{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T18:10:17Z","timestamp":1730916617873,"version":"3.28.0"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"20","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>\n            Anamnese\u2002Eine 65-j\u00e4hrige Patientin wurde aufgrund des Verdachts einer reaktivierten Tuberkulose zur weiteren Diagnostik zugewiesen.<\/jats:p><jats:p>\n            Untersuchung und Diagnose\u2002Radiologisch zeigte sich rund 14 Monate nach abgeschlossener Standardtherapie einer pulmonalen Tuberkulose ein bipulmonaler Progress. Klinisch bestanden Husten und Nachtschwei\u00df. Mikrobiologisch wurde eine multiresistente Tuberkulose (Resistenzen gegen Isoniazid und Rifampicin) nachgewiesen. Nach Aktendurchsicht fiel auf, dass bereits bei initialer Diagnose eine Resistenz gegen Isoniazid bestand, welche therapeutisch nicht ber\u00fccksichtigt worden war.<\/jats:p><jats:p>\n            Therapie und Verlauf\u2002Eine f\u00fcr 18 Monate geplante orale Therapie mit Bedaquilin, Linezolid, Terizidon und Levofloxacin wurde eingeleitet.<\/jats:p><jats:p>\n            Folgerung\u2002Bei der Therapie einer Tuberkulose m\u00fcssen Resistenzen unbedingt bedacht werden. Um eine ineffektive Therapie zu vermeiden, sollte auch molekulare Diagnostik eingesetzt werden; Kulturbefunde sind jedoch immer anzustreben. Durch diagnostische Latenz, zunehmende Resistenzen und eine lange Therapiedauer ist die Behandlung der Tuberkulose komplex. Seit 2014 gibt es aus diesem Grund die M\u00f6glichkeit, Patienten mit Tuberkulose oder atypischer Mykobakteriose (auch bei Verdacht) in Ambulanzen der spezialfach\u00e4rztlichen Versorgung (ASV) zu behandeln.<\/jats:p>","DOI":"10.1055\/a-2369-3807","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T23:05:51Z","timestamp":1727132751000},"page":"1222-1226","source":"Crossref","is-referenced-by-count":0,"title":["Provokation der Entstehung einer multiresistenten Tuberkulose durch inad\u00e4quate Behandlung einer Isoniazid-Monoresistenz"],"prefix":"10.1055","volume":"149","author":[{"given":"Jonas","family":"Fr\u00fch","sequence":"additional","affiliation":[{"name":"Pneumologie, Klinikum W\u00fcrzburg-Mitte gGmbH, Standort Missioklinik, W\u00fcrzburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rn","family":"Strasen","sequence":"additional","affiliation":[{"name":"Pneumologie, Klinikum W\u00fcrzburg-Mitte gGmbH, Standort Missioklinik, W\u00fcrzburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Held","sequence":"additional","affiliation":[{"name":"Pneumologie, Klinikum W\u00fcrzburg-Mitte gGmbH, Standort Missioklinik, W\u00fcrzburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,9,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1055\/a-1934-8303","article-title":"Tuberkulose im Erwachsenenalter: Eine S2k-Leitlinie zur Diagnostik und Therapie, Chemopr\u00e4vention und Chemoprophylaxe der Tuberkulose im Erwachsenenalter des Deutschen Zentralkomitees zur Bek\u00e4mpfung der Tuberkulose e. 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