Case 10

Multi-drug resistant tuberculosis (MDR-TB) is defined by resistance to both isoniazid and rifampicin, the two most effective first line anti-tuberculous drugs. Resistance to one or other drug plus resistance to other first line agents (streptomycin, pyrazinamide and ethambutol) represents an important treatment challenge. The case provides insight into the challenges faced treating MDR-TB and extensively drug-resistant tuberculosis (XDR-TB).