Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Church of Scotland Hospital, Tugela Ferry, KwaZulu-Natal, South Africa.
Lancet Respir Med. 2015 Apr;3(4):269-70. doi: 10.1016/S2213-2600(15)00109-5.
In early 2014, a man aged 46 years with HIV and a distant history of tuberculosis treatment was admitted to the communal medical ward of a district hospital in rural KwaZulu-Natal, South Africa, in respiratory distress. He was initially treated empirically for bacterial pneumonia. Sputum taken on day 5 of his hospital stay was positive for acid-fast bacilli with rifampicin resistance on line probe assay. After 11 days in hospital, his doctors learned that he had previously failed treatment for extensively drug-resistant (XDR) tuberculosis and had been discharged without being given further treatment options. He had been living at home with his wife, elderly mother, and five young children, sharing a bedroom with several other family members. The patient and his family believed he had successfully completed treatment; they did not understand his prognosis or the transmissibility of his disease.
2014 年初，一名 46 岁的艾滋病毒感染者和结核病治疗的遥远病史的男子因呼吸窘迫住进了南非夸祖鲁-纳塔尔省农村地区一家区医院的公共医疗病房。他最初被经验性地治疗细菌性肺炎。他在住院第 5 天的痰液经抗酸杆菌检测呈阳性，利福平耐药线探针检测呈阳性。在住院 11 天后，他的医生得知他之前曾因广泛耐药性（XDR）结核病治疗失败，出院时没有得到进一步的治疗方案。他与妻子、年迈的母亲和五个年幼的孩子住在一起，与其他几个家庭成员共用一间卧室。患者和他的家人认为他已经成功完成了治疗；他们不了解他的预后或疾病的传染性。
