In Part 1, Dr. Jess Pelletier speaks with Dr. Moses Kitakule about tuberculosis: epidemiology, pathophysiology, and diagnosis.
Take-Home Points:
- TB is a pathogen impacting only humans which infects about ⅓ of the globe
- Most cases of TB are latent and asymptomatic, but TB can reactivate at any time, particularly if a host becomes immunocompromised or highly exposed to TB
- Patients with active pulmonary TB may have fevers, night sweats, weight loss, cough lasting more than 3 weeks, hemoptysis, dyspnea, or fatigue, but older adults and those with immune compromise may be asymptomatic or present atypically
- Imaging abnormalities on chest x-ray, POCUS, or CT should be seen in active TB (but not always in immunocompromised hosts)
- Diagnostic testing in the ED should involve sending sputum AFB smear and culture, as well as a NAAT, which may help make the diagnosis more rapidly
- Miliary TB patients may need targeted testing of other body fluids
- Protecting staff and other patients is critical
You can view the full show notes and references here: https://docs.google.com/document/d/1xrs7Yy5bAtSp8F2Esale44DKY3gRkiVwQiioQjAoNHI/edit?usp=sharing
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