ID4U Episode 3 Tuberculosis Part 2

In Part 2, Dr. Jess Pelletier speaks with Dr. Moses Kitakule about tuberculosis (TB) complications, including pulmonary and extrapulmonary emergencies and serious side effects of anti-TB medications.

Take-Home Points:

• There are a number of life-threatening pulmonary emergencies that can occur in active or latent TB patients due to structural lung changes, and we need to be ready to manage them
• Extrapulmonary TB can impact any organ system, but some of the most dangerous emergencies to be aware of include:
  • Cardiac
    • Cardiac tamponade 2/2 pericarditis with effusion
    • Myocarditis/sudden cardiac death
    • Increased risk of coronary artery disease/acute coronary syndrome
    • Aortitis
  • Neurologic
    • Meningitis
    • Tuberculomas
    • Spinal tuberculous arachnoiditis
    • Increased risk of ischemic stroke
  • Hematologic
    • Decreased cell lines, TTP, coagulopathy
  • GI
    • Bowel obstruction/perforation
    • Peritonitis
    • Tuberculous appendicitis
  • Osteoarticular
    • Osteomyelitis
    • Septic arthritis
• First-line anti-TB drugs can be quite toxic, with the most concerning emergencies including seizures, hepatoxicity, hematologic emergencies, life-threatening rashes, optic neuritis, and pneumonitis

You can view the full show notes and references here: https://docs.google.com/document/d/1ubGVR3i9lab1MM7NgXMjeORhQ-jFQt6C51R-9xI1VW4/edit?usp=sharing