Tb Flashcards
Tb is what type of bacteria
Aerobe Acid fast bacili
hiv/aids riks for tb is
10% every year
Left untreated each person with active TB disease will infect between
10 to 15 people every year
Negative for ppd skin test
can react to other microbacteria
HIV+ (or IVDU and unknown HIV) Close contact of active case Fibrotic CXR lesions Persons on steroids/immunosuppressive drugs Transplant patients
> 5mm
High prevalence country IVDU and HIV negative Medically underserved Long-term care facilities Healthcare workers
> 10mm
Normal reactive size
> 15mm
Complexities impacting tb
immigration
*immunosuppression drugs
non-compliance
MDR/XDR (resistance)
Describe new blood test for TB
Interferon release gamma assays 1- take blood 2- expose blood mononuclear cells to antigen 3- look for sign of immune response ELISA OR ELISPOT
benefits to igra
results in 24 hour with out return visit
not subject to biases or error
increase acceptacne to treatemtn for LTBI
Latent vs active TB
Cough (3 weeks or longer) Hemoptysis Unexplained weight loss Fever/chills/night sweats (drenching) Chest pain Fatigue Loss of appetite
Treatment for LTBI
RIFAPENTINE 900mg once weekly x12weeks and Isoniazid
Directly Observed Therapy (DOT)
Watch patient take medications
Active TB workup
cxr
acid fast sputum with abdnormal cxr
Active TB workup
cxr
acid fast Bacili sputum stain with abdnormal cxr
higher the number more positive
tympically takes 8-10weeks for sputum culture what else can be done quicker
use PCR to start treatment earlier