tuberculosis
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Etiology
- inhalation of aerosolized droplets containing MTB
- direct inoculation of abraded skin
- risk factors for primary progression or reactivation of quiescent disease
- immunosupression
- malnutrition, alcoholism
- chronic renal failure
- diabetes mellitus
- ileojejunal bypass
- head & neck cancer
- pulmonary fibrosis, silicosis
- injection drug use
- incarceration, homelessness, living in shelter
- stress
- cigarette smoking may be risk factor[17]
Epidemiology
- 2 billion people worldwide believed to have latent TB
- each year worldwide, ~9 million people develop active tuberculosis[4]
- lifetime risk of a person infected with tuberculosis for developing active disease is 5-10%
- coinfection of HIV & tuberculosis
- when coinfected with MTB & HIV, risk of active TB is increased to 8-40%/year
- average CD4 count of AIDS patients developing tuberculosis is 150-200/mm3
- 6-8% of patients with MTB are coinfected with HIV[19][30]
- > 1/3 of patients with HIV1 infection worldwide are coinfected with MTB
- 20% of deaths in patients with HIV1 infection are due to tuberculosis[4]
- outbreaks of multi-drug resistant tuberculosis have occurred in urban populations at risk for TB & HIV
- 5.1 cases/100,000 people in 2003[9]
- 60-65% of new TB cases in foreign born individuals[4][9]; 30% of these cases diagnosed within 2 years of entry into the US; 45% lived in U.S. for >= 10 years[39]
- prevalence of tuberculosis is 11-15 times higher in foreign- born US residents than US-born residents[4][30][39]
- Asians have highest incidence of tuberculosis (0.018%); whites have lowest incidence 0.0006%[30][39]
- California, Florida, New York, & Texas account for 50% of tuberculosis in U.S.[30]
Pathology
- progression to active tuberculosis can occur after initial infection or by reactivation of latent tuberculosis
- pulmonary disease (most frequent clinical presentation)
- accounts for 70% of active disease[4]
- lymphatic/reticuloendothelial disease
- genitourinary disease
- osteomyelitis (lower spine 'Pott's disease')
- meningitis, peritonitis, pericarditis, adrenalitis
- miliary TB
- immunocompromised patients are more likely to have extrapulmonary tuberculosis
- Mycobacterial isocitrate lyase protects MTB against interferon-mediated macrophage elimination
a human-like protein kinase G renders mycobacteria resistant to bactericidal activity of macrophages, probably by inhibiting fusion of phagosomes with lysosomes[10]
- iron-binding acute phase protein detected with variable frequency in serum of patients with tuberculosis (non-specific)
- granulomas contain macrophages that possess CYP27B1, the 5-hydroxyvitamin D-1 alpha hydroxylase that forms calcitriol from calcifediol, resulting in hypercalcemia
Genetics
- polymorphisms in vitamin D3 receptor may determine Mycobacterium tuberculosis susceptibility
- polymorphisms in SLC11A1 determine Mycobacterium tuberculosis susceptibility
- polymorphisms in CCL2 determine Mycobacterium tuberculosis susceptibility
Clinical manifestations
- productive chronic cough over weeks or months
- patients typically present with chronic cough
- absence of cough in immunocompetent patient sufficient to rule out pulmonary tuberculosis[29]
- purulent sputum[4], may be blood-tinged
- hemoptysis
- pleuritic chest pain
- dyspnea with extensive disease or pleural effusion
- fever with night sweats
- malaise, fatigue
- anorexia
- weight loss
- if CNS involvement, basilar meningitis & cranial nerve palsy
- immunocompromised patients may not present with typical signs/symptoms
- AIDS patients more likely to present with extrapulmonary tuberculosis[4]
- may be asymptomatic, especially
- initial phase
- HIV patients[4]
- most patients asymptomatic, develop latent tuberculosis[4]
- latent tuberculosis is asymptomatic
- case report of non-pulmonary abdominal tuberculosis presenting as urinary tract infection[40]
