Case study for Tuberculosis

Case study for Tuberculosis

Introduction of case /pathology

Tuberculosis (TB ) is a disease caused by bacteria belonging to the Mycobacterium tuberculosis complex . This usually affects the lungs although in up to 1 /3 of the cases , other organs are also involved . If properly treated , TB is reversible in virtually all cases . If left untreated , the disease may be fatal within 5 years in more than half of the cases (Rotvigline and O 'Bien , 1998 . Tuberculosis is transmitted via airborne droplets nuclei that are produced when persons with TB cough sneeze or

sing (Leung , 1999

Patient Medical History : J .M , 35 years old , male , chronic smoker (15 pack years ) came in for consultation due to cough

Patient 's medical history started 1 month prior to admission . He had unproductive cough with on and off , low-grade fever especially in the late afternoon and anorexia . This was accompanied with night sweats . No medication was taken nor consultation done . After 3 weeks , he developed productive cough with noted significant weight loss and easy fatigability . He consulted to a doctor and was advised for work-up Pertinent physical exam revealed clear breath sounds on both lung fields ) cervical lymphadenopathy ) slight pale palpebral conjunctivae . Chest x-ray revealed ) parenchymal patches at the apical segment of bilateral lobes . Tuberculin skin test (Mantoux Test ) was positive . He was found positive for AFB smear

Diagnostic tests

Radiography is still best initial screening method of choice . Although most often this is done in conjunction with tuberculin skin testing (Leung , 1999

1 . Tuberculin skin test . The tuberculin skin test can show if the person has ever been "infected " by tuberculosis (TB ) germs . There are several kinds of thttp /www2 .dmi .columbia .edu /resources /tbcpp /abouttb .htmluberculin skin tests . The most reliable test called the Mantoux PPD ( Angello Kellner , and Holtzman , 1994

2 . AFB microscopy and Mycobacterial culture . Main diagnostic procedures in persons with a productive cough . These require isolation and identification of M tuberculosis in a sputum however , sputum smears that fail to demonstrate acid-fast bacilli do not exclude the diagnosis of TB (Leung , 1999

3 . Drug susceptibility testing . Drug susceptibility testing should be performed on organisms initially isolated in all patients with newly diagnosed TB (Bass JB , Jr , Farer LS , Hopewell PC , et al , 1994

Specifics of case study /pathology

Initial differential diagnoses

Pneumonia was considered due to fever and productive cough however ruled out due to the result of chest x-ray and clear breath sounds Pneumonia usually has consolidation (Samuel , 2004

Lung neoplasm was considered due to presence of weight loss however , it was ruled out due to chest x-ray . Lund neoplasm usually presents with solitary nodule (Samuel , 2004

Focal lymphadenopathy secondary to infection was ruled in due to presence of lymphadenopathy however , it was ruled out due to absence of local infection in the patient 's medical history

pulmonary tuberculosis was considered in this case due to the patient 's medical history of productive cough , low grade fever usually at night anorexia and significant weight loss . Diagnostic exams also suggest...