Prognosis for TB Traveler: Isolation, Surgery, Uncertainty

May 31, 2007— -- Had 31-year-old Atlanta lawyer Andrew Speaker walked into Denver's National Jewish Medical and Research Center unaccompanied, it is unlikely anyone would have known that he had a communicable disease -- one that doctors estimate kills one out of every two people it infects.

However, he did not walk in alone.

Surrounded by health workers and security personnel wearing masks, a symptom-free Speaker entered a room Thursday morning where he will likely spend weeks, or even months, fighting a potentially deadly tuberculosis infection that drugs have so far failed to eliminate.

Now doctors say that Speaker will likely face treatment with an unorthodox battery of medicines -- and possibly even surgery -- in his battle against his infection.

In an interview on ABC's "Healthy Life" Thursday, Dr. Neil Schluger, professor of epidemiology at Columbia University School of Medicine in New York, said that most of the time, antibiotic therapy is enough to rein in and eventually eliminate tuberculosis infections.

"The vast majority of these cases -- 98 percent or more -- can be treated with medications alone," he said.

But he said in the case of extremely drug-resistant TB, antibiotics may not be available to treat the infection.

Thursday, doctors at National Jewish planned to try two more antibiotics against the extensively drug-resistant disease -- one oral, the other an intravenous injection.

Dr. Henry Boom, director of the tuberculosis research unit at Case Western Reserve University School of Medicine, said such a "cocktail" is a common strategy for a resistant case like Speaker's.

"What's done in this situation is that you look at the drug-resistance pattern and try to come up with a cocktail of at least two or three drugs that have potential for treatment," he said.

Three more antibiotics may be on the way for Speaker this week, and doctors will continue to scrutinize an isolated sample of bacterium taken from Speaker's body to see if anything in the current arsenal of medicines can kill it.