Laboratory
- sputum:
- a sputum volume of at least 3 mL (optimally, 5-10 mL) is required[36]
- acid fast smears provide presumptive ID, but Nocardia & other Mycobacterium spp also appear acid fast on smear
- 3 specimens for microscopy & culture prior to treatment[4][36]
- initial diagnostic test of choice for active tuberculosis[50][51]
- exception appears to be lymphocyte predominant pleural effusion[46]
- sputum culture of 3 specimens
- obtain when actve disease suspected, even when acid fast smears are negative or when Mycobacterium tuberculosis nucleic acid is positive[4]
- both liquid & solid mycobacterial cultures should be performed for every specimen[36]
- recovered isolates should be identified according to standard criteria[36]
- culture provides basis for drug susceptibility testing[4]
- sputum acid-fast staining & culture most likely to confirm diagnosis of active pulmomary tuberculosis[4]
- blood culture: positive in 26-42% of AIDS patients
- Mycobacterium tuberculosis nucleic acid
- PCR (sputum, CSF) for Mycobacterium tuberculosis DNA when diagonosis suspected but not confirmed[4][32]
- Mycobacterium tuberculosis rRNA
- molecular testing of sputum samples facilitates sooner discontinuation of respiratory isolation & provides clinical & economic benefits[41]
- excludes nontuberculous Mycobacteria[4]
- a negative test does not exclude tuberculosis[4]
- QuantiFERON-TB test (IFN-gamma release) or tuberculin skin testing
- latent tuberculosis
- tuberculin skin testing or QuantiFERON-TB test for all patients with suspected active TB
- QuantiFERON-TB test is preferred to tuberculin skin testing unless <5 years[4]
- may be negative in patients with anergy, miliary or disseminated TB[4]
- HIV testing
- see ARUP consult[20]
- serum calcium, serum phosphorus
- genotyping for epidemiological reasons[36]
- RNA expression signatures obtained from peripheral blood may provide data that helps distinguish tuberculosis from other diseases[26]
- Mycobacterium tuberculosis rifampin resistance & optionally Mycobacterium tuberculosis isoniazid resistance in patients at risk for drug-resistant tuberculosis[36]
- adenosine deaminase in body fluid for extrapulmonary TB[36]
- elevated interferon-gamma in pleural fluid virtually diagnostic of tuberculous pleuritis in patients with lymphocytic exudates[45]
- acid-fast stain. mycobacterial culture & histopathology for extrapulmonary tuberculosis[4]
- baseline laboratory values:
- complete blood count (CBC):
- pancytopenia suggests bone marrow involvement
- investigational:
- nanoparticles coated with antibodies that recognize peptides specific for Mycobacterium tuberculosis may be useful for diagnosis of extrapulmonary tuberculosis for blood samples[37]
Diagnostic procedures
- bronchoscopy with bronchoalveolar lavage for patients with suspected active TB, but negative sputum acid fast smears[4]
- including patient on TNF-alpha inhibitors[49]
- thoracentesis & pleural biospy for tuberculous pleural effusion[4][46]
- sputum acid-fast bacilli smears have low diagnostic yield for pleural disease[45]
Radiology
- chest X-ray
- upper lobe cavitary lesions without air-fluid levels may be associated with latent TB, reactivation TB or primary progressive TB[4]
- infiltrates in apical-posterior segments of upper lobe & superior segment of lower lobe in reactivation TB
- primary progressive TB
- interstitial disease, bilateral infiltrates & pleural effusions may be seen in patients with severe immunosuppression
- radiologic findings may absent with severe immunosuppression[4]
- HIV infection strongest predictor of non upper-lobe lesion[12]
- millet seed appearance (uniform reticulonodular infiltrate) in milliary TB[4]
- multiple small pulmonary nodules
- pleural thickening
- chest CT may identify abnormalities not seen on chest X-ray
Complications
- tuberculous sepsis -> systemic inflammatory response syndrome ->septic shock (immunosuppressed patients)[4]
