Morehead R S
Division of Pulmonary and Critical Care Medicine, University of Kentucky School of Medicine and Veterans Affairs Medical Center, Lexington, USA.
South Med J. 2000 May;93(5):507-10.
A patient with fulminant pulmonary tuberculosis died after 41 days of intensive care despite pansensitive organisms and no known underlying immunosuppression. Two factors leading to death in this patient were a delay in seeking medical attention and a subtherapeutic serum level of rifampin, though no obvious evidence of malabsorption existed. Malabsorption of antitubercular drugs is under-recognized and of extreme importance in the treatment of critically ill patients with active pulmonary tuberculosis. Factors associated with mortality from tuberculosis and selected aspects of critical care management are discussed.
一名暴发性肺结核患者在重症监护41天后死亡，尽管病原体对所有药物敏感且无已知的潜在免疫抑制。导致该患者死亡的两个因素是就医延迟和利福平血清水平未达到治疗剂量，尽管没有明显的吸收不良证据。抗结核药物吸收不良未得到充分认识，在重症活动性肺结核患者的治疗中极为重要。本文讨论了与结核病死亡率相关的因素以及重症监护管理的某些方面。
