Pastakia Tuberculosis Flashcards
Infection Eliminated–>Innate Immune Response
TST (PPD): negative
Quantiferon (IGRA): negative
Culture: negative
Sputum: negative
Infectious: No
Symptoms: None
Treatment: None
Infection Eliminated–>Acquired Immune Response
TST (PPD): positive
Quantiferon (IGRA): positive
Culture: negative
Sputum: negative
Infectious: No
Symptoms: none
Treatment: none
Latent
TST (PPD): positive
Quantiferon (IGRA): positive
Culture: negative
Sputum: negative
Infectious: No
Symptoms: none
Treatment: preventative
Subclinical
TST (PPD): positive
Quantiferon (IGRA): positive
Culture: intermittently positive
Sputum: negative
Infectious: sporadically
Symptoms: mild
Treatment: multidrug tx
Active
TST (PPD): postive
Quantiferon (IGRA): positive
Culture: positive
Sputum: either or
Infectious: Yes
Symptoms: mild-severe
Treatment: multidrug tx
Standard Treatment
Intensive: Rifampin 600 + Isoniazid 300 + Ethambutol 800-1600 + PZA 1000-2000 daily x 8 weeks
Continuation: Rifampin 600 + Isoniazid 300 daily x 18 weeks
Rifapentine based
Intensive: Rifapentine 1200 + Isoniazid 300 + Moxifloxacin 400 + PZA 1000-2000 daily x 8 weeks
Continuation: Rifapentine 1200 + Isoniazid 300 + Moxifloxacin 400 daily x 9 weeks
Drug Susceptible
sensitive to standard 1st line agents
Monoresistant
sensitive to just 1 anti-TB drug
Polyresistant
resistant to > 1 anti-TB drug not INH or RIF
Multidrug Resistant
resistant to INH and RIF
Extensively Drug Resistant
resistant to INH and RIF + at least 1 injectable + FQ
AVOID RIFAMPIN DUE TO CYP ENZYMES
AVOID RIFAMPIN DUE TO CYP ENZYMES
Resistance
Mycobacterium contain a spontaneous rate of mutations develop as bacilli proliferating to 1 out of 10^8 cavity
RIF=10^-8
INH=10^-6
PZA=10^-6
Combination: No bacteria will be resistant to all 3, if monotherapy resistance to bacteria proliferates
