Development of multidrug-resistant Mycobacterium tuberculosis in the biofilm of a peritoneal-venous shunt
Publication Title
IDCases
Document Type
Article
Publication Date
1-1-2023
Keywords
washington; spokane; pshmc; Biofilm; Denver catheter; Foreign body; Multi-drug resistance; Relapse; Tuberculosis
Abstract
A patient with ascites received a peritoneal-venous shunt for presumed cirrhosis, however surgical specimens grew Mycobacterium tuberculosis (MTb) sensitive to all anti-tuberculous drugs. Directly-Observed-Therapy (DOT) led to improvement followed by relapse with multidrug resistant MTb (MDRTB). We discuss pathways for selection of MDRTB within mycobacterial biofilm. This case illustrates the potential for development of MDRTB in patients with long-term indwelling catheters. We emphasize catheter removal and if not possible continuing follow-up for symptoms and signs of relapse.
Specialty
Infectious Diseases
Specialty
Pharmacy
Specialty
Internal Medicine
DOI
10.1016/j.idcr.2023.e01801