A Case Report: Rifampicin-Resistant Tuberculosis
Background: Rifampicin-resistant TB (RR-TB) defined as resistance to rifampicin detected using genotypic or phenotypic methods with or without resistance to other first-line anti-TB drugs. Multidrug-resistant tuberculosis (MDR-TB) is defined as disease due to Mycobacterium tuberculosis that is resistant to isoniazid (H) and rifampicin (R) with or without resistance to other drugs. At the global report, Indonesia was ranked 8th out of 27 countries with the highest burden of MDR-TB/RR-TB in the world. East java was ranked 2nd out of 33 provinces with the highest burden of MDR TB/RR-TB based on Indonesia’s epidemiological data in 2016.
Case presentation: A 44-years-old man came to emergency room. Patient complained of breathless. He complained that he was often coughing up the blood and green phlegm. He felt weight and appetite loss significantly. Patient also often got fever since 1 month ago. The patient complained of 3 small lumps in the left neck. The lumps were chewy, solid, and have clear line. The patient has never been diagnosed as having tuberculosis and never consumed anti-tuberculosis drug. Based on physical examination, there was decreased of blood pressure, increased of respiratory rate and body temperature, decreased of fremitus palpation and vesicular sound in both of right and left lung, and also the rhonchi sound on auscultation. Chest X-Ray examination revealed pulmonary tuberculosis. MTB and Rifampicin Resistant were detected on Rapid molecular tuberculosis test. Tuberculous lymphadenitis was diagnosed using FNAB test. Based on WHO, he must have been treated using conventional standart combination drugs.
Conclusion: In this paper, we report the rare case of 44 years old man who was diagnosed as having Rifampicin-Resistant tuberculosis although he has never been diagnosed as having tuberculosis in the past.
Keywords - Rifampicin-Resistant TB, Multidrug-Resistant Tuberculosis, Tuberculous Lymphadenitis, Conventional Standart Combination Drugs.