title: Managing a case of extensively drug-resistant (XDR) pulmonary tuberculosis in Singapore.
abstract: BACKGROUND
  Extensively drug-resistant tuberculosis (XDR-TB) is an emerging global health risk. We present the first case report of XDR-TB in Singapore.
  
  
  METHODS
  A 41-year-old Indonesian lady with previously treated pulmonary tuberculosis presented with chronic cough. Her sputum was strongly acid-fast bacilli positive and grew Mycobacterium tuberculosis complex resistant to first and second-line TB medications.
  
  
  METHODS
  She received 5 months of intensive multidrug treatment without sputum smear conversion. She then underwent resection of the diseased lung. The total cost incurred amounted to over S$100,000.
  
  
  RESULTS
  She achieved sputum smear/culture conversion post-surgery, but will require further medical therapy for at least 18 months.
  
  
  CONCLUSIONS
  XDRTB is poorly responsive to therapy and extremely expensive to manage. Its prevention by strict compliance to therapy is paramount.
authors: Tuberculosis Control Unit, Tan Tock Seng Hospital, Singapore.
authors: Chee Kiang
authors: CK
authors: Phua
authors: Cynthia B E
authors: CB
authors: Chee
authors: Angeline P G
authors: AP
authors: Chua
authors: Suay Hong
authors: SH
authors: Gan
authors: Aneez D B
authors: AD
authors: Ahmed
authors: Yee Tang
authors: YT
authors: Wang