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Journal of Clinical Microbiology, February 2009, p. 507-510, Vol. 47, No. 2
0095-1137/09/$08.00+0     doi:10.1128/JCM.01473-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

CASE REPORT

Evolution of Central Nervous System Multidrug-Resistant Mycobacterium tuberculosis and Late Relapse of Cryptic Prosthetic Hip Joint Tuberculosis: Complications during Treatment of Disseminated Isoniazid-Resistant Tuberculosis in an Immunocompromised Host{triangledown}

Arlo Upton,1,{dagger} Andrew Woodhouse,2,{ddagger} Ross Vaughan,1 Sandie Newton,1 and Rod Ellis-Pegler2*

Clinical Microbiology, Auckland City Hospital, Auckland, New Zealand,1 Department of Infectious Diseases, Auckland City Hospital, Auckland, New Zealand2

Received 31 July 2008/ Returned for modification 10 November 2008/ Accepted 14 December 2008

We report a case of disseminated isoniazid-resistant tuberculosis in an immunocompromised patient with evolution of rifampin (rifampicin) resistance in the central nervous system. This was cured with intraventricular and oral treatment but was followed by a late relapse of the original infection in a prosthetic hip joint. We provide drug levels in cerebrospinal fluid and serum.

* Corresponding author. Mailing address: Medical Specialists' Group, 100 Mountain Rd., Epsom, Auckland, New Zealand. Phone: 64 9 6231170. Fax: 64 9 6231172. E-mail: rodbep{at}gmail.com

{triangledown} Published ahead of print on 24 December 2008.

{dagger} Present address: Auckland Clinical Studies, Auckland, New Zealand.

{ddagger} Present address: Dept. of Clinical Microbiology and Infectious Diseases, Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom.

Journal of Clinical Microbiology, February 2009, p. 507-510, Vol. 47, No. 2
0095-1137/09/$08.00+0     doi:10.1128/JCM.01473-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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