Sandbox:Mydah

Mydah Sajid, MD[1]

Tuberculosis

Pathogenesis

It is caused by inhalation of acid fast bacilli Mycobacterium tuberculosis.

Clinical presentation

The patient presents with chronic productive cough which may contain blood. The patient also complains of systemic symptoms like night sweats, weight loss and low-grade fever.

Diagnostic Tests

• Sputum smear for microscopy and ZN staing
• Chest X-ray
• Sputum culture on Lowenstein Jensen medium
• Sputum for Nucleic acid amplification testing

Management

Standard Regimen

The patient is given five drugs regime during the intensive phase of therapy which lasts for two month. The regimen contains Isoniazid, Rifampicin, Ethambutol, Pyrazinamid and Streptomycin. The continuation phase lasts for additional four months patients are given Isoniazid and Rifampicin in it.

Adverse Effects of Medications

1. Thrombocyopenia: Rifampicin
2. Neuropathy: Isoniazid
3. Vertigo: Streptomycin
4. Hepatitis: Pyrazinamide, Isoniazid, Rifampicin
5. Rash: Pyrazinamid, Rifampicin, Ethambutol