The third report involves the daughter of the aforementioned married couple: a 23-year-old female, vaccinated against TB as a child, mother of a 4-year-old child, smoker since youth (6 pack-years), presenting as not yet seriously ill. The patient occasionally works as a waitress in a bar and resides with her son and parents in the same apartment. She participated in the TB contact investigation on the basis of being a close contact of her father. During the previous month, the patient noticed a cough and weight loss of 3 kg. She was afebrile, no perspiration, and reportedly felt quite well. TST results showed an induration of +16 mm; HIV test results were negative. A chest X-ray showed findings of pulmonary infiltrates in both lungs with numerous caverns in the right upper lobe (Fig. 3).
The patient was hospitalized immediately. Sputum was smear-positive and culture-positive for MTB for a period of 2 months. Mycobacterium testing with the Bactec MGIT 960 was also positive. The patient was started on first-line AT therapy with a combination of rifampicin, isoniazid, ethambutol, and pyrazinamide. Her sputum was smear-positive and culture-positive for MTB for a period of 2 months. Given the extent of the findings, the initial phase was extended to three months, and the follow-on phase involved bi-therapy with rifampicin and isoniazid in a daily regime for 4 months.