Differential diagnosis
- other Mycobacterium
Management
- pulmonary TB: (treatment after laboratory verification of infection)
- INH 300 mg PO QD + (50 mg pyridoxine PO QD)
- rifampin (RIF) 600 mg PO QD
- pyrazinamide (PZA) 1.5-2.0 g PO QD
- ethambutol (EMB) 15 mg/kg PO QD or streptomycin 15 mg/kg IM QD
- treatment for 6-9 months
- 4 drug regimen for 2 months followed by INH + rifampin for 4-7 months[4]
- if isolate is found to be susceptible to INH & rifampin, ethambutol or streptomycin may be dropped & 3 drugs:
- INH, rifampin, & pyrazinamide continued for 8 weeks followed by 4-7 months of INH & rifampin
- 7 months recommended for patients with cavitary disease at diagnosis, patients who did not receive pyrazinamide as part of initial therapy, positive cultures after initial 2 months of therapy[4]
- rifapentine-based regimens have potent antimycobacterial activity that may allow for a shorter course in patients with drug-susceptible pulmonary TB
- rifapentine, isoniazid, pyrazinamide, moxifloxacin for 4 months[48]
- respiratory isolation
- all hospitalized patients with pulmonary TB in a negative pressure room
- remove from respiratory isolation when patient is on adequate anti-tuberculous drug therapy for 2 weeks &
- hospitalization for respiratory isolation is not required
- extrapulmonary TB:
- treat same as pulmonary TB for 6-9 months
- tuberculous pericarditis:
- INH-resistant TB:
- rifampin 600 mg PO QD
- pyrazinamide 1.5-2.0 g PO QD
- ethambutol 15 mg/kg PO QD or
- streptomycin 15 mg/kg IM QD
- duration of therapy 6 months
- multidrug resistant TB:
- empiric therapy should consist of 5-6 drugs
- treatment should consist of at least 3 drugs to which the organism is sensitive
- addition of linezolid may be of benefit[21]
- adverse effects common
- addition of bedaquiline (Sirturo) may be of benefit[24]
- consider surgery for which the bulk of the disease is resectable
- continue 5-6 drug intensive phase for 5-7 months after culture negative
- follow with 4 drugs for at least 15-21 months months (continuation phase)
- associated with increased mortality[4]
- patients who must be treated parenterally
- other 1st line agents
- other 2nd line agents
- cycloserine
- ethionamide
- kanamycin plus amikacin
- fluoroquinolones
- ciprofloxacin, ofloxacin, levofloxacin, moxifloxacin, gatifloxacin
- treatment of fluoroquinolone-sensitive tuberculosis for 4 months is inadequate[27]
- para-aminosalicylate
- new drug(s) on the horizon
- monitoring therapy at least monthly[4]
- directly observed therapy
- recommended when medication administration is <7 days/week
- recommended because medical noncompliance can result in:
- transmission of tuberculosis
- treatment failure
- drug resistance[4]
- pulmonary TB:
- weekly sputum smears & cultures for the 1st 6 weeks of therapy
- smears & cultures obtained thereafter until cultures are negative
- continued positive smears or cultures after 3 months suggest drug-resistance or non-compliance with medications
- routine laboratory testing recommended for patients with baseline laboratory abnormalities or increased risk of adverse effects
- liver function should be monitored often, perhaps as often as every 2 weeks[8]
- patients taking ethambutol should be tested for visual acuity & red-green color perception
- directly observed therapy
- treatment does not affect HIV antiretroviral therapy[15]
- never add a single drug to a failing regimen[4]
- discontinuation of therapy for >= 2 weeks
- restart orginal antituberculous regimen from the beginning[22]
- see screening for tuberculosis
- see chemoprophylaxis for latent tuberculosis
- prevention
- Bacillus Calmette-Guerin (BCG)
- live virus vaccine
- most effective in preventing disseminated infection & tuberculous meningitis in children[3]
- MTB vaccines in clinical trials[33]
- Bacillus Calmette-Guerin (BCG)
- The Health Dept. should be notified in all cases of TB.
