Tuberculosis - Revision history

Danbot: Add Rifampin and Streptomycin AntibioticDose entries

2026-03-20T11:01:42Z

Add Rifampin and Streptomycin AntibioticDose entries

@@ Línea 110: / Línea 110: @@
 **immunocompromised patients (or plan to start immunosuppressive medications)
 *New vaccine has demonstrated effectiveness (50%) in preventing progression to active TB<ref>Final analysis of a trial of M72/AS01E vaccine to prevent tuberculosis Tait DR, Hatherill M, Van Der Meeren O, et al. N Engl J Med. 2019;381(25):2429-2439.</ref>. However, this is not yet widely available and further research is needed.
 ==Disposition==

Rossdonaldson1: /* External Links */

2022-12-14T18:45:46Z

External Links

← Revisión anterior		Revisión del 18:45 14 dic 2022
Línea 124:		Línea 124:

	==External Links==		==External Links==
	https://www.cdc.gov/tb/default.htm		*https://www.cdc.gov/tb/default.htm

	==References==		==References==

Elcatracho: /* References */

2021-01-12T21:53:19Z

References

← Revisión anterior		Revisión del 21:53 12 ene 2021
Línea 122:		Línea 122:
	*Diagnosis is uncertain		*Diagnosis is uncertain
	*Patient is treatment non-adherent		*Patient is treatment non-adherent

			==External Links==
			https://www.cdc.gov/tb/default.htm

	==References==		==References==

Elcatracho: /* Active TB */

2021-01-04T18:06:53Z

Active TB

← Revisión anterior		Revisión del 18:06 4 ene 2021
Línea 101:		Línea 101:
	*[[Isoniazid]] + [[rifampin]] + [[pyrazinamide]] + [[ethambutol]] x 8wk followed by INH/rifampin x18wk		*[[Isoniazid]] + [[rifampin]] + [[pyrazinamide]] + [[ethambutol]] x 8wk followed by INH/rifampin x18wk
	**2 drug continuation treatment x 18-31wk		**2 drug continuation treatment x 18-31wk
			**Use of [[pyrazinamide]] in pregnancy is controversial and typically reserved for women with MDR TB<ref>Sokolove PE, Derlet RW: Tuberculosis, in Walls RM, Hockberger RS, Gausche-Hill M, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 9. Philadelphia, Elsevier 2018, (Ch) 127:p 1682-1692.</ref>

	===Latent TB===		===Latent TB===
	*Isoniazid x 9 months		*Isoniazid x 9 months

Rossdonaldson1: /* Latent TB */

2020-03-10T23:03:13Z

Latent TB

← Revisión anterior		Revisión del 23:03 10 mar 2020
Línea 107:		Línea 107:
	**close contact with active TB		**close contact with active TB
	**immunocompromised patients (or plan to start immunosuppressive medications)		**immunocompromised patients (or plan to start immunosuppressive medications)
	*~~There is a new~~ vaccine ~~which~~ has demonstrated effectiveness ~~against Tuberculosis~~ (50% ~~effective~~ in preventing progression to active TB<ref>Final analysis of a trial of M72/AS01E vaccine to prevent tuberculosis Tait DR, Hatherill M, Van Der Meeren O, et al. N Engl J Med. 2019;381(25):2429-2439.</ref>. However, this is not yet widely available and further research is needed.		*New vaccine has demonstrated effectiveness (50%) in preventing progression to active TB<ref>Final analysis of a trial of M72/AS01E vaccine to prevent tuberculosis Tait DR, Hatherill M, Van Der Meeren O, et al. N Engl J Med. 2019;381(25):2429-2439.</ref>. However, this is not yet widely available and further research is needed.

	==Disposition==		==Disposition==

Rossdonaldson1 at 23:01, 10 March 2020

2020-03-10T23:01:39Z

← Revisión anterior		Revisión del 23:01 10 mar 2020
Línea 1:		Línea 1:
	==Background==		==Background==
	*Over 1/3 of world's population is infected~~[[File:Tuberculosis-x-ray-1.jpg\|thumbnail\|Bilateral pulmonary tuberculosis]]~~		*Over 1/3 of world's population is infected

	===Infection Types===		===Infection Types===
Línea 46:		Línea 46:

