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We present the case of a 39-year old male patient with various comorbidities including spastic paraparesis due to peripartum hypoxia subsequent to a gemellary pregnancy, coexisting with seizures (under treatment with sodium valproate), intravenous drug abuse since childhood, chronic hepatitis C virus (HCV) infection and human immunodeficiency virus (HIV) infection. Numerous hospitalizations and continuously monitored combined antiretroviral therapy were required for HIV infection. His immunocompromised status led to an infection started in 2013 with multi-drug resistant Mycobacterium tuberculosis, debuted in a lymph node and further extended to the lungs, brain and spleen, remitted after 2015. Since 2018, a different clinical entity appeared and the patient presented multiple condylomas in the genital and inguinal regions. The lesions progressed rapidly despite the self-administered treatment with 5mg/ml podophyllotoxinum cutaneous solution. During the most recent admissions the clinical picture consisted of extensive exophytic cauliflowerlike protrusions as well as plane brown-violaceous tumour masses located in the genital area, completely covering the inguinal folds, penian basis and scrotum bilaterally, without tendency to spontaneous remission. During hospitalization, multiple cryotherapy sessions combined with podophyllin cream 25% were performed. Due to a deficiency and asymmetry in walking, with the left lower limb more adducted than the right one, leading to relative closure of the right inguinal fold, lack of ventilation and a tendency to moisture formation and tissue maceration, the healing was slower on this side. The patient was discharged with an indication for home treatment with an ointment containing Camellia sinensis dry leaf extract, remaining under observation with monthly controls for some persisting lesions. [ABSTRACT FROM AUTHOR]

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Introduction: Multi-drug resistant tuberculosis (MDR-TB) is a major concern in the medical community. Knowledge about the drug resistance pattern of Mycobacterium tuberculosis strains plays an essential role in the management of the disease., Material and Methods: We conducted a retrospective, 3-year study (2009-2011), in an urban area. We collected data on the drug resistance for 497 M. tuberculosis strains, isolated from patients with pulmonary TB. Among the 497 strains, we identified 158 MDR strains. Eighty medical recorders of patients infected with MDR strains were available and we included those patients in the study group., Results: Of the 497 analysed strains, 8% were resistant to a single anti-TB drug. We identified 5.2% polyresistant drug strains, the most frequent combination being INH+EMB (1.4%). Of the 158 MDR strains identified (31.8%), over 60% were resistant to all first line anti-TB drugs tested. Most of them presented resistance to STM (86.1%) and EMB (67.7%). With respect to second line anti-TB drugs resistance to KM (23.4%) was the most common, followed by OFX (8.2%). With respect to the patients with MDR-TB, a percentage of 61.2% of them had a history of anti-TB treatment. Regarding lifestyle habits, 61.2% of the patients were smokers and 18.8% were abusing alcohol. Out of 51 patients, for whom information was available regarding their occupation, only 33.3 % were employees., Conclusion: MDR strains of Mycobacterium tuberculosis display an increased resistance to first line anti-TB drugs. Extension of resistance to second line anti-TB drugs narrows the therapeutic options. Knowledge of MDR-TB risk factors is imperative for the correct and rapid initiation of the treatment.