When tuberculosis kills lung tissue, it can produce gaping
holes like in the lung on the right.
For a long time, tuberculosis was a gruesome and incurable disease. Antibiotics changed that, but over the last century, as the drugs have been incorrectly used, the tuberculosis bacterium has been developing resistance to them. Multi-drug resistant tuberculosis, which requires a cocktail of many drugs to treat it, has become common. Now Indian doctors have reported in a medical journal that a strain that is resistant to all known drugs for tuberculosis has appeared in Mumbai. Twelve patients so far have been diagnosed with the strain, and it’s likely that they are just the tip of the iceberg in terms of those infected.
At the Superbug blog, Maryn McKenna explains that this is the third time on record that totally drug-resistant TB (TDR-TB) has appeared. The most recent cases were in Iran in 2009, but the earliest cases were in Italy in 2003, in two middle-class Italian women:
They were both diagnosed by local doctors and treated with repeated rounds of the normal TB drugs — three rounds each — before someone recognized that something unusual was happening. They were separately admitted to the Morelli hospital with what the paper calls “a very severe clinical picture (extended bilateral cavities),” which means the TB infection had eaten away the tissue of their lungs, leaving empty dead zones. (If you’d like to see what that looks like, here are some pathology images, not from these women.)
