Recurrent Pulmonary Tuberculosis in Low Prevalence Settings: Case Report from Louisiana

Recurrence of Pulmonary tuberculosis (TB) after successful completion of supervised treatment may be due to relapse or reinfection. Recurrence is common with an incidence rate of 2.26 per 100 person years over a mean follow up of 2.3 years. However, it is uncommon for an immunocompetent individual to experience multiple episodes of recurrences. We describe a 67yo, Human Immunodeficiency Virus (HIV) seronegative man, seen in the public health system in Louisiana, USA with multiple relapses of TB due to drug susceptible MTB despite successful completion of guideline based direct observed treatment regimen in each episode. This case report highlights the need for increased awareness and recognition of risk factors contributing to the recurrence of TB even in countries with low prevalence of TB. Better understanding of the importance of drug penetration and action on varying mycobacterial populations within diseased lung tissue would also aid clinicians in the management of these relapses.