- infection control
- N95 respirator is used by medical personel in contact with tuberculosis patients[13]
- airborne precautions (surgical face mask) for visitors[31]
- determination patient is no longer contagious requires
More general terms
More specific terms
- cutaneous tuberculosis; includes tuberculous chancre, tuberculosis verrucosa cutis
- drug-resistant tuberculosis
- extensively drug-resistant tuberculosis (XDR-TB)
- HIV1/tuberculosis coinfection
- latent tuberculosis; inactive tuberculosis
- scrofula
- silicotuberculosis
- tuberculoma
- tuberculous arthritis
- tuberculous enteritis
- tuberculous meningitis
- tuberculous peritonitis
- tuberculous pleural effusion
- tuberculous pleurisy
Additional terms
- chemoprophylaxis for tuberculosis
- contacts of persons with tuberculosis
- Mycobacterium tuberculosis (MTB)
- Mycobacterium tuberculosis DNA
- purified protein derivative (PPD, Tubersol)
- QuantiFERON-TB test; interferon gamma release assay (IGRA)
- screening for tuberculosis
- tuberculin-skin testing (TST)
References
- ↑ Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 183-86
- ↑ 3.0 3.1 American Thoracic Society: Am J Crit Care Med 149:1359-1374 1994
- ↑ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 4.34 4.35 4.36 Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 1998, 2006, 2009, 2012, 2015, 2018, 2021.
Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022 - ↑ Prescriber's Letter 7(7):40 2000
- ↑ Journal Watch 20(19):153, 2000
- ↑ Davies P. Tuberculosis in the elderly. Epidemiology and optimal management. Drugs Aging, 8:436, 1996 PMID: https://www.ncbi.nlm.nih.gov/pubmed/8736627
- ↑ 8.0 8.1 Journal Watch 21(19):155, 2001 Centers for Disease Control and Prevention (CDC). Update: Fatal and severe liver injuries associated with rifampin and pyrazinamide for latent tuberculosis infection, and revisions in American Thoracic Society/CDC recommendations
United States, 2001. MMWR Morb Mort Wkly Rep 50:733, 2001 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11787580 - ↑ 9.0 9.1 9.2 Journal Watch 24(8):64, 2004 Centers for Disease Control and Prevention (CDC). Trends in Tuberculosis - United States 1998-2003, MMWR Morb Mort Wkly Rep 52:209, 2004 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/15029114 <Internet> http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5310a2.htm
- ↑ 10.0 10.1 Journal Watch 24(13):107, 2004 Walburger A, Koul A, Ferrari G, Nguyen L, Prescianotto-Baschong C, Huygen K, Klebl B, Thompson C, Bacher G, Pieters J. Protein kinase G from pathogenic mycobacteria promotes survival within macrophages. Science. 2004 Jun 18;304(5678):1800-4. Epub 2004 May 20. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15155913
- ↑ 11.0 11.1 Journal Watch 25(4):31-32, 2005 Andries K, Verhasselt P, Guillemont J, Gohlmann HW, Neefs JM, Winkler H, Van Gestel J, Timmerman P, Zhu M, Lee E, Williams P, de Chaffoy D, Huitric E, Hoffner S, Cambau E, Truffot-Pernot C, Lounis N, Jarlier V. A diarylquinoline drug active on the ATP synthase of Mycobacterium tuberculosis. Science. 2005 Jan 14;307(5707):223-7. Epub 2004 Dec 09. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15591164
- ↑ 12.0 12.1 Journal Watch 25(15):121, 2005 Geng E, Kreiswirth B, Burzynski J, Schluger NW. Clinical and radiographic correlates of primary and reactivation tuberculosis: a molecular epidemiology study. JAMA. 2005 Jun 8;293(22):2740-5. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15941803
- ↑ 13.0 13.1 Veterans Administration, Mather CA
- ↑ Controlling Tuberculosis in the United States Recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of America MMWR: Recommendations and Reports November 4, 2005 / 54(RR12);1-81 http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5412a1.htm
