Pulmonary Tuberculosis

Pulmonary Tuberculosis Dave Jay S. Manriquez RN. February 1, 2009

Tuberculosis ,[object Object],[object Object],[object Object],[object Object]

Epidemiology ,[object Object],[object Object],[object Object],[object Object]

Epidemiologic Pearl ,[object Object],[object Object]

Incidence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pathogenesis ,[object Object],[object Object],[object Object],[object Object],[object Object]

Primary disease ,[object Object],[object Object],[object Object],[object Object]

Reactivation of disease ,[object Object],[object Object],[object Object],[object Object],[object Object]

Pulmonary Tuberculosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pulmonary Tuberculosis ,[object Object],[object Object],[object Object]

Complications ,[object Object],[object Object],[object Object],[object Object]

Complications ,[object Object],[object Object],[object Object],[object Object],[object Object]

TREATMENT OF TUBERCULOSIS, 2003 Division of Tuberculosis Elimination Centers for Disease Control and Prevention American Thoracic Society Centers for Disease Control and Prevention Infectious Diseases Society of America

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Antituberculosis Drugs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],First-Line Drugs Second-Line Drugs * Not approved by the U.S. Food and Drug Administration for use in the treatment of TB

Role of New Drugs ,[object Object],[object Object]

Role of New Drugs ,[object Object],[object Object],[object Object],[object Object]

When to Consider Treatment Initiation ,[object Object],[object Object],[object Object],[object Object],[object Object]

Baseline Diagnostic Examinations for TB ,[object Object],[object Object],[object Object]

Other Examinations to Conduct When TB Treatment Is Initiated ,[object Object],[object Object],[object Object]

Other Examinations to Conduct When TB Treatment Is Initiated ,[object Object],[object Object]

Treatment Regimens ,[object Object],[object Object],[object Object]

Why Extend Continuation-Phase Treatment for 3 Months? ,[object Object],[object Object]

When to Extend Continuation-Phase Treatment for 3 Months? ,[object Object],[object Object],[object Object],[object Object]

Is specimen collected at end of initial phase (2 months) culture positive? NO YES Place patient on initial-phase regimen: INH, RIF, EMB, PZA for 2 months Give continuation-phase treatment of INH/RIF daily or twice weekly for 4 months Algorithm to Guide Duration of Continuation-Phase Treatment for Culture-Positive TB Patients High clinical suspicion for active TB

Give continuation-phase treatment of INH/RIF daily or twice weekly for 7 months Give continuation- phase treatment of INH/RIF daily or twice weekly for 4 months NO YES Was there cavitation on initial CXR? NO YES Is the patient HIV positive? Algorithm to Guide Duration of Continuation-Phase Treatment for Culture-Positive TB Patients Give continuation- phase treatment of INH/RIF daily for 7 months

MDR vs. XDR TB ,[object Object],[object Object],[object Object],[object Object]

References ,[object Object],[object Object]

Pulmonary Tuberculosis

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Pulmonary Tuberculosis