	==Clinical Features==		==Clinical Features==
			[[File:Screen Shot 2015-09-11 at 9.27.22 AM.png\|thumbnail\|Tuberculous lymphadenopathy]]
	===Primary Tuberculosis===		===Primary Tuberculosis===
	*Usually asymptomatic (only identified by positive PPD/quantiferon gold)~~[[File:Screen Shot 2015-09-11 at 9.27.22 AM.png\|thumbnail\|Tuberculous lymphadenopathy]][[File:Screen Shot 2015-09-11 at 9.21.17 AM.png\|thumbnail\|Tuberculous vertebral osteomyelitis (Pott's Disease)]]~~		*Usually asymptomatic (only identified by positive PPD/quantiferon gold)
	*May be rapidly progressive and fatal in immunocompromised patients		*May be rapidly progressive and fatal in immunocompromised patients
	**[[Fever]], malaise, weight loss, [[chest pain]]		**[[Fever]], malaise, weight loss, [[chest pain]]
Línea 74:		Línea 75:

	==Evaluation==		==Evaluation==
	~~===[[CXR]]===~~
	[[File:Miliary.png\|thumbnail\|CXR of miliary TB]]		[[File:Miliary.png\|thumbnail\|CXR of miliary TB]]
	[[File:MiliaryTB.png\|thumb\|Miliary TB neonate born to mother with active TB]]		[[File:MiliaryTB.png\|thumb\|Miliary TB neonate born to mother with active TB]]
			[[File:Tuberculosis-x-ray-1.jpg\|thumbnail\|Bilateral pulmonary tuberculosis]]
			[[File:Screen Shot 2015-09-11 at 9.21.17 AM.png\|thumbnail\|Tuberculous vertebral osteomyelitis (Pott's Disease)]]
			===[[CXR]]===
	*Primary infection		*Primary infection
	**Infiltrates in any area of the lung		**Infiltrates in any area of the lung

Rossdonaldson1 at 22:59, 10 March 2020

2020-03-10T22:59:47Z

← Revisión anterior		Revisión del 22:59 10 mar 2020
Línea 1:		Línea 1:
	==Background==		==Background==
	~~[[File:MiliaryTB.png\|thumb\|Miliary TB neonate born to mother with active TB]]~~
	*Over 1/3 of world's population is infected[[File:Tuberculosis-x-ray-1.jpg\|thumbnail\|Bilateral pulmonary tuberculosis]]		*Over 1/3 of world's population is infected[[File:Tuberculosis-x-ray-1.jpg\|thumbnail\|Bilateral pulmonary tuberculosis]]

Línea 77:		Línea 76:
	===[[CXR]]===		===[[CXR]]===
	[[File:Miliary.png\|thumbnail\|CXR of miliary TB]]		[[File:Miliary.png\|thumbnail\|CXR of miliary TB]]
			[[File:MiliaryTB.png\|thumb\|Miliary TB neonate born to mother with active TB]]
	*Primary infection		*Primary infection
	**Infiltrates in any area of the lung		**Infiltrates in any area of the lung

Gpowellhb: /* Latent TB */

2020-02-13T00:37:03Z

Latent TB

← Revisión anterior		Revisión del 00:37 13 feb 2020
Línea 104:		Línea 104:
	**close contact with active TB		**close contact with active TB
	**immunocompromised patients (or plan to start immunosuppressive medications)		**immunocompromised patients (or plan to start immunosuppressive medications)
			*There is a new vaccine which has demonstrated effectiveness against Tuberculosis (50% effective in preventing progression to active TB<ref>Final analysis of a trial of M72/AS01E vaccine to prevent tuberculosis Tait DR, Hatherill M, Van Der Meeren O, et al. N Engl J Med. 2019;381(25):2429-2439.</ref>. However, this is not yet widely available and further research is needed.