Jensen PA, Lambert LA, Iademarco MF, Ridzon R; CDC. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recomm Rep. 2005 Dec 30;54(17):1-141. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16382216 - ↑ 15.0 15.1 Breen RAM et al, Virological response to highly active antiretroviral therapy is unaffected by tuberculosis therapy. J Infect Dis 2006; 193:1437 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16619192
- ↑ Liu Y et al Overseas screening for tuberculosis in U.S.-bound immigrants and refugees. N Engl J Med 2009 Jun 4; 360:2406. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19494216
- ↑ 17.0 17.1 Shang S et al. Cigarette smoke increases susceptibility to tuberculosis - Evidence from in vivo and in vitro models. J Infect Dis 2011 May 1; 203:1240 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21357942
- ↑ Recommendations and Reports Prevention and Control of Tuberculosis in Correctional and Detention Facilities: Recommendations from CDC MMWR July 7, 2006 July 7, 2006 / 55(RR09);1-44 Corresponding NGC guideline withdrawn Dec 2011 http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5509a1.htm
- ↑ 19.0 19.1 Centers for Disease Control and Prevention Trends in Tuberculosis - United States, 2011 MMWR March 23, 2012 / 61(11);181-185 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6111a2.htm
- ↑ 20.0 20.1 ARUP Consult: Mycobacterium tuberculosis - TB The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/mycobacterium-tuberculosis
- ↑ 21.0 21.1 Lee M et al. Linezolid for treatment of chronic extensively drug-resistant tuberculosis. N Engl J Med 2012 Oct 18; 367:1508 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23075177
- ↑ 22.0 22.1 22.2 American Thoracic Society; CDC; Infectious Diseases Society of America. Treatment of tuberculosis. MMWR Recomm Rep. 2003 Jun 20;52(RR-11):1-77 PMID: https://www.ncbi.nlm.nih.gov/pubmed/12836625
- ↑ Caminero JA, Sotgiu G, Zumla A, Migliori GB. Best drug treatment for multidrug-resistant and extensively drug-resistant tuberculosis. Lancet Infect Dis. 2010 Sep;10(9):621-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20797644
- ↑ 24.0 24.1 World Health Oragnization (WHO). 2013 The use of bedaquiline in the treatment of multidrug-resistant tuberculosis. Interim Policy Guideline. http://apps.who.int/iris/bitstream/10665/84879/1/9789241505482_eng.pdf
World Health Oragnization (WHO). 2013 WHO interim guidance on the use of bedaquiline to treat MDR-TB https://mail.google.com/mail/u/0/?shva=1#inbox/13f425db09d8dfc1 - ↑ World Heath Organization Global tuberculosis report 2013 http://www.who.int/tb/publications/global_report/en/index.html
- ↑ 26.0 26.1 Anderson ST et al. Diagnosis of childhood tuberculosis and host RNA expression in Africa. N Engl J Med 2014 May 1; 370:1712 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24785206 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1303657
- ↑ 27.0 27.1 Gillespie SH et al Four-Month Moxifloxacin-Based Regimens for Drug-Sensitive Tuberculosis. N Engl J Med 2014; 371:1577-1587. October 23, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25196020 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1407426
Merle CS et al A Four-Month Gatifloxacin-Containing Regimen for Treating Tuberculosis. N Engl J Med 2014; 371:1588-1598. October 23, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25337748 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1315817
Jindani A et al High-Dose Rifapentine with Moxifloxacin for Pulmonary Tuberculosis. N Engl J Med 2014; 371:1599-1608. October 23, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25337749 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1314210
