A Unique Case of Cure of the Patient with Disseminated Bilateral Fibrous Cavernous Pulmonary Tuberculosis with Extensive Drug Resistance after 18 Years of Treatment Failures
O. G. Komissarova,
A. M. Tikhonov,
V. A. Shorokhova,
O. V. Lovacheva,
N. A. Chernykh,
R. Yu. Abdullaev https://doi.org/10.58838/2075-1230-2024-102-6-108-117
Abstract
The article describes a unique clinical case of 18-year comprehensive treatment of the patient with disseminated fibrous cavernous pulmonary tuberculosis with extensive drug resistance, continuous bacterial excretion and severe concomitant pathology resulting in successful cure of tuberculosis. It demonstrates the complexity of the decision-making on patient management tactics as well as a rare example of exceptional patient adherence to treatment.
Keywords
tuberculosis,
treatment,
short-course chemotherapy regimens,
adverse reactions to anti-tuberculosis drugs,
adherence to
treatment
Supporting agencies: Part of the work was carried out with the financial support of TB Alliance; from 2015 to 2022 it funded a 6-month study with the B-Pa-L regimen in XDR TB or MDR TB patients who were intolerant to treatment or developed treatment failure (the ZeNix study).
About the Authors
O. G. Komissarova
Central Tuberculosis Research Institute; Pirogov Russian National Research Medical University, Russian Ministry of Health
Russian Federation
Russian Federation
Oksana G. Komissarova - Doctor of Medical Sciences, Deputy Director for Scientific and Medical Work, Professor of Phthisiology Department, Faculty of General Medicine, Pirogov Russian National Research Medical University, Russian Ministry of Health
2 Yauzskaya Alleya, Moscow, 107564
Phone: +7 (499) 785-90-27
A. M. Tikhonov
Central Tuberculosis Research Institute
Russian Federation
Russian Federation
Aleksey M. Tikhonov - Candidate of Medical Sciences, Deputy Head Physician
2 Yauzskaya Alleya, Moscow, 107564
Phone: +7 (499) 785-90-27
V. A. Shorokhova
Central Tuberculosis Research Institute
Russian Federation
Russian Federation
Violetta A. Shorokhova - Candidate of Medical Sciences, Researcher of Department of Pathomorphology, Cellular Biology and Biochemistry
2 Yauzskaya Alleya, Moscow, 107564
Phone: +7 (499) 785-90-27
O. V. Lovacheva
National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Russian Ministry of Health
Russian Federation
Russian Federation
Olga V. Lovacheva - Doctor of Medical Sciences, Professor, Chief Researcher of Department of Differential Diagnosis and Treatment of Tuberculosis and Concurrent Infections
Build. 2, 4 Dostoevskiy St., Moscow, 127473
Phone: +7 (495) 681-11-66
N. A. Chernykh
Central Tuberculosis Research Institute
Russian Federation
Russian Federation
Natalia A. Chernykh - Candidate of Medical Sciences, Head of Therapy Department no. 3
2 Yauzskaya Alleya, Moscow, 107564
Phone: +7 (499) 785-90-27
R. Yu. Abdullaev
Central Tuberculosis Research Institute
Russian Federation
Russian Federation
Rizvan Yu. Abdullaev - Doctor of Medical Sciences, Professor, Head of Department of Pathomorphology, Cellular Biology and Biochemistry
2 Yauzskaya Alleya, Moscow, 107564
Phone: +7 (499) 785-90-27
References
1. Abdullaev R.Yu., Komissarova O.G., Chumakova E.S., Odinets V.S., Ergeshov A.E. Hepatotoxic reactions during treatment of newly diagnosed patients with pulmonary multiple drug resistant tuberculosis. Tuberculosis and Lung Diseases, 2019, vol. 97, no. 7, pp. 21-27. (In Russ.) https://doi.org/10.21292/2075-1230-2019-97-7-21-27
2. Vasilyeva I.A., Samoylova A.G., Zimina V.N., Lovacheva O.V., Abramchenko A.V. Chemotherapy for tuberculosis in Russia – the story continues. Tuberculosis and Lung Diseases, 2023, vol. 101, no. 2, pp. 8-12. (In Russ.) https://doi.org/10.58838/2075-1230-2023-101-2-8-12
3. Gayda A.I., Abramchenko A.V., Romanova M.I., Toichkina T.V., Burykhin V.S., Borisov S.E. et al. Justification of chemotherapy duration in patients with multiple and pre-extensive drug resistant tuberculosis in the Russian Federation. Tuberculosis and Lung Diseases, 2022, vol. 100, no. 12, pp. 44-53. (In Russ.) https://doi.org/10.21292/2075-1230-2022-100-12-44-53
4. Golubchikov P.N., Petrenko T.I., Schegertsov D.Yu., Stepanova E.P., Pravdina I.I., Pershina I.Yu. Immediate and postponed results of short-course chemotherapy regimens containing bedaquiline in tuberculosis patients with multiple drug resistance. Tuberculosis and Lung Diseases, 2023, vol. 101, no. 4, pp. 72-79. (In Russ.) https://doi.org/10.58838/2075-1230-2023-101-4-72-79
5. Ivanova D.A., Tityukhina M.V. Drug-associated liver disorders in tuberculosis patients. Tuberkulez i Sotsialno-Znachimye Zabolevaniya, 2014, no. 1-2, pp. 32-43. (In Russ.)
