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논문분류	춘계학술대회 초록집
제목	Rare Case Report: A Challenging Case of Pulmonary TB with Rifampicin Resistant, DKD Stage V Dialysis, Type 2 Diabetes Mellitus and Heart Failure Patients
저자	Aspuri Sekartika Dien
출판정보	2024; 2024(1):
키워드
초록	As the high cost and high burden of Tuberculosis (TB) and Diabetes Mellitus (DM) treatment, with often worse outcomes of TB-DM and DR-TB (Drug Resistant Tuberculosis), it is seen as necessary to study the association of DM and DR-TB in Indonesia. Diabetes is often associated with failure of tuberculosis treatment, which may related to drug-resistance mycobacterial genotype. A 54-year-old woman presented with complaints of shortness of breath. The patient had dialysis twice a week and had an HD Cath installed in the right neck. The patient also complained of coughing and had a history of TB treatment for three months. Physical examination showed the conjunctiva was pale, Cardiac examination There is cardiomegaly and murmurs. Pulmonary examination revealed coarserales and crackles. Edema in the lower extremity. Laboratory examination revealed anemia, hypoalbuminemia, impaired renal function, hypernatremia, and hypercalcemia. On chest x-ray examination, there was cardiomegaly with pulmonary edema and pneumonia. Gen Expert result found MTB detected low with Rifampicin resistance detected. Echocardiography examination showed the impression of concentric LVH, EF 56%, and Mild MR TR. The patient was diagnosed with Rifampicin Resistant Pulmonary Tuberculosis and MDR New Case Diagnosed, DKD 5 Dialysis with Pulmonary Edema, Type 2 DM, HFpEF 56%, Anemia Renal, Asymptomatic Hyperuricemia, Dyslipidemia, and Moderate Hyperosmolar Hyponatremia. The patient was given LTR Anti Tuberculosis Drug therapy, Levofloxacin Inj 750 mg/24 hours, Novorapid Inj 6-6-6, Lantus Inj 0-0-0-10, Nebu Combivent, Hemodialysis 12 hours/week and symptomatic therapy. There was improvement in patient condition.
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