ARCHIVES
VOL. 11, ISSUE 6 (2025)
Persistent pulmonary cavity and mediastinal lymphadenopathy despite adequate anti-tubercular therapy: Importance of therapeutic drug monitoring and dose optimization — A retrospective observational case report
Authors
Dr. Rajendra Tatu Nanavare, Dr. Pradeepkumar Kapsiker
Abstract
A 52-year-old male presented with chronic
cough, fever, and chest pain for one month. Chest imaging revealed a right
mid-zone cavity with mediastinal widening, and CT chest demonstrated necrotic
mediastinal lymphadenopathy. GenXpert confirmed Mycobacterium tuberculosis
without rifampicin resistance. The patient received first-line anti-tubercular
therapy (ATT) for nine months with partial clinical improvement, but
radiological resolution was unsatisfactory. Therapeutic drug monitoring (TDM)
revealed suboptimal plasma concentrations of first-line drugs, suggesting
altered pharmacokinetics. After dose adjustment and extended therapy, gradual
improvement ensued. This case emphasizes the role of TDM in optimizing ATT
efficacy, particularly in patients with poor radiological response.
Download
Pages:34-39
How to cite this article:
Dr. Rajendra Tatu Nanavare, Dr. Pradeepkumar Kapsiker "Persistent pulmonary cavity and mediastinal lymphadenopathy despite adequate anti-tubercular therapy: Importance of therapeutic drug monitoring and dose optimization — A retrospective observational case report". International Journal of Medical and Health Research, Vol 11, Issue 6, 2025, Pages 34-39
Download Author Certificate
Please enter the email address corresponding to this article submission to download your certificate.