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General Information:
XDR TB is “extensively drug resistant tuberculosis”—resistant to isoniazid, rifampin, any fluoroquinolone, and at least one of the 3 injectable 2nd line drugs
Clinical Presentation:
- Identical to regular TB (weight loss, fevers, night sweats, cough, hemoptysis)
- Suspect in patients who are failing usual treatment
-Exposure in Eastern Europe or Russia (highest prevalence, although 84 countries have had documented XDR, including the US.)
Diagnosis:
- Plating on agar or liquid media for drug susceptibility testing
Treatment:
- Should be guided by susceptibility testing
- Isolate the patient!
Bottom Line:
XDR TB is increasing in prevalence, have a high index of suspicion in patients with persistent symptoms who are receiving treatment and isolate if any concerns.
University of Maryland Section of Global Emergency Health
Author: Andi Tenner, MD, MPH
References
Abubakar I, Zignol M, Falzon D, et al. Drug-resistant tuberculosis: time for visionary political leadership. The Lancet. 2013. Accessed online at http://dx.doi.org/10.1016/S1473-3099(13)70030-6 on August 14, 2013.
http://www.cdc.gov/tb/publications/factsheets/drtb/xdrtb.htm