CLINICAL CASES OF FOCAL PULMONARY TUBERCULOSIS IN CHILDREN WITH MINIMUM INVOLVEMENT IN MULTIDRUG RESISTANCE IN MYCOBACTERIUM TUBERCULOSIS

Abstract

The paper describes two clinical cases of progressive focal pulmonary tuberculosis in 11- and 12-year-old children. Chemotherapy regimen III was used because of the absence of bacterial excretion and the mild involvement of lung tissue. Following 4-month therapy, a focal decay appeared in the left lung (C1-2) of the former patient. The female patient was operated on. M. tuberculosis DNA was identified by PCR in her intraoperative specimen; isoniazid and rifampicin resistance was determined. Occult multidrug resistance was a reason for ineffective treatment with first-line drugs. After 6-month chemotherapy, the size of a focus in the right left (C1-2) doubled and a new focal shadow emerged in the lung of the latter patient. The progression was related to the untimely obtained information on a broad drug resistance in the infection pathogen and to the chemotherapy performed by ignoring these data. Chemotherapy correction in view of the data of a drug susceptibility test could provide a positive result in both cases.