A Case of Multidrug-Resistant Tuberculosis of the Lung and Breast Due to Intrafamilial Transmission

A 23-year-old primiparous mother with a chronic draining breast lesion was smear-positive for acid-fast bacilli in the sputum examination after learning that her husband was a patient noncompliant to treatment. Despite negative microbiological examination of the breast drainage, she was culture-positive for multidrug-resistant Mycobacterium tuberculosis complex in her sputum culture. Because she was in the lactation period, with unilateral breast involvement, and accompanying culture-proven pulmonary tuberculosis, she was accepted as secondary breast tuberculosis. After therapy with a combination of ofloxacin, cycloserin, pyrazinamid, ethambuthol and amikacin, the breast lesion healed completely. As this case demonstrated that family screening is important for finding new patients, and tuberculous mastitis, albeit rare, should be considered in the differential diagnosis of chronic breast infections with unproven etiology.