Epidemiology of Drug-resistant Tuberculosis in a Tertiary Care Center in Oman, 2006-2015.

OBJECTIVES: The aim of this study was to estimate the prevalence and identify the risk factors for the development of drug-resistant Mycobacterium tuberculosis infection in a tertiary care center in Oman. METHODS: We performed a cross-sectional review of culture-confirmed tuberculosis (TB) cases diagnosed at Sultan Qaboos University Hospital between August 2006 and March 2015. We compared drug-resistant TB cases with drug-sensitive cases to identify predictors of drug-resistant TB using univariate and multivariate logistic regression analysis. RESULTS: Of the 260 TB cases reviewed, 73.1% were confirmed by culture. The proportion of multi-drug resistant TB was 1.8%. TB isolates resistant to any of the first-line TB drugs comprised (7.5%) of cases. Pyrazinamide monoresistance was the most frequently reported drug monoresistant pattern (3.5%). Previous treatment for TB (odds ratio (OR) 14.81; 95% CI 3.09-70.98, p < 0.001), female gender (OR 3.85; 95% Cl 1.07-13.90, p < 0.039), and younger age (OR 6.80; 95% Cl 1.61-28.75, p < 0.009) were found to be risk factors for development of first-line antituberculosis drug-resistant TB in multivariate analysis. CONCLUSIONS: Our results show that the rate of drug-resistant TB in our population is a public health issue of great concern. Previous treatment with antituberculosis drugs, female gender, and younger age are risk factors for the development of drug-resistant TB. These findings are useful adjuvants to guide clinicians and public health professionals in the early detection and appropriate treatment of cases of drug-resistant TB.

Hughes-stovin syndrome and massive hemoptysis: a management challenge.

Hughes-Stovin syndrome is a very rare clinical entity characterized by pulmonary artery aneurysms and deep vein thrombosis (DVT). Here we report the case of a 53-year-old man, admitted to Sultan Qaboos University Hospital, Muscat, Oman, with bilateral pulmonary artery aneurysms and lower-limb DVT who developed massive hemoptysis. He was managed successfully with high-dose steroids in combination with cyclophosphamide.

Chronic renal failure presenting for the first time as pulmonary mucormycosis with a fatal outcome.

Pulmonary mucormycosis is an uncommon, but important, opportunistic fungal pneumonia which is often diagnosed late. Renal failure as the predominant presenting feature is not common in mucormycosis. Moreover, sudden, massive hemoptysis is not a usual complication. In this report we describe fatal pulmonary mucormycosis in a young patient with a previously undiagnosed chronic renal failure.