In September 2006, Alessandra was 11 years old and experiencing symptoms of TB. Alessandra was often in close contact with her 18-year-old brother, who had been receiving irregular treatment for pulmonary TB. In November 2006, two months after her symptoms appeared, Alessandra was diagnosed with TB.
Her doctor had limited experience treating children with TB, but immediately started her on a treatment regimen containing rifampicin, isoniazid, and pyrazinamide. After two months of treatment, pyrazinamide was removed from her treatment regimen. In January 2007, Alessandra’s chest X-rays showed that she was not improving on her current treatment, and her doctor, who also knew of her older brother’s failure to complete treatment, suspected that Alessandra had MDRTB. A month later, while waiting for the DST results, Alessandra died (February 2007). The DST results later showed that Alessandra’s strain of TB was resistant to rifampicin and isoniazid, the two first-line drugs with which her doctor had treated her.