Warner DF, Mizrahi V. Shortening Treatment for Tuberculosis - Back to Basics. N Engl J Med 2014; 371:1642-1643. October 23, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25337754 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMe1410977 - ↑ World Health Organiziation (WHO). Oct 22, 2014 Improved data reveals higher global burden of tuberculosis. http://www.who.int/mediacentre/news/notes/2014/global-tuberculosis-report/en/
- ↑ 29.0 29.1 Levine AC, Shetty PP, Henwood PC, Sabeti P, Katz JT, Vaidya A. Interactive medical case. A Liberian health care worker with fever. N Engl J Med. 2015 Jan 29;372(5):e7. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25629759 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMimc1414101
- ↑ 30.0 30.1 30.2 30.3 30.4 Scott C et al Tuberculosis Trends - United States, 2014. MMWR Weekly. March 20, 2015 / 64(10);265-269 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6410a2.htm
- ↑ 31.0 31.1 Orciari Herman A, Sadough S, Sofair A Guidelines Issued on Isolation Precautions for Hospital Visitors; Utility of Face Masks Reviewed Physician's First Watch, April 13, 2015 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
Munoz-Price LS et al Isolation Precautions for Visitors. Infection Control & Hospital Epidemiology. April 10, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26017347 <Internet> http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9641478&fileId=S0899823X15000677 - ↑ 32.0 32.1 Centers for Disease Control and Prevention (CDC). Availability of an assay for detecting Mycobacterium tuberculosis, including rifampin-resistant strains, and considerations for its use - United States, 2013. MMWR Morb Mortal Wkly Rep. 2013 Oct 18;62(41):821-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24141407 Free full text
- ↑ 33.0 33.1 Rowland R, McShane H. Tuberculosis vaccines in clinical trials. Expert Rev Vaccines. 2011 May;10(5):645-58. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21604985 Free PMC Article
- ↑ Centers for Disease Control and Prevention (CDC), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Prevention and control of tuberculosis in correctional and detention facilities: recommendations from CDC. Endorsed by the Advisory Council for the Elimination of Tuberculosis, the National Commission on Correctional Health Care, and the American Correctional Association. MMWR Recomm Rep. 2006 Jul 7;55(RR-9):1-44. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16826161 Free full text
- ↑ Nahid P, Dorman SE, Alipanah N et al Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis. Clin Infect Dis. (2016) Aug 10. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27516382 <Internet> http://cid.oxfordjournals.org/content/early/2016/07/20/cid.ciw376
- ↑ 36.0 36.1 36.2 36.3 36.4 36.5 36.6 36.7 Lewinsohn DM, Leonard MK, LoBue PA et al. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention clinical practice guidelines: Diagnosis of tuberculosis in adults and children. Clin Infect Dis 2016 Dec 8 http://cid.oxfordjournals.org/content/early/2016/12/08/cid.ciw694
- ↑ 37.0 37.1 Liu C, Zhao Z, Fan J et al. Quantification of circulating Mycobacterium tuberculosis antigen peptides allows rapid diagnosis of active disease and treatment monitoring. Proc Natl Acad Sci U S A 2017 Apr 11; 114:3969 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28348223 Free PMC Article <Internet> http://www.pnas.org/content/114/15/3969
- ↑ Lewinsohn DM, Leonard MK, LoBue PA et al. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention clinical practice guidelines: diagnosis of tuberculosis in adults and children. Clin Infect Dis 2017 Jan 15; 64:e1 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27932390
- ↑ 39.0 39.1 39.2 39.3 Stewart RJ, Tsang CA, Pratt RH, Price SF, Langer AJ. Tuberculosis - United States, 2017. MMWR Morb Mortal Wkly Rep 2018;67:317-323 https://www.cdc.gov/mmwr/volumes/67/wr/mm6711a2.htm
