To be or Not TB
Speaker Credentials
MS-III
Speaker Credentials
BS
College
College of Allopathic Medicine
Medical Specialty
Internal Medicine
Format
Poster
Start Date
November 2024
End Date
November 2024
Track
2
Abstract
Introduction: Tuberculosis (TB) is an aerosol-transmitted disease that primarily affects the lungs, with active infection presenting as fever, night sweats, weight loss, and productive cough. While it is prevalent worldwide, there may be a lower degree of clinical suspicion in developed countries where it remains uncommon. Therefore, it is important to focus on certain risk factors (travel history, immunosuppression, certain living conditions) in the patient workup. The purpose of this case report is to discuss the presentation and management of a patient with active TB presenting atypically. Case Description: The 47yo male patient with a recent history of pneumonia presented to the ED complaining of hemoptysis, denying other symptoms. He is a former everyday smoker with reported travel to Peru 2 months ago. Admitting vital signs were stable. Physical exam was positive for distant breath sounds, and imaging demonstrated lung opacities. Labs and blood cultures were unremarkable. Tuberculosis was confirmed with positive Quantiferon test and organisms on acid-fast bacilli sputum. The patient began a regimen of rifampin, isoniazid, pyrazinamide, and ethambutol. Three subsequent sputum samples were negative for TB after treatment initiation. With three negative samples and resolution of symptoms, the patient was discharged after 15 days with the same anti-TB regimen, with recommendations to follow up as outpatient. Discussion: In the absence of typical symptoms for active TB in a non-endemic country, maintaining a high index of suspicion allows for prompt identification and management of tuberculosis, which in this patient led to better health outcomes and decreased length of hospital admission.
To be or Not TB
Introduction: Tuberculosis (TB) is an aerosol-transmitted disease that primarily affects the lungs, with active infection presenting as fever, night sweats, weight loss, and productive cough. While it is prevalent worldwide, there may be a lower degree of clinical suspicion in developed countries where it remains uncommon. Therefore, it is important to focus on certain risk factors (travel history, immunosuppression, certain living conditions) in the patient workup. The purpose of this case report is to discuss the presentation and management of a patient with active TB presenting atypically. Case Description: The 47yo male patient with a recent history of pneumonia presented to the ED complaining of hemoptysis, denying other symptoms. He is a former everyday smoker with reported travel to Peru 2 months ago. Admitting vital signs were stable. Physical exam was positive for distant breath sounds, and imaging demonstrated lung opacities. Labs and blood cultures were unremarkable. Tuberculosis was confirmed with positive Quantiferon test and organisms on acid-fast bacilli sputum. The patient began a regimen of rifampin, isoniazid, pyrazinamide, and ethambutol. Three subsequent sputum samples were negative for TB after treatment initiation. With three negative samples and resolution of symptoms, the patient was discharged after 15 days with the same anti-TB regimen, with recommendations to follow up as outpatient. Discussion: In the absence of typical symptoms for active TB in a non-endemic country, maintaining a high index of suspicion allows for prompt identification and management of tuberculosis, which in this patient led to better health outcomes and decreased length of hospital admission.