This is a follow-up on the post below: this is the 60 y/o woman with dramatic smoking history and enlarging RUL mass.
We must have all trained in the same place or read the same data... I had the same exact thoughts as you have outlined.
She was seen by our CT surgeons and the mass was ressected. The frozen suggested benign inflammatory tissue. The path was caseating granulomata and the micro on the explant was smear+ for AFBs. Smears of the airways and other respiratory secretions were negative.
It looks like this is a tuberculoma but there still seem to be viable AFB within it. She has already completed a previous course of Tx for TB. What would you do now?
Wednesday, September 07, 2005
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Interesting...I suppose that, at this point, I'd start 4 drugs and await the sensativities, then tailor treatment...
Now, what 4 drugs would I start? I'm not sure... I'd also see if we had the sensitivities from the prior isolate, and even consider fingerprinting the two isolates to determine if they are the same bug.
We have new Cxs pending. The previous isolate was truly pan-sensitive (every drug tested).
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