A catastrophic seven-year course of drug-resistant tuberculosis and lessons for multidisciplinary management: a case report

BACKGROUND: We describe the catastrophic seven-year journey of a young man with drug-resistant tuberculosis (TB) in China, initially managed with empiric therapy without baseline molecular testing. CASE PRESENTATION: He relapsed with rifampicin-resistant TB, complicated by empyema, bronchopleural fistula, and multiple failed surgeries. Management required prolonged, individualized therapy with severe toxicities, including linezolid-induced peripheral neuropathy, and staged thoracic reconstruction. INTERPRETATION: Although microbiological cure was achieved, the patient was left with severe post-tuberculosis lung disease and functional disability. This case highlights the consequences of omitting rapid molecular diagnostics, the essential role of multidisciplinary collaboration, and the need to extend TB care beyond microbiological cure to long-term rehabilitation. This case report is reported in accordance with the CARE guidelines.