- ↑ 40.0 40.1 McBride JA, Lepak AJ, Dhaliwal G The Wrong Frame of Mind. N Engl J Med 2018; 378:1716-1721 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29719187 https://www.nejm.org/doi/full/10.1056/NEJMcps1710814
- ↑ 41.0 41.1 Chaisson LH, Duong D, Cattamanchi A et al Association of Rapid Molecular Testing With Duration of Respiratory Isolation for Patients With Possible Tuberculosis in a US Hospital. JAMA Intern Med. Published online August 27, 2018. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30178007 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2697838
Salfinger M. Molecular Assay Testing to Rule Out Tuberculosis - Be That Early Adopter. JAMA Intern Med. Published online August 27, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30178040 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2697836 - ↑ Nahid P, Dorman SE, Alipanah NNahid P et al Executive Summary: Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis. Clin Infect Dis. 2016 Oct 1;63(7):853-67. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27621353
- ↑ Lewinsohn DM, Leonard MK, LoBue PA et al Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children. Clin Infect Dis. 2017 Jan 15;64(2):111-115. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28052967 Free PMC Article
- ↑ Centers for Disease Control and Prevention TB Guidelines http://www.cdc.gov/tb/publications/guidelines/Treatment.htm
- ↑ 45.0 45.1 45.2 Light RW Update on tuberculous pleural effusion. Respirology. 2010 Apr;15(3):451-8 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20345583
- ↑ 46.0 46.1 46.2 NEJM Knowledge+ Question of the Week. June 23, 2020 https://knowledgeplus.nejm.org/question-of-week/566/
Zhou Q et al. Diagnostic accuracy of T-cell interferon-gamma release assays in tuberculous pleurisy: a meta-analysis. Respirology 2011 Feb 9; 16:473 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21299686
Keng LT et al. Evaluating pleural ADA, ADA2, IFN-gamma and IGRA for diagnosing tuberculous pleurisy. J Infect 2013 Jun 26; 67:294 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23796864 - ↑ Deutsch-Feldman M, Pratt RH, Price SF, Tsang CA, Self JL. Tuberculosis - United States, 2020. MMWR Morb Mortal Wkly Rep 2021;70:409-414 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33764959 https://www.cdc.gov/mmwr/volumes/70/wr/mm7012a1.htm
- ↑ 48.0 48.1 Dorman SE, Nahid P, Kurbatova EV et al Four-Month Rifapentine Regimens with or without Moxifloxacin for Tuberculosis. N Engl J Med 2021; 384:1705-1718. May 6 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33951360 https://www.nejm.org/doi/full/10.1056/NEJMoa2033400
- ↑ 49.0 49.1 Godfrey MS, Friedman LN Tuberculosis and Biologic Therapies: Anti-Tumor Necrosis Factor-alpha and Beyond. Clin Chest Med. 2019 Dec;40(4):721-739 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31731980
- ↑ 50.0 50.1 Jacobson KR Tuberculosis. Ann Intern Med. 2017 Feb 7;166(3):ITC17-ITC32 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28166561
- ↑ 51.0 51.1 Zumla A, Raviglione M, Hafner R, von Reyn CF. Tuberculosis. N Engl J Med. 2013 Feb 21;368(8):745-55 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23425167 Review. https://www.nejm.org/doi/pdf/10.1056/NEJMra1200894
- ↑ Muneer A, Macrae B, Krishnamoorthy S, Zumla A. Urogenital tuberculosis - epidemiology, pathogenesis and clinical features. Nat Rev Urol. 2019 Oct;16(10):573-598 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31548730 Review.
- ↑ Jacob JT, Nguyen TM, Ray SM. Male genital tuberculosis. Lancet Infect Dis. 2008 May;8(5):335-42. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18471778
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