Question

1. A 20 year-old Asian woman, a recent immigrant to the United States, develops fever and a cough productive of blood-streaked sputum. She has lost 6 kg body weight in the last six weeks. Her chest film shows bilateral upper lobe infiltrates with cavities. (3 points)

a. What tests do you recommend to determine the nature of the disease?

b. What additional tests do you recommend to confirm your diagnosis?

c. What treatment plan do you suggest?

Answer 1

1. The patient is suffering from tuberculosis

a. Tests to determine the nature of tuberculosis is

montoux tuberculin skin test

interferon gamma release assay test.

b. Additional tests are

zn method of sputum by acid fast stain

culture by solid and liquid medias

CBNAAT both detection and isoniazid resistance

PCR

CT SCAN OF CHEST

c. Dots plus regimen for 6weeks

includes

intensive phase - 2weeks

isoniazid , rifampicin , ethambutol , pyrinazamide.

continuation phase - 4 weeks

isoniazid , rifampicin , ethambutol.