STUDY OF CLINICO-PATHOLOGICAL PROFILE, RADIOLOGICAL PATTERN OF NEW SMEAR POSITIVE (CATEGORY I) PULMONARY TUBERCULOSIS RIFAMPICIN-RESISTANT PATIENTS IN SRMSIMS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 15
Abstract
BACKGROUND Tuberculosis (TB) is a curable and preventable disease, which is caused by Mycobacterium TB (MTB). It most commonly affects the lungs, but can potentially involve any system or organ of the body. It is estimated that one untreated infectious TB patient is likely to infect 10 - 15 people, because when they cough or sneeze they expel large number of droplets containing large number of bacteria. Sputum smear positive (SSP) pulmonary TB patients are the most significant source of droplet nuclei, which carry infectious bacilli. The situation is made worse by the emergence of drug-resistant TB, particularly the multi-drug resistant (MDR) and extensively drug-resistant (XDR) TB. A case of MDR-TB is about 20 - 40 times more expensive to manage than a case of drugsensitive. Aims and Objectives- To study the profile of patient’s symptoms, signs and radiological abnormalities in new smear positive pulmonary tuberculosis Rifampicin-resistant patients. MATERIALS AND METHODS 60 patients who were new smear positive, admitted during 6 months period were seen for Rifampicin resistance and studied for clinico-pathological profile and radiological pattern. RESULTS 60 patients were studied, out of those 60 patients, 5 patients were documented with Rifampicin resistance, and all of them belonged to 2nd, 3rd and 4th decade, i.e. younger age group and 80% were males and 20% were females with male-to-female ratio of 4:1 respectively. Cough (100%), breathlessness (100%), fever (80%) and weight loss (80%) were the most common presenting clinical features. The chest x-ray of rifampicin resistance patients showed that 81.7% had unilateral and 18.3% had bilateral disease. Out of those, 40% had destroyed lung, 40% had cavitatory lesions and 20% had bronchiectasis with infiltration on chest xray (PA view). CONCLUSION One of the concerning issues was that there were no definitive clinical or routine investigations connected with rifampicin resistance, thus showing that passage of resistant strain is quite prevalent in society. To tackle this problem, it is recommended that drug resistance evaluation should be made mandatory part of the tuberculosis control programme and appropriate customised management strategies in view of the drug resistance pattern of individual patient should be made.
Authors and Affiliations
Rajeev Tandon, Sumit Prakash, Anurag Agrawal, Lalit Singh
Keywords
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