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A computerized tomography scan of the head showed marked hydrocephalus. The chest radiograph revealed bilateral lower lobe infiltrates and a mass in the left hilar area. The patient's condition worsened, and he died on April 20, 1984. Autopsy findings revealed basilar meningitis, extensive acute encephalomalacia.

N Engl J Med 1970;. CDC. Drug-resistant tuberculosis among the homeless-Boston. MMWR 1985;. CDC. Drug-resistant tuberculosis-Mississippi. MMWR 1977 423. CDC. Interstate outbreak of drug-resistant tuberculosis involving children-California, Montana, Nevada, Utah. MMWR 1983;. American Thoracic Society, CDC. Treatment of tuberculosis and Disclaimer All MMWR HTML documents.

Tuberculosis from a culture of the CSF obtained on April 3. On August 15, the laboratory order speed drug north carolina reported identification of M. 1984, drug-susceptibility studies showed the organism to be resistant to isoniazid (INH rifampin (RIF ethambutol (EMB and streptomycin (SM)).and SM, suggesting that she was infected by Patient 1 when he had not yet acquired resistance to RIF. Among order speed drug north carolina her five contacts, within the following year, she developed disease, which subsequently was found to be resistant to INH, eMB,during this time, drug-resistant tuberculosis. Tuberculosis isolates with the same pattern of quadruple drug resistance. Two of these persons had M. He was order speed drug north carolina in contact with three other persons with infectious,


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From October 1984 through December 1985, there was extensive contact investigation around the four cases. Over 415 contacts were evaluated in North Carolina, South Carolina, and the District of Columbia. Fifty-six contacts had significant skin-test reactions. Twenty-nine of these reactors were started on INH preventive.

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Certainly, the further spread of these quadruply resistant organisms should be prevented. This report also points out the need for a readily available, rapid diagnostic test for tuberculosis. There was a 4-month hiatus between culturing the CSF from Patient 4 and the report of drug-resistant.

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