Case Studies

Pediatric TB: What to Expect and When to Expect it

A 34 year old Hispanic male was diagnosed with pulmonary tuberculosis based on clinical findings, positive AFB sputum smears and a Nucleic Acid Amplification test (NAAT) positive for M. tuberculosis.

Case Study

On 9/8/2010 a 27 year old Hispanic man was admitted to a psychiatric facility for treatment of undifferentiated schizophrenia. The patient received treatment with risperidone 3 mg daily. The patient’s psychiatric issues were well controlled and he tolerated the medication well.

Case Study

A 40 year old Native American male with a 1 year history of untreated HIV infection presented with shortness of breath, productive cough and fever of 6 weeks duration. He was noted to have cervical and axillary lymphadenopathy on exam.

Tuberculosis Pleural Effusions and a Case of Empyema Necessitatis

A 15 year old pregnant female presented to the emergency department of a local hospital with respiratory distress at 32 weeks gestation. She had failed to gain weight appropriately during her pregnancy and throughout her thrid trimester of pregnancy had cough, shortness of breath and night sweats.

Determining Treatment Options with Limited Documentation

A 62 year old woman from Mexico was referred to the local health department in November 2009 with a positive Tuberculin Skin Test (TST) (22 mm), and an abnormal chest x-ray.

Using Genotyping to Confirm a Suspected Case of Tuberculosis Cross Contamination

Patient A was a 45-year old US-born white female with a six month history of illness characterized by a twenty pound weight loss, dry cough, shortness of breath (SOB), and chest pain.

Utilizing Mental Health Assessments to Improve TB Outcomes

A 48 year old Caucasian male was diagnosed with pulmonary tuberculosis in May 2006. The patient's initial isolate was resistant to isoniazid, ethionamide, levofloxacin, ofloxacin, and moxifloxacin.

The Use of Interferon-Gamma Release Assays in a Contact Investigation

A 23 year old university student from Africa was diagnosed with active TB disease in April 2008. The patient presented with an infrequent productive cough and no other symptoms. His tuberculin skin test (TST) was 15mm and chest radiographs were abnormal.

The Impact of Nutrition on TB Treatment Outcomes

A 49 year old male was diagnosed with recurrent pulmonary tuberculosis after presenting to an emergency room with a 3 month history of malaise, chills, subjective fevers, shortness of breath, productive cough; and weight loss over the past year.

Hookah Smoking: A Rising Tuberculosis Health Risk Behavior

A 20 year old Russian university student, who had entered the United States 2 ½ years earlier, was diagnosed with extremely drug resistant tuberculosis (XDR TB). She noted travel back to Russia 6 months prior to the onset of symptoms.

Adherence Difficulties in a Child with Tuberculosis

A 15 month old child with active pulmonary tuberculosis became a significant management challenge to his public health nursing providers because of his consistent refusal to take medications.

Tuberculosis in an Adoptee

A 6-year-old girl presented to her pediatrician with decreased hearing acuity found by routine elementary-age screening. She had been adopted from a Korean orphanage at 9 months of age and had a history of poor growth there.

Primary Tuberculosis Following Exposure

A twenty year old woman was evaluated as a contact of a patient who had extensive smear positive pulmonary tuberculosis (drug susceptible isolate). She denied any symptoms of cough, weight loss, fatigue, night sweats or fever.

Delayed Culture Conversion, Low Serum Drug Levels

Our patient is a 54 year-old male who presented to his physician for follow up of a right upper lobe carcinoma which was ressected in 1979. He complained of shortness of breath, weight loss, fatigue, chest pain and a productive cough but no hemoptysis.

Failure to Convert: Non Adherence to Treatment

A 67 year old Hispanic male was diagnosed with drug susceptible pulmonary tuberculosis in September 2005. He presented with a three week history of night sweats, weight loss, nausea, shortness of breath and a productive cough.

Missed Opportunities

A 52 year old Hispanic female presented in January 2006 with left upper quadrant (LUQ) pain. An abdominal x-ray series revealed a density in the left upper lung; there was no hilar, mediastinal or axillary adenopathy.

Evaluation and Management of Childhood Contacts to Infectious Pulmonary Tuberculosis

A 31 year old male was admitted to the hospital after experiencing gross hemoptysis. He had a 2 month history of productive cough, a 25 pound weight loss, night sweats, and fatigue. A chest x-ray (CXR) revealed bilateral cavitary infiltrates.

Abdominal Tuberculosis

A 27-year old Hispanic female presented to hospital on January 27, 2005 with a fever of 104°, a two week history of abdominal swelling, decreased appetite and body aches. She was admitted for diagnostic testing and follow-up.

TB in a Patient Receiving Immunosuppression Including a TNF Alpha Blocker

A 55-year old female emigrated from El Salvador in the mid 1980s. She had been employed by a poultry processing plant for 15 years (high risk environment associated with TB transmission).