PMID- 30604698
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231005
IS  - 0970-2113 (Print)
IS  - 0974-598X (Electronic)
IS  - 0970-2113 (Linking)
VI  - 36
IP  - 1
DP  - 2019 Jan-Feb
TI  - Extrapulmonary drug-resistant tuberculosis at a drug-resistant tuberculosis 
      center, Mumbai: Our experience - Hope in the midst of despair!
PG  - 3-7
LID - 10.4103/lungindia.lungindia_192_18 [doi]
AB  - BACKGROUND: Drug-resistant tuberculosis (DR-TB) is a global problem with only 52% 
      reported cure rate. Extrapulmonary (EP) DR-TB poses a formidable diagnostic, 
      therapeutic challenge. We aimed to study their clinical profile and treatment 
      outcomes under the programmatic setting. MATERIALS AND METHODS: This 
      retrospective observational study included the database of consecutive EPDR-TB 
      cases enrolled at the DR-TB center from 2012 to 2014. The demographic, clinical 
      details, drug susceptibility tests (DSTs), follow-up, therapy, adverse events 
      (AEs), and outcome were reviewed. Statistical analysis was done using percentages 
      and mean. RESULTS: Of total 1743 DR-TB patients, 76 (4.4%) EPDR-TB cases were 
      included. These consisted of 53 (69.7%) adults and 23 (30.3%) children, with 
      female preponderance. The mean age in adults and children was 27.96 (9.63) and 
      12.56 (3.83), respectively. EP sites involved were lymph nodes in 39 (51.3%), 
      spine in 15 (19.7%), other bones in 6 (7.9%), pleural effusion in 9 (11.9%), 
      central nervous system in 2 (2.6%), and disseminated EP disease in 5 (6.6%). 
      Forty-one (53.9%) had multi-DR-TB (MDR-TB), 29 (38.2%) MDR-TB with 
      fluoroquinolone resistance preextensively DR-TB (Pre-XDR-TB (FQ)), 1 (1.3%) 
      MDR-TB with aminoglycoside resistance (Pre-XDR-TB (AM)), and 5 (6.6%) extensively 
      DR-TB (XDR-TB) on DST. Thirteen (17.11%) had comorbidities. None had HIV. Two 
      (2.63%) had DM. Patients were treated as per the revised TB control program - 
      programmatic management of DR-TB guidelines. Duration of intensive (IP) was 6.55 
      (1.22) months. Ten (13.2%) received shorter regimens, wherein therapy was stopped 
      at 12-18 months due to severe adverse drug reactions and treatment response. 
      Sixty-two (81.6%) completed treatment, 8 (10.5%) defaulted, 3 (4%) died, 2 (2.6%) 
      failed, and 1 (1.3%) was transferred out. Two-third of patients reported AE. 
      CONCLUSION: The prevalence of EP cases in DR-TB was 4.4%. Treatment completion 
      rate was very high (81.6%). Shorter regimens were efficacious.
FAU - Desai, Unnati
AU  - Desai U
AD  - Department of Pulmonary Medicine, T. N. Medical College, B. Y. L. Nair Hospital, 
      Mumbai, Maharashtra, India.
FAU - Joshi, Jyotsna M
AU  - Joshi JM
AD  - Department of Pulmonary Medicine, T. N. Medical College, B. Y. L. Nair Hospital, 
      Mumbai, Maharashtra, India.
LA  - eng
PT  - Journal Article
PL  - India
TA  - Lung India
JT  - Lung India : official organ of Indian Chest Society
JID - 8405380
PMC - PMC6330803
OTO - NOTNLM
OT  - Extrapulmonary
OT  - shorter regimen
OT  - treatment outcome
COIS- None
EDAT- 2019/01/04 06:00
MHDA- 2019/01/04 06:01
PMCR- 2019/01/01
CRDT- 2019/01/04 06:00
PHST- 2019/01/04 06:00 [entrez]
PHST- 2019/01/04 06:00 [pubmed]
PHST- 2019/01/04 06:01 [medline]
PHST- 2019/01/01 00:00 [pmc-release]
AID - LungIndia_2019_36_1_3_249161 [pii]
AID - LI-36-3 [pii]
AID - 10.4103/lungindia.lungindia_192_18 [doi]
PST - ppublish
SO  - Lung India. 2019 Jan-Feb;36(1):3-7. doi: 10.4103/lungindia.lungindia_192_18.