Due to our government's generousity in accepting foreign workers without proper screening, TB has returned to Malaysia! Welcome back, old friend(or foe?)
Return of disease linked to foreign workers
Because i foresee that our government will continue to be generous for many years to come, I think its essential for us to equip ourself with the knowledge about our old friend here.
As usual, basic sciences are essential
1) What is Tuberculosis
2) Describe the etiologic agent
3) Clinical features
4) How is it transmitted
5) What investigations need to be done
6) What other organism or disease that can mimic tuberculosis
7) Complications of tuberculosis
8) Pott's paraplegia-what is it?
9) What are the regimens for anti TB drug? how long it should be given? Based on what do we decide the exact duration?
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1) Do u mean pulmonary TB?
2) Acid fast bacilli and obligate aerobe
3) Depends of the form of TB but in case of PTB, chronic cough esp productive, hemoptyis, constitutional symptoms such as night sweats, persistent fever( one of the common causes of fever of unknown origin), and loss of weight etc
4) In case of PTB, mainly by droplets and in other forms mainly hematogenous
5) Mantoux test, CXR, sputum for AFB detection and in some cases, Csf analysis, pleural fluid analysis, PCR….
6) Maybe Hodgkin lymphoma, HIV , lung cancer, pneumonia…
7) Pleural effusion, TB meningitis, pott paraplegia etc
8) Pott paraplegia- spinal cord compression due to TB spondylitis
9) Standard regimen: Rifampicin, Isoniazid, Pyrazinamide and Ethambutol for first 2 months and continue rifampicin and isoniazid for another 4 months
How long should we assess the effectiveness of therapy?
I think the duration is mainly based on the form of TB and also the effectiveness of treatment
I would like to ask, what r the signs in CXR that indicates the PTB is active?
Thx
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