DDx for Upper Lobe Cavitary Lesions:
- Think TB and Sarcoid (Usually patients with Sarcoid have prominent disease on radiography but clinically look well)
Posted 11/17/16 11:22:28 AM by Adam Faye
- Laryngeal TB- Most infectious form of TB
- Smoking makes it:
- more likely latent TB --> active TB
- harder to treat
- more likely to relapse
- TB can cause SIADH as well (typically we think of SIADH from Small Cell Lung Ca)
Posted 11/17/16 11:30:37 AM by Adam Faye
- Smear has ~50-65% sensitivity; typically need 100,000 organisms to be positive.
- GeneXpert- detects DNA, also tests genetic mutations a/w rifampin resistance - higher sensitivity and can detect with only 150 organisms.
- Induced sputum can be as good as bronchoscopy in obtaining a sample.
Posted 11/17/16 11:36:30 AM by Adam Faye
- 100% non-infectious only when the Culture becomes negative.
- Once under going treatment, time to positive growth of culture should lengthen.
- Cavitary lesions and more organisms on smear lead to longer periods of time until Cultures clear.
Posted 11/17/16 12:12:48 PM by Adam Faye
Drug Sensitive TB - Do NOT need to give Ethambutol
Posted 11/17/16 04:59:20 PM by Adam Faye
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