From Cure to Relapse: A Case of Recurrent Pulmonary Tuberculosis

A 35-year-old male, a daily wage laborer, presented to the chest clinic with a two-month history of cough, evening rise of fever, night sweats, and progressive weight loss. The cough was productive, occasionally streaked with blood. He also reported exertional shortness of breath over the last three weeks. On further inquiry, the patient revealed that he had been diagnosed with pulmonary tuberculosis three years ago. He had completed a six-month course of first-line anti-TB drugs and was declared cured. He denied any history of diabetes, HIV, or steroid use. He lived in a congested neighborhood with poor ventilation and admitted to smoking 1–2 cigarettes daily for the past ten years. There was no recent family history of tuberculosis. On examination, he appeared thin, pale, and cachectic. His temperature was 99.8°F, respiratory rate 22/min, and pulse 92/min. Chest examination revealed coarse crepitations and bronchial breath sounds in the right upper lobe. No lymphadenopathy or clubbing was noted. Investigations showed: Chest X-ray: Right upper lobe cavitary lesion Sputum AFB smear: Positive GeneXpert MTB/RIF: MTB detected, rifampicin-sensitive HIV serology: Negative Based on clinical features and investigations, he was diagnosed with recurrent pulmonary tuberculosis (sputum-positive, rifampicin-sensitive). The patient was counseled regarding his condition and started on the retreatment regimen according to national TB control guidelines, with drug susceptibility testing to rule out multidrug resistance. He was also provided nutritional support, smoking cessation advice, and infection control counseling. Regular follow-up was planned with sputum microscopy at 2, 5, and 6 months.

From Cure to Relapse: A Case of Recurrent Pulmonary Tuberculosis

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