Thursday, May 19, 2005

Persistent infiltrates - Follow up

Regarding
  • previous post
  • He had come in on a Friday and was placed on resp isolation for the reasons you outlined. He was scheduled for a bronch on Monday but over the weekend his sputum smears were + for large AFB.His PPD was negative. We started him on 4-drug TB Tx and sent him home. On F/up he was much better with clearing infiltrates. His Cx though grew M. kansasii and no MTb.
    Any comments on therapy?

    3 comments - CLICK HERE to read & add your own!:

    Jennings said...

    According to the guidelines it's INH/Rif/ethambutol. No role for pyrazidamide. These 3 drugs are given for 18 months. You need > 12 months documented negative sputums.

    Good case.

    Baleeiro said...

    That seems to be the consensus. PPD are also usually neg with kansasii as in this case. We are planning on keeping him on the INH/RIF/ETH combo for at least a year, re-checking Cx's and taking it from there...

    CWRU/SVCH said...

    Presenting cases is an excellent idea. We have started a similar project on ClinicalCases.blogspot, there are plenty of pulmonary cases, and we will be glad to collaborate.