Patient: Description of the condition (onset, symptoms, hospital, etc.): In 2010, nodules and shadows were found in the right upper lung, and there were many lymph nodes in the right clavicle and the right axilla, and the lymph nodes were biopsied for lymphatic tuberculosis, so I started taking medication in November 10 and stopped in February 2012. The sputum culture was found to be non-tuberculous mycobacterium three times. After 15 months of treatment, the axillary lymph was completely eliminated, there is still a small one on the clavicle, and there are only a few nodules in the lungs. The doctor at the tuberculosis hospital suggested to take the medicine for three months and continue to take it for one to two years if it turns negative, but if it doesn’t turn negative, I don’t want to take it anymore, but I want to have a baby first before treatment because I’m not young. Now there is no discomfort. Wen Wenpei, Department of Tuberculosis, Guangdong Tuberculosis Control Center
Wen Wenpei, Department of Tuberculosis, Guangzhou Chest Hospital.
If the sputum is negative, the sputum culture type is identified as non-tuberculous mycobacterium, and all the drugs are resistant, the patient can only rely on his own immunity to cope with it, before the availability of effective drugs, we have to co-exist with non-tuberculous mycobacteria for a long time. In general, the bacterium is not very aggressive to the human body.
As for the possibility of pregnancy, it is not easy to say! There are two risks: one is that the immunity of the body may change during pregnancy and the activity of non-tuberculous mycobacteriosis increases, and then the mother needs to be treated with drugs that affect the development of the fetus; the second is that the fetus may or may not be infected by the bacterium and get sick. The above advice is for reference.
The first-line drugs are all resistant, and the second-line drugs are only amikacin and what is the drug resistant, the other drugs are all resistant, the disease seems to be treated with a combination of drugs, but only two drugs can be eaten, so is it easy to re-emerge drug resistance?
The Department of Tuberculosis, Guangzhou Chest Hospital, Wen Wenpei.
Is it amikacin and clarithromycin? The combination of only two drugs is prone to drug resistance. You may not be able to use it, because I don’t know if you have any toxic side effects after using these two drugs. Some patients get diarrhea when they use clarithromycin. The immunity of your body and bacteria will change, after a period of time, some of the original drug-resistant drugs may regain sensitivity, and then find more than three effective and safe drugs to form a new program, supplemented by immunonutrition therapy, will receive results. Another point, in vitro tests are not sensitive to drugs, such as in vivo immune help, with the help of other drugs, the drug is not necessarily ineffective.
Do not be discouraged, believe that tomorrow will be better!
Patient: Thank you from the bottom of my heart!