The Emergence of Drug Resistance in Extrapulmonary Tuberculosis: A Case Series

Authors

  • Herikurniawan Herikurniawan Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Aziza Harris Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Mira Yulianti Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Ni Nyoman Indirawati Kusuma Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Cleopas Martin Rumende Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Keywords:

Tuberculosis, multi-drug resistant, extrapulmonary, rifampicin, molecular diagnostic technique, drug resistance, Bacterial

Abstract

Drug-resistant extrapulmonary tuberculosis (DR-EPTB) represents an escalating global health challenge, complicated by rising rates of rifampicin-resistant (RR-TB) and multidrug-resistant tuberculosis (MDR-TB). Despite growing awareness, DR-EPTB remains underdiagnosed and underreported, often due to presumptive assumptions of drug sensitivity. This case series describes three distinct cases of DR-EPTB: a 34-year-old woman diagnosed with primary MDR-TB involving the lungs and colon; a 41-year-old man with RR-TB-associated arthritis of the elbow joint, following a previous history of pulmonary TB; and a 63-year-old immunosuppressed woman presenting with primary laryngeal and pulmonary RR-TB. These cases highlight the diagnostic complexities and emphasize the necessity of prompt and precise diagnosis facilitated by molecular diagnostics, particularly GeneXpert MTB/RIF. Increased awareness and vigilance for DR-EPTB among clinicians are critical for early detection, effective management, and curbing the spread of drug-resistant strains.

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Published

2025-12-23

How to Cite

Herikurniawan, H., Harris, A., Yulianti, M., Kusuma, N. N. I., & Rumende, C. M. (2025). The Emergence of Drug Resistance in Extrapulmonary Tuberculosis: A Case Series. Acta Medica Indonesiana, 57(4), 521. Retrieved from http://www.actamedindones.org/index.php/ijim/article/view/3097

Issue

Vol. 57 No. 4 (2025): Acta Medica Indonesiana

Section

CASE REPORT

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