Primary Pre-Extensively Drug-Resistant Tuberculosis (Pre XDR-TB) Pulmonary Tuberculosis with Diabetes Mellitus: A Case Report

DOI

10.2991/978-94-6239-836-8_15How to use a DOI?

Keywords

Drug-resistant tuberculosis; pre-extensively drug-resistant tuberculosis; diabetes mellitus

Abstract

Drug-resistant tuberculosis remains a major challenge in tuberculosis control, and the occurrence of resistance in patients without any prior treatment history raises concern about the transmission of resistant strains within the community. We report the case of a 63-year-old woman presenting with cough for more than two months, marked weight loss, and intermittent fever, without any previous tuberculosis treatment or known contact with a tuberculosis patient. She had a history of diabetes mellitus. Physical examination revealed bronchial breath sounds with rhonchi, and chest radiography revealed infiltration at the right upper lung apex. Rapid molecular testing detected Mycobacterium tuberculosis with resistance to rifampicin, and second-line drug susceptibility testing further revealed additional resistance to isoniazid, fluoroquinolone, and ethionamide, leading to a diagnosis of primary pre-extensively drug-resistant tuberculosis. Random blood glucose was elevated and was managed with insulin, while mild hypochromic anaemia was managed with iron supplementation. The patient received bedaquiline, pretomanid, and linezolid, and remained clinically stable without significant adverse effects after one week of therapy. This case highlights the importance of vigilance for primary drug-resistant tuberculosis and the role of rapid molecular testing in early diagnosis and appropriate treatment selection.

Copyright

© 2026 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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TY  - CONF
AU  - Nina Herlina
AU  - Darween Rozehan Shah Iskandar Shah
PY  - 2026
DA  - 2026/11/11
TI  - Primary Pre-Extensively Drug-Resistant Tuberculosis (Pre XDR-TB) Pulmonary Tuberculosis with Diabetes Mellitus: A Case Report
BT  - Proceedings of the3rd Malikussaleh International Conference on Health and Disaster Medicine 2026  (MICOHEDMED 2026)
PB  - Atlantis Press
SP  - 162
EP  - 169
SN  - 2468-5739
UR  - https://doi.org/10.2991/978-94-6239-836-8_15
DO  - 10.2991/978-94-6239-836-8_15
ID  - Herlina2026
ER  -