Complicated silicotuberculosis in a South African gold miner: A case report.
We present a case of complicated silicotuberculosis in a former gold miner with a sufficiently heavy silica dust exposure to cause International Labor Organization grade 2/2 silicosis after a cumulative exposure duration of 11 years. We describe a cascade of complications-active pulmonary tuberculosis despite recent isoniazid prophylactic therapy, non-tuberculous mycobacterial disease, chronic airways obstruction, and spontaneous pneumothorax-and the difficulties, which arose, in diagnosis and management of such combined disease. We highlight three implications of such cases: the need to understand the interaction of silicosis and tuberculosis in this setting, the importance of maintaining continuity of care in the management of these conditions in miners and former miners, and control of silica dust exposure as a primary form of prevention of tuberculosis.
Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.|Clinical Infectious Disease Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Tolu
T
Oni
Division of Occupational Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Rodney
R
Ehrlich
D000995:Antitubercular Agents / Q000627:therapeutic use; D003266:Continuity of Patient Care; D004391:Dust; D006046:Gold; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D000067572:Miners; D008906:Mining; D009165:Mycobacterium Infections, Nontuberculous / Q000209:etiology; D016273:Occupational Exposure / Q000517:prevention & control; D011030:Pneumothorax / Q000209:etiology; D056990:Post-Exposure Prophylaxis; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology; D012822:Silicon Dioxide / Q000633:toxicity*; D012830:Silicotuberculosis / Q000150:complications* / Q000628:therapy; D013019:South Africa
D000995:Antitubercular Agents; D004391:Dust; D006046:Gold; D012822:Silicon Dioxide; D007538:Isoniazid
gold mining; mycobacteria; silicosis; tuberculosis