RESUMEN
In the context of rising rates of drug-resistant tuberculosis (TB) in India, this communication presents some field observations during screening of new cases registered with the Revised National Tuberculosis Control Programme (RNTCP) in urban and rural areas of Maharashtra, India. It appears that erroneous categorisation and treatment that contributes to multiple drug resistance results from a lack of patient screening for previous treatment, ambiguity in categorisation and reluctance to disclose a history of anti-tuberculosis treatment. Suggested measures include detailed screening of new cases, computerisation of patient records and an empathetic dialogue between patient and health care provider.
Asunto(s)
Antituberculosos/uso terapéutico , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , India , Población Rural , Resultado del Tratamiento , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Población UrbanaRESUMEN
Rhodocci have a morphology similar to that of Mycobacterium tuberculosis (TB), and are indistinguishable from normal diphtheroid flora. Symptoms include fever, productive/non-productive cough and pleuritic chest pain. Rhodococcal infections, being resistant to routine anti-tuberculosis medications, may be misdiagnosed as drug-resistant TB, thus prompting treatment for TB with rifampicin-containing regimens that promote the emergence of resistance. We present here a sputum smear AFB-positive case who, although clinically cured, remains unresolved despite a series of technological investigations as to the cause of infection being purely rhodococci or mixed infection with M. tuberculosis.