Surgery in Extensively Drug Resistant Tuberculosis, Emphasized in the Preventing of Disease Transmision to the Environment: Case Study in Persahabatan Hospital


Panji Utomo, Susan Hendriarini Mety, Agung Wibawanto

The burden of tuberculosis in Indonesia has become more emerging and challenging with the increasing number of multidrug resistant tuberculosis (MDR TB) and the extensively drug resistant tuberculosis (XDR TB). The XDR TB is defined as resistance to at least rifampicin and isoniazid (which is the definition of MDR TB), in addition to any fluoroquinolone, and to at least one of the three injectable drugs used in anti-TB treatment: capreomycin, kanamycin and amikacin. Medical treatment only is not adequate, as its consequences are; long medication period, high toxicity, and low curability. Surgery is a part of the multimodality treatment for MDR/XDR TB, to achieve the negative sputum smear or culture for fast acid bacilli (FAB). We reported a case of XDR TB, has been receiving 18 months medical therapy with persistent positive sputum smear for FAB. We performed upper lobectomy and apical segmentectomy of the left lung. The surgical aspect of MDR/XDR TB management is discussed in this paper, and the prevention of the disease transmission to health care giver, other patients, and environment will be emphasized. (J Respir Indo. 2013; 33:122-5)

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