistant tuberculosis”—resistant to isoniazid, rifampin, any fluoroquinolone, and at least one of the 3 injectable 2nd line drugs

Clinical Presentation:

- Identical to regular TB (weight loss, fevers, night sweats, cough, hemoptysis)

- Suspect in patients who are failing usual treatment

-Exposure in Eastern Europe or Russia (highest prevalence, although 84 countries have had documented XDR, including the US.)

Diagnosis:

- Plating on agar or liquid media for drug susceptibility testing

Treatment:

- Should be guided by susceptibility testing

- Isolate the patient!

Bottom Line:

XDR TB is increasing in prevalence, have a high index of suspicion in patients with persistent symptoms who are receiving treatment and isolate if any concerns.

University of Maryland Section of Global Emergency Health

Author: Andi Tenner, MD, MPH

References

 

Abubakar I, Zignol M, Falzon D, et al.  Drug-resistant tuberculosis: time for visionary political leadership.  The Lancet. 2013. Accessed online at http://dx.doi.org/10.1016/S1473-3099(13)70030-6 on August 14, 2013.

http://www.cdc.gov/tb/publications/factsheets/drtb/xdrtb.htm