6. Kasaeva T.Ch., Belostotskiy A.V., Kuzmina N.V., Nelidova N.V. Problem of treatment adherence in tuberculosis patients. Tuberculosis and Lung Diseases, 2015, no. 4, pp. 4-8. (In Russ.)
7. Kildyusheva E.I., Skornyakov S.N., Medvinsky I.D., Motus I.D., Zaletayeva G.E., Savelyev A.V. Pneumoperitoneum in the comprehensive treatment of disseminated destructive pulmonary tuberculosis. Uralskiy Meditsinskiy Journal, 2013, no. 2, pp. 69-75. (In Russ.)
8. Komissarova O.G., Tikhonov A.M., Shorokhova V.A., Abdullaev R.Yu., Romanov V.V., Ergeshov A.E. Efficacy and safety of short-course chemotherapy with pretomanid in patients with multiple and extensive drug resistance of M. tuberculosis. Siberian Medical Review, 2023, no. 4, pp. 83-90. (In Russ.) https://doi.org/10.20333/25000136-2023-4-83-90
9. Lovacheva O.V., Bagirov M.A., Bagdasaryan T.R., Krasnikova E.V., Shergina E.A., Gritsay I.Yu. Use of endobronchial valves and extrapleural plombage for treatment of bilateral massive cavities in a female patient with multiple drug resistant pulmonary tuberculosis. Tuberculosis and Lung Diseases, 2017, no. 9, pp. 60-66. (In Russ.)
10. Maryandyshev A.O., Kulizhskaya A.I., Khimova E.S., Perkhin D.V., Sveshnikova O.M., Presnova S.E., Kurochkina N.P., Sotnikov A.S., Lesheva N.A., Vasilyeva I.A. Short course treatment regimens for multiple drug resistant tuberculosis in Arkhangelsk, Murmansk and Belgorod Regions. Tuberculosis and Lung Diseases,2019, vol. 97, no. 7, pp. 5-10. (In Russ.) https://doi.org/10.21292/2075-1230-2019-97-7-5-10
11. Mordyk A.V., Ivanova O.G., Nagibina L.A., Sitnikova S.V., Maryekhina O.A. Drug-induced liver lesions and their management in the clinical picture of tuberculosis. Tuberculosis and Lung Diseases, 2015, no. 9, pp. 47-53. (In Russ.)
12. Edict no. 127N by the Russian Ministry of Health as of March 13, 2019 On Approval of the Procedure of Dispensary Follow-up over Tuberculosis Patients, Those Exposed to Tuberculosis Infection, and Persons Suspected to Have Tuberculosis and Cured of Tuberculosis and the Recognition of Clauses 16-17 of the Procedure of Medical Care for Tuberculosis Patients, Approved by Edict no. 932n of the Russian Ministry of Health as of November 15, 2012, as no longer valid. (In Russ.) Available: https://www.minzdrav.gov.ru/system/attachments/attaches/000/054/529/original/Приказ_№_127н_от_13.03.2019.pdf?1612443232 Accessed January 01, 2024
13. Starshinova A.A., Dovgalyuk I.F., Osipov N.N., Kudlay D.A. Bedaquiline efficacy in the Russian Federation: meta-analysis with a random effects model. Tuberculosis and Lung Diseases, 2023, vol. 101, no. 3 pp. 52-61. (In Russ.) https://doi.org/10.58838/2075-1230-2023-101-3-52-61
14. Yablonskiy P.K., Vasiliev I.V., Sokolovich E.G. The role of surgery in diagnostics and treatment of pulmonary tuberculosis (review of literature). Vestnik Sankt-Peterburgskogo Universiteta, 2016, no. 3, pp. 64-70. (In Russ.) https://doi.org/10.21638/11701/spbu11.2016.306
15. Global tuberculosis report 2023. Geneva, World Health Organization, 2023. Licence: CC BY-NC-SA 3.0 IGO. Available: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2023 Accessed August 08, 2024
16. Horter S., Stringer B., Greig J., Amangeldiev A., Tillashaikhov M.N., Parpieva N., Tigay Z., du Cros P. Where there is hope: a qualitative study examining patients' adherence to multi-drug resistant tuberculosis treatment in Karakalpakstan, Uzbekistan. BMC Infect. Dis., 2016, no. 16, pp. 362. https://doi.org/10.1186/s12879-016-1723-8
17. Shringarpure K., Gurumurthy M., Sagili K.D., Taylor M., Garner P., Tonsing J., Rao R., Sachdeva K.S. Patient adherence to tuberculosis treatment in the Indian subcontinent: systematic review and meta-synthesis of qualitative research. BMJ Open, 2023, vol. 13, no. 5, pp. e063926. https://doi.org/10.1136/bmjopen-2022-063926
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For citations:
Komissarova O.G., Tikhonov A.M., Shorokhova V.A., Lovacheva O.V., Chernykh N.A., Abdullaev R.Yu. A Unique Case of Cure of the Patient with Disseminated Bilateral Fibrous Cavernous Pulmonary Tuberculosis with Extensive Drug Resistance after 18 Years of Treatment Failures. Tuberculosis and Lung Diseases. 2024;102(6):108-117. (In Russ.) https://doi.org/10.58838/2075-1230-2024-102-6-108-117
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