A mediastinal mass was demonstrated on chest radiograph
in a 29-year-old Turkish woman, and histopathologic examination of a
supraclavicular lymph node diagnosed tuberculosis (TB) in May
1996. There was no proof by culture. For reasons of pregnancy,
therapy was not initiated until September 1996, when isoniazid, 300 mg
qd, and ethambutol, 20 mg/kg of body weight, was administered for 2
months until delivery. Then, a therapy of isoniazid; rifampicin,
600 mg; ethambutol; and streptomycin, 1 g 5 days a week for 6
weeks, was begun; after 4 more months, a chest radiograph did not
reveal any change for the better. There was no evidence of
noncompliance on the part of the patient. In March 1997,
mediastinoscopy was performed, and histopathologic examination of the
lymph node specimen showed typical features of active TB.
Microbiological analysis of biopsy material identified acid-fast
bacilli, but culture results were negative.