Question

Wilson is a 36-year-old migrant worker. He was admitted to the Hospital with a cough, unintended weight loss, and night sweats. He is staying with 6 friends in a one bedroom apartment near the strawberry field where he works. The ED physician suspects Tuberculosis (TB).

What diagnostic testing will the Provider order to confirm a diagnosis of TB?

What Isolation precautions do you expect to be put in place and why?

Describe the recommended treatment regimen for TB, including the rationale for combination drug therapy.

Identify the reason compliance to medication therapy is often a concern in the patient with TB.

What should be done for Wilson's 6 roommates?

Answer 1

In this case if the physician suspects the TB on the basis of the symptoms further to assure the diagnostic test in the case of the TB is first the Mantoux test the sputum test as well as the chest X-ray and if it is confirmed that this is the case of the TB, first it is advised for isolation and to take the precautions to spread it.

In this case the recommended therapy is the DOT therapy. It involves the use of the drugs as rifampin, isoniazid, pyrazinamide, and ethambutol or the streptomycin for 6-9 months.

If there is drug resistance in the future we can use the fluoroquinolones as well as the amino glycoside class of the antibiotics by the parenteral route.

As per the patient compliance is concerned with the TB therapy the patient should be informed regarding the drug resistance cases as it may be as well as the possible ADRs associated with the therapy.

Then it is advised to patient to follow the timely medication schedule with utmost care.

In this case the Wilson's roommates are also advise to take precautions and try to make the distance/to be isolated from the patient as its an airborne disease, hence should be prevented to spread it and if any symptom persist just consult to the physician.