Granulomatous infection by Mycobacterium tuberculosis, most commonly pulmonary.
Clinical features
- • Cough >3 weeks
- • Haemoptysis
- • Weight loss, night sweats, fever
- • Extrapulmonary: lymphadenitis, spine (Pott), meningitis
Investigations
- • Sputum AFB ×3 + GeneXpert MTB/RIF
- • CXR (upper lobe cavitation, fibrosis)
- • Mantoux / IGRA (latent)
- • HIV test
Management
- • RIPE 2 months → RI 4 months (drug-sensitive)
- • Pyridoxine 10 mg OD with isoniazid
- • Contact tracing + DOTS
Drug therapy
- • Rifampicin 10 mg/kg OD
- • Isoniazid 5 mg/kg OD
- • Pyrazinamide 25 mg/kg OD
- • Ethambutol 15 mg/kg OD
Complications
- • Hepatotoxicity (check LFT)
- • Optic neuritis (ethambutol)
- • MDR-TB
References
- • WHO TB 2024
- • NICE NG33
Related in WardRound
Educational — verify locally.
