PT  - JOURNAL ARTICLE
AU  - G. Dravniece
AU  - K. P. Cain
AU  - T. H. Holtz
AU  - V. Riekstina
AU  - V. Leimane
AU  - R. Zaleskis
TI  - Adjunctive resectional lung surgery for extensively drug-resistant tuberculosis
AID  - 10.1183/09031936.00047208
DP  - 2009 Jul 01
TA  - European Respiratory Journal
PG  - 180--183
VI  - 34
IP  - 1
4099  - http://erj.ersjournals.com/content/34/1/180.short
4100  - http://erj.ersjournals.com/content/34/1/180.full
SO  - Eur Respir J2009 Jul 01; 34
AB  - Extensively drug-resistant (XDR) tuberculosis (TB) poses significant management challenges as there are limited pharmacological treatment options for cure. Adjunctive resectional lung surgery decreases case-fatality rates for some patients with multidrug-resistant tuberculosis (MDR-TB), but its use has not been well documented for patients with XDR-TB. We describe 17 XDR-TB patients treated with surgery as part of their case management in Latvia during 1999–2005. One patient had no previous TB treatment history, 10 were previously treated for drug-susceptible TB and six were previously treated for MDR-TB. Mycobacterium tuberculosis isolates from the 17 patients were resistant to a mean of 9.2 drugs. Due to failure of pharmacological therapy, one due to a large cavity and one due to pulmonary haemorrhage, 15 patients were treated with surgery. Despite failure of pharmacological treatment in 15 out of 17 patients, eight (47%) were cured with adjunctive surgical treatment. Surgery should be explored as a possible treatment option for patients with XDR-TB.