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Tuberculosis, Emergency Medicine

Vittorio J. Raho Reviewed 06/2017
 


Basics

Description

  • Tuberculosis (TB) is an infectious disease with protean manifestations, causing significant global morbidity and mortality.

Mechanism

  • Infectious droplet nuclei are inhaled through the ...

Diagnosis

Signs and Symptoms

  • Depending upon site of infection; all human tissues have potential for infection.

  • Pulmonary TB:

    • Cough

    • Fever, night sweats

    • Malaise, weight loss

    • Hemoptysis

    • Pleuritic chest pain

    • Shor...

Treatment

Pre-Hospital

  • Place patient in respiratory isolation (negative flow).

  • Place a mask on the patient to prevent respiratory spread of the disease.

  • Initiate treatment with an IV, oxygen, and pulse o...

Follow-Up

Disposition

Admission Criteria

  • Respiratory compromise

  • Suspicion of diagnosis

  • Inability to comply with outpatient therapy

  • Unavailable outpatient resources (no PCP)

  • Involuntary admission for noncomp...

Pearls and Pitfalls

  • Early isolation and respiratory precautions

  • Careful history to establish risk factors

  • The chest x-ray and PPD are great diagnostic aids.

  • Initial 4-drug regimen for active disease

  • Nonad...

Additional Reading

  • American Thoracic Society; CDC; Infectious Diseases Society of America. Treatment of tuberculosis. MMWR Recomm Rep.  2003;52(RR-11):1–77.

  • American Thoracic Society; Centers for ...

Codes

ICD9

  • 010.90 Primary tuberculous infection, unspecified, unspecified

  • 011.90 Unspecified pulmonary tuberculosis, unspecified

  • 795.51 Nonspecific reaction to tuberculin skin test without active tubercu...

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