Drug-resistant tuberculosis after gastrectomy. Double jeopardy?
Although an increased incidence of Mycobacterium tuberculosis infection is found in patients after subtotal gastrectomy, to my knowledge, the potential for gastrectomy to alter the course and outcome of typical mycobacterial disease has not been noted. I report the case of a patient who developed tuberculosis after a Billroth II subtotal gastrectomy, malabsorbed his antibiotics, and subsequently manifested infection with a drug-resistant strain of M tuberculosis. Altered drug pharmacokinetics should be considered as an important metabolic consequence of subtotal gastrectomy.
Welsh
C H
CH
University of Colorado Health Sciences Center, Denver.
D000368:Aged; D000904:Antibiotics, Antitubercular / Q000493:pharmacokinetics* / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D007408:Intestinal Absorption; D008297:Male; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000209:etiology
D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents