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
- Cardiac
- 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
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