Lung dz: TB and Chlamydia Flashcards
three body foci of localized Mycobacterium Avium complex (MAC) inf
lungs, lymphnodes, SSTI’s
what is a requirement of disseminated version of Myco avium complex inf
HIV with CD4 counts less than 50
how is MAC diagnosed
culture
how to treat disseminated MAC (2 drug tx a MUST)
Clarithro and ethembutol (with or without rifambutin)
when can prophylactic tx (macrolide) of MAC be discontinued in HIV pt’s
when CD4 count exceeds 100 for 3 months
what type of inf is typical of immunocompromised with pre-existing lung dz
pulmonary MAC
tx for pulmonary MAC inf (3)
rifampin + ethembutol + streptomycin (3-5 times/ week x 18-24 months)
which condition would show cavitary lesions with patchy infiltrates on x-ray
pulmonary MAC or progressive primary TB
how many of those with latent TB inf reactivate (usually from immune impairment)
ten percent of those with latent, and only 5 percent will subsequently get progressive primary TB
how should culture be obtained for TB
3 consecutive mornings, or bronchial washings, then wait up to 12 weeks to grow
where is node enlargement in TB (as seen in x-ray)
next to mediastinum - hilar and paratracheal areas
where are TB lesions in x-ray
small infiltrates throughout, leading to mediastinal, cavitation, and PE later in dz
Ghon and Ranke complexes describe what radiologic finding
healed calcified primary TB infections
how long after exposure before TB inf shows a positive skin test
2-10 weeks (test doesn’t discriminate between latent and active)
Positive TB test for immunosuppresed people or those with fibrotic lung xrays
greater than or equal to 5 mm
