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Lung Disorders (TB (Microbiology (3 samples (1 early morning) - "…

- - - - 150 times higher (approx)
    - - Sub-Saharan Africa
      - South Asia
      - Born/ arrived from in last 5 years.
    - - 1 in 3
  - - - Primary usually asymptomatic. TB is then insidious in onset.
    - - Fatigue, malaise, fever, wt loss, anorexia , FTT, PUO
    - - 60% of TB is resp
        
        Chronic cough with purulent sputum +/- blood.
        
        May cause: Lobar collapse, bronchiectasis, pleural effusion and pneumonia
    - - 2nd most common
      - Sterile, Pyruria (pus in urine)
      - may have kidney lesions, Salpingitis (infection of fallopian tubes) abscesses and infertility in females. Swelling of the epididymis in males
      - MSK :
        
        Pain, arthritis, osteomyelitis and abscess formation ( loin/psoas mass from spinal TB), nerve root compression, monoarthrtisis
      - CNS
        
        TB Meningitis and tuberculomas
      - GI
        
        Many ileocaecal lesions
      - Lymph nodes
        
        Hilar, paratracheal, superficial node involvement
        
        palpable nodes may be initially tender, firm and discrete but later matted and suppurative with discharginf sinuses
      - Skin
        
        erythema nododum, skin sinus, erythema induratum
  - - - central apical with left lower lobe infiltrate or pleural effusion
  - - - 2nd line if mantoux +Ve (those with BCG vaccine)
  - - - 6 Months
        
        Rifampicin
        
        Isoniazid
      - initial 2 Months
        
        Pyrazinamide
        
        Ethambtol
      - Meningeal TB : 12 months. (same initial 2 months) + Glucocorticoid
      - Liver toxicity: assoicated with RIPE drugs
      - Kidney function issues: avoid ethambutyol and streptomycin
      - Ethambutol : visiual disturbnces
      - Isoniazid: peripheral neuropathies