Fistulized multidrug-resistant tuberculosis
Naoual El Omri, Fadwa Mekouar
The Pan African Medical Journal. 2017;26:67. doi:10.11604/pamj.2017.26.67.11745

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Fistulized multidrug-resistant tuberculosis

Cite this: The Pan African Medical Journal. 2017;26:67. doi:10.11604/pamj.2017.26.67.11745

Received: 23/01/2017 - Accepted: 31/01/2017 - Published: 05/02/2017

Key words: Tuberculosis, multiresistant, fistula

© Naoual El Omri et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/26/67/full

Corresponding author: Naoual El Omri, Internal Medicine Department, Mohammed V Military Teaching Hospital, Rabat, Morocco (elomrinaoual@gmail.com)


Fistulized multidrug-resistant tuberculosis

Naoual El Omri1,&, Fadwa Mekouar1

 

1Internal Medicine Department, Mohammed V Military Teaching Hospital, Rabat, Morocco

 

 

&Corresponding author
Naoual El Omri, Internal Medicine Department, Mohammed V Military Teaching Hospital, Rabat, Morocco

 

 

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A 21-year-old woman with no history of tuberculosis was admitted to the emergency room with an acute abdominal accompanied by fever. She underwent an emergency abdominal operation surgery and histological studies revealed a peritoneal and appendicular ovarian tuberculosis. The patient received antibacillar (Rifampicine, Isoniazid, Pyrazinamide). Two months later, she was readmitted with fever and a general physical deterioration while being on antituberculosis medications. Chest X-Ray and CT scan revealed a miliary tuberculosis with pleural and peritoneal effusion and lymphadenopathy above and below the diaphragm. HIV serology was negative. This peritoneal collection had caused a fistula on the abdominal wall with two sinus tracts in the midline. The bacteriological examination of the purulent material revealed a Mycobacterium tuberculosis with a high resistance to all anti-bacillar drugs except Etambuthol and Pyrazinamide. The patient was treated by etionamide, pyrazinamide, spiramycin and etambutole, with favorable outcome.

 

Figure 1: two sinus tracts in the midline of abdominal wall and abdominal computed tomography showing the sinus tract

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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ISSN: 1937-8688. © 2017 - Pan African Medical Journal. All rights reserved