A miner with No left lung: Extensive pulmonary destruction in delayed effective Multi-Drug-Resistant Tuberculosis treatment

Patrick D M C Katoto; Patrick Musole; Ghislain Maheshe; Bertrand Bamuleke; Aime Murhula; Patrick Balungwe; Liliane N Byamungu

doi:10.1016/j.rmcr.2020.101234

A miner with No left lung: Extensive pulmonary destruction in delayed effective Multi-Drug-Resistant Tuberculosis treatment

Respir Med Case Rep. 2020 Sep 28:31:101234. doi: 10.1016/j.rmcr.2020.101234. eCollection 2020.

Authors

Patrick D M C Katoto^{1

2}, Patrick Musole¹, Ghislain Maheshe³, Bertrand Bamuleke¹, Aime Murhula¹, Patrick Balungwe⁴, Liliane N Byamungu^{5

6}

Affiliations

¹ Department of Internal Medicine, Division of Respiratory Medicine & Prof. Lurhuma Biomedical Research Laboratory, Mycobacterium Unit, The Expertise Center on Mining Governance (CEGEMI), Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.
² Department of Global Health, Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
³ Department of Medical Imagery, Provincial General Hospital of Bukavu, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.
⁴ Department of Otorhinolaryngology, Provincial General Hospital of Bukavu, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.
⁵ Department of Paediatric, Provincial General Hospital of Bukavu, Catholic University of Bukavu, Bukavu, Democratic Republic of the Congo.
⁶ Department of Paediatric, University of KwaZulu Natal, Durban, South Africa.

Abstract

We report a case of extensive pulmonary destruction due to delayed effective pulmonary tuberculosis (TB) treatment in an adult artisanal miner in eastern Democratic Republic of Congo. Xpert MTB/RIF was positive after his second rifampicin-susceptible TB treatment. Chest X-rays were suggestive of large cavity, fibrosis of remaining lung and air-fluid levels at the base of the destroyed lung. The patient passed away after delayed effective TB regimens. Clinicians should be aware that urgent surgical intervention is often required to prevent lethal acute respiratory failure and shock notwithstanding effective chemotherapy in such condition. Effort is needed to timely diagnose multidrug resistance TB and to implement thoracic surgery for TB in high burden countries.

Keywords: Complication; Democratic republic of Congo; Mycobacterium tuberculosis; Thoracic surgery.

Publication types

Case Reports