Drug resistant tuberculosis complicated with pulmonary hypertension in adolescent: A case report

Tuberculosis (TB) diagnosis in children is usually less challenging in adolescents than in younger population, but is still rarely bacteriologically confirmed. Consequently, drug resistant cases in that population are hardly detected. We report a case of drug resistant TB complicated with pulmonary hypertension (PH) in adolescent. The patient had TB contact with his father who died from TB. At first, he was diagnosed with pulmonary TB clinically and received regular TB treatment for 12 months with good adherence, but showed no clinical improvement. He was hypoxic and severely wasted. Chest examination revealed weaker vesicular lung sound and ronchi in right lung. Chest imaging showed destroyed lung, tuberculin skin test and Quantiferon Gold In Tube were positive. Molecular test with Xpert MTB/RIF was positive for Mycobacterium tuberculosis, resistant to rifampicin. Echocardiography showed moderate PH. The patient was referred to National Pulmonary Referral Hospital for further treatment, but died 2 after diagnosed.