Olesya – Italy

Both of 10-year-old Olesya’s parents were being treated for TB. Olesya lived in Ukraine with her father, who was on first-line therapy for DS-TB. Her mother was living in Italy, where she was being treated for MDR-TB with second-line drugs. Unsurprisingly, in August 2007, Olesya fell ill. Shortly after, in September 2007, Olesya was diagnosed with TB.

Olesya was on her fifth month of first-line therapy when her mother made a dangerous voyage across the border and snuck her back into Italy. Olesya’s mother’s doctor evaluated her for TB, but her tests came back negative. She was discharged and instructed to complete her remaining six months of first-line therapy.

In June 2008, one month after she was discharged from the hospital in Italy, and nine months after her initial diagnosis with TB in Ukraine, Olesya’s cultures came back positive for MDR-TB. DST found Olesya’s strain of TB resistant to streptomycin, isoniazid, rifampicin, ethambutol, pyrazinamide, cycloserine, ethionamide, PAS, and kanamycin. Olesya’s doctor in Italy put her on a regimen of the second-line drugs amikacin, moxifloxacin, ethionamide, and linezolid.

A few months later, in September 2008, Olesya was hospitalized for peripheral neuropathy (nerve damage), inflammation of the tongue, and abdominal pain. While in the hospital, her doctor switched her to a more tolerable regimen of linezolid, amoxicillin, moxifloxacin, and clofazimine. After 19 months of treatment, Olesya was cured of MDR-TB.

Story Collected by: Luigi R. Codecasa, MD, and Maurizio Ferrarese, MD, Regional TB Reference Centre, Villa Marelli Institute, Niguarda Hospital-Milano, Italy