CLINICAL PRACTICE

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ROBERT M.; JASMER M.; NAHID P.; PHILIP C.; HOPPWELL C.

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Journal: Medical Journal of Mashhad University of Medical Sciences Year:2003 | Volume:46 | Issue:80 Page(s): 83-88

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Title

CLINICAL PRACTICE

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Abstract

Global migration is changing the international landscape of infectious diseases. In developed countries, immigration has become an increasingly important factor in the epidemiology of tuberculosis. The WHO estimates that in 1999 there were 8.4 million new cases, up from 8.0 million in 1997. The WHO also estimates that there are nearly 2 million deaths from tuberculosis annually. In countries with a low incidence of tuberculosis, identification and treatment of persons with latent tuberculosis infection is important. There are two tests for identification of latent tuberculosis infection: tuberculin skin test and a new test, by measuring the release of interferon gamma in whole blood in response to stimulation by PPD that has been approved by FDA.The goal of testing for latent tuberculosis infection is to identify persons who are at increased risk for the development of tuberculosis and would benefit from treatment of tuberculosis infection.Persons with highest risk of tuberculosis intection include: Persons with HIV infection, in close contact of persons with active tuberculosis, persons with abnormal CX-Ray showing upper lobe fibrosis consistent with previous TB and immuno suppressed patients who have been receiving at least, 15 mg Prednisolon per day for at least one month.The first choice for treatment of latent TB infections is INH 5 mg/kg of b.w. maximum 300 mg for 9 months.The second choice for treatment of L.T. infection is Rifampin for 4 month, and the third choice for treatment is Rifampin and Pyrazinamid for 2 months.Answer: In 27 years schoolteacher who was born in U.S. the induction of PPD is 17 mm. There is no symptom and a normal chest radiograph. Should this patient receive treatment for latent tuberculosis infection?Reply: This man is at low risk for the development of tuberculosis and should not have been tested.Nonetheless, she has latent tuberculosis infection as evidenced by her tuberculin reaction of more than 15 mm. However, she should not be treated, because she has no conditions that increase her risk of progression to tuberculosis and it is unknown when she became infected. One can not conclude that she has had recent tuberculin conversion, because she has not had a negative tuberculin test within the past two years.

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APA: Copy

ROBERT, M., JASMER, M., NAHID, P., PHILIP, C., & HOPPWELL, C.. (2003). CLINICAL PRACTICE. MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES, 46(80), 83-88. SID. https://sid.ir/paper/52301/en

Vancouver: Copy

ROBERT M., JASMER M., NAHID P., PHILIP C., HOPPWELL C.. CLINICAL PRACTICE. MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES[Internet]. 2003;46(80):83-88. Available from: https://sid.ir/paper/52301/en

IEEE: Copy

M. ROBERT, M. JASMER, P. NAHID, C. PHILIP, and C. HOPPWELL, “CLINICAL PRACTICE,” MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES, vol. 46, no. 80, pp. 83–88, 2003, [Online]. Available: https://sid.ir/paper/52301/en

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