Pulmonary Tuberculosis

1. - Symptoms:

1.1. cough 2 weeks or longer

1.2. chest pain

1.3. coughing up blood

1.4. weakness/fatigue

1.5. weight loss

1.6. loss of appetite

1.7. chills

1.8. fever

1.9. night sweats

2. - Assessment:

2.1. Symptoms of active TB

2.2. Vaccine

2.3. Chest X-ray

2.4. Lab tests

2.5. Site of disease

2.6. HIV risk assessment

2.7. History of TB disease

2.8. History of LTBI

2.9. History of other respiratory illness treatment

2.10. Underlying illness that increases risk for TB

2.11. Started treatment

2.12. Non-TB Meds

3. - Treatment

3.1. - Anti TB Drugs o isoniazid (INH). – prevent TB disease for LTBI o rifampin (RIF). o ethambutol (EMB). o pyrazinamide (PZA). o Streptomycin (STR).

3.2. - Anti bacterial drugs

3.3. - Special dietary meals

3.4. - Vitamins

3.5. - Probiotics

3.6. - Immunomodulators - HUMIRA

3.7. - Immunostimulants – Vaccines, drugs for chronic infections, immunodeficiency, autoimmunity and neoplastic disease. – TABRECTA – lung Ca

4. Latent TB infection

5. - Infectious disease that mainly affects the lungs, can affect kidney, spine and brain.

6. - Caused by Mycobacterium Tuberculosis - Spread thru droplet transmission

7. - US: 2018 2.8 per 100,000 persons or 28 cases/million, 2025 Target ≤1.3 TB cases per 100,000 - PH: 2018 107M population 591K best est; uncertain interval 332–924K

8. - Preventable and curable - 1.5M dies every year

9. TB disease

10. - Risk Factors:

10.1. Contact with person with TB disease

10.2. Countries with high prevalance

10.3. High risk settings

10.4. Healthcare workers

10.5. Infants, children, and adolescents

11. - Vaccines: Bacille Calmette-Guerin (BCG)

12. - Testing:

12.1. TB Skin test - Mantoux tuberculin skin test

12.2. - Sputum Culture 3x

12.3. - QuantiFERON®-TB Gold In-Tube test (QFT-GIT)

12.4. - T-SPOT®.TB test (T-Spot)

12.5. - GeneXpert MTB/RI