	==Disposition==		==Disposition==

ClaireLewis at 21:50, 13 October 2019

2019-10-13T21:50:50Z

← Revisión anterior		Revisión del 21:50 13 oct 2019
Línea 27:		Línea 27:
	***Presentation more commonly that of primary TB		***Presentation more commonly that of primary TB
	**>5yr - classic symptoms		**>5yr - classic symptoms
	**<5yr - ~~milliary~~ TB, meningitis, cervical lymphadenitis, pneumonia that does not respond to usual antibiotics		**<5yr - miliary TB, [[meningitis]], [[scrofula\|cervical lymphadenitis]], [[pneumonia]] that does not respond to usual antibiotics
	**Children are usually not infectious due to their weak cough		**Children are usually not infectious due to their weak cough

Línea 50:		Línea 50:
	*Usually asymptomatic (only identified by positive PPD/quantiferon gold)[[File:Screen Shot 2015-09-11 at 9.27.22 AM.png\|thumbnail\|Tuberculous lymphadenopathy]][[File:Screen Shot 2015-09-11 at 9.21.17 AM.png\|thumbnail\|Tuberculous vertebral osteomyelitis (Pott's Disease)]]		*Usually asymptomatic (only identified by positive PPD/quantiferon gold)[[File:Screen Shot 2015-09-11 at 9.27.22 AM.png\|thumbnail\|Tuberculous lymphadenopathy]][[File:Screen Shot 2015-09-11 at 9.21.17 AM.png\|thumbnail\|Tuberculous vertebral osteomyelitis (Pott's Disease)]]
	*May be rapidly progressive and fatal in immunocompromised patients		*May be rapidly progressive and fatal in immunocompromised patients
	**Fever, malaise, weight loss, chest pain		**[[Fever]], malaise, weight loss, [[chest pain]]
	*Tuberculous pleural effusion may occur if subpleural node ruptures into the pleura		*Tuberculous [[pleural effusion]] may occur if subpleural node ruptures into the pleura
	**Pleuritic chest pain		**Pleuritic [[chest pain]]
	**Exudative fluid		**Exudative fluid
	***Organisms may not be visible on acid-fast staining (need pleural biopsy)		***Organisms may not be visible on acid-fast staining (need pleural biopsy)

	===Reactivation Tuberculosis===		===Reactivation Tuberculosis===
	*Pulmonary: Productive cough, hemoptysis, dyspnea, pleuritic chest pain		*Pulmonary: Productive [[cough]], [[hemoptysis]], [[dyspnea]], pleuritic [[chest pain]]
	*Systemic: Fever, night sweats, malaise, fatigue, wt loss		*Systemic: [[Fever]], night sweats, malaise, fatigue, weight loss
	*Extrapulmonary		*Extrapulmonary
	**Painless lymphadenopathy/[[scrofula]] (most common extrapulmonary manifestation)		**Painless lymphadenopathy/[[scrofula]] (most common extrapulmonary manifestation)
	**Pericarditis		**[[Pericarditis]]
	**Peritonitis		**[[Peritonitis]]
	**Meningitis		**[[Meningitis]]
	**Adrenal insufficiency		**[[Adrenal insufficiency]]
	***If adrenals affected, TB typically spreads to bilateral adrenals rather than unilateral		***If adrenals affected, TB typically spreads to bilateral adrenals rather than unilateral
	***Think about in the patient presenting in shock with TB risk factors		***Think about in the patient presenting in shock with TB risk factors
	**Arthritis		**[[Arthritis]]
	**Osteomyelitis		**[[Osteomyelitis]]
	***Pott's disease, usually in thoracic ~~spione~~		***Pott's disease, usually in thoracic spine

	==Differential Diagnosis==		==Differential Diagnosis==
Línea 75:		Línea 75:

	==Evaluation==		==Evaluation==
	===CXR===		===[[CXR]]===
	[[File:Miliary.png\|thumbnail\|CXR of miliary TB]]		[[File:Miliary.png\|thumbnail\|CXR of miliary TB]]
	*Primary infection		*Primary infection
Línea 103:		Línea 103:
	**Recent conversion to PPD-positive		**Recent conversion to PPD-positive
	**close contact with active TB		**close contact with active TB
	**immunocompromised patients (or plan to start ~~immunosupressive~~ medications)		**immunocompromised patients (or plan to start immunosuppressive medications)

	==Disposition==		==Disposition==

Kxl328: /* Reactivation Tuberculosis */

2018-09-30T19:53:40Z

Reactivation Tuberculosis

← Revisión anterior		Revisión del 19:53 30 sep 2018
Línea 65:		Línea 65:
	**Meningitis		**Meningitis
	**Adrenal insufficiency		**Adrenal insufficiency
			***If adrenals affected, TB typically spreads to bilateral adrenals rather than unilateral
	***Think about in the patient presenting in shock with TB risk factors		***Think about in the patient presenting in shock with TB risk factors
	**Arthritis		**Arthritis