Katoto Patrick D M C, Musole Patrick, Maheshe Ghislain, Bamuleke Bertrand, Murhula Aime, Balungwe Patrick, Byamungu Liliane N
Department of Internal Medicine, Division of Respiratory Medicine & Prof. Lurhuma Biomedical Research Laboratory, Mycobacterium Unit, The Expertise Center on Mining Governance (CEGEMI), Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.
Department of Global Health, Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Respir Med Case Rep. 2020 Sep 28;31:101234. doi: 10.1016/j.rmcr.2020.101234. eCollection 2020.
We report a case of extensive pulmonary destruction due to delayed effective pulmonary tuberculosis (TB) treatment in an adult artisanal miner in eastern Democratic Republic of Congo. Xpert MTB/RIF was positive after his second rifampicin-susceptible TB treatment. Chest X-rays were suggestive of large cavity, fibrosis of remaining lung and air-fluid levels at the base of the destroyed lung. The patient passed away after delayed effective TB regimens. Clinicians should be aware that urgent surgical intervention is often required to prevent lethal acute respiratory failure and shock notwithstanding effective chemotherapy in such condition. Effort is needed to timely diagnose multidrug resistance TB and to implement thoracic surgery for TB in high burden countries.
我们报告了刚果民主共和国东部一名成年手工矿工因延迟有效治疗肺结核（TB）而导致广泛肺部破坏的病例。在他接受第二次对利福平敏感的结核病治疗后，Xpert MTB/RIF检测呈阳性。胸部X光片显示有大空洞、剩余肺组织纤维化以及被破坏肺底部的气液平面。在延迟有效的结核病治疗方案后，该患者去世。临床医生应意识到，尽管在此类情况下有有效的化疗，但往往仍需要紧急手术干预以防止致命的急性呼吸衰竭和休克。在高负担国家，需要努力及时诊断耐多药结核病并实施结核病胸外科手术。
