Epidural Abscess Due to a Mycobacterium tuberculosis Strain with Primary Resistance to Isoniazid and Ethambutol

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dc.authoridAlper Akçalı/0000-0003-0325-886X
dc.contributor.authorSener, Alper
dc.contributor.authorAlper Akçalı
dc.contributor.authorKaratag, Ozan
dc.contributor.authorKosar, Sule
dc.contributor.authorDegirmenci, Yildiz
dc.contributor.authorAkman, Tarik
dc.date.accessioned2025-01-27T20:59:53Z
dc.date.available2025-01-27T20:59:53Z
dc.date.issued2012
dc.departmentÇanakkale Onsekiz Mart Üniversitesi
dc.description.abstractTuberculosis is primarily characterized by pulmonary involvement, however, one third of the cases exhibit extrapulmonary tuberculosis. In this report, a case of epidural abscess due to Mycobacterium tuberculosis with primary resistance to isoniazid and ethambutol was presented. A 57-year-old male patient was admitted to emergency service with ten days history of weakness in legs, disability of walking and fever. Neurological examination revealed paraplegia of lower extremities, numbness distal to T2 disc level and hyperactivity of deep tendon reflexes indicating transverse myelitis. Laboratory findings were as follows; ESR: 74 mm/hour, CRP: 22 g/L, ALT: 42 IU/L, AST: 45 IU/L and white blood cell count 23.000/mm(3) (45% polymorphonuclear leukocyte, 45% lymphocyte, 10% monocyte). Spinal magnetic resonance imaging showed a fusiform abscess localized at anterior epidural space and extending along levels of C5-6 and C6-7. The longitudinal dimension of the abscess was 3 cm. The lesion was hypoin-tense on T1 and hyperintense on T2 weighted MRI images with prominent rim shaped contrast enhancement on contrast-enhanced T1-weighted images. At fourth day of hospitalization the patient underwent neurosurgical management. M.tuberculosis was isolated from the cultures of operation material by Mycobacteria Growth Incubator Tube system (MGIT, BBL; BD, USA) on the 12th day. The isolate was found susceptible to streptomycin and rifampisin, but resistant to isoniazid and ethambutol. The treatment was initiated with rifampicin 600 mg/day, pyrazinamid 2 g/day, ethambutol 1.5 g/day and levofloxacin 500 mg/day. At the end of second month levofloxacin 500 mg/day and rifampisin 600 mg/day combination was sustained and total treatment period was planned as nine months. As far as the national literature was considered, this was the first case of extrapulmonary tuberculosis with primary resistance to isoniazid and ethambutol.
dc.identifier.endpage694
dc.identifier.issn0374-9096
dc.identifier.issue4
dc.identifier.pmid23188583
dc.identifier.startpage689
dc.identifier.urihttps://hdl.handle.net/20.500.12428/26871
dc.identifier.volume46
dc.identifier.wosWOS:000311330900018
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isotr
dc.publisherAnkara Microbiology Soc
dc.relation.ispartofMikrobiyoloji Bulteni
dc.relation.publicationcategoryinfo:eu-repo/semantics/openAccess
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WoS_20250125
dc.subjectMycobacterium tuberculosis
dc.subjectepidural abscess
dc.subjectisoniazid
dc.subjectethambutol
dc.subjectprimary resistance
dc.titleEpidural Abscess Due to a Mycobacterium tuberculosis Strain with Primary Resistance to Isoniazid and Ethambutol
dc.typeArticle

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