Tuberculosis or known as TB remains a leading cause of morbidity and mortality in the world, especially in developing countries. A combination of factors including high costs, limited resources and the poor performance of various diagnostic tests make the diagnosis of TB difficult in developing countries. According to Centers for Disease Control and Prevention (2014), one third of the world’s population is infected with tuberculosis. In 2012, nearly nine million people around the world become sick with tuberculosis disease, and there were around one point three million TB related deaths worldwide.
A nurse admitted a patient to the hospital with a possible diagnosis of active tuberculosis (TB). The patient was noted on admission to have a fever of 99.9°F. The patient has a cough with hemoptysis. On physical examination, the nurse notes an increased respiratory rate of 24, crackles in the lungs, and a regular heart rate of 88.
Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, in which bacteria may invade many parts of the body, such as the brain, the kidneys, and the spine. Mycobacterium tuberculosis is a rod shaped, aerobic bacterium that is resistant to destruction and can persist in necrotic and calcified lesion for prolonged periods and remain capable of reinstating growth (Porth, 2011). However, the most common target is the lungs (Wouk, 2010). The Tuberculosis bacteria severely damage the lungs that it is difficult for a person to breathe. According to Wouk, there are two main types of Tuberculosis. The first type is latent, which means a person carries the tuberculosis germ, but he or she is not sick and can not pass the germ on to the other person, and the other type is active tuberculosis.
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...n of purified protein derivative or PPD, which is derived from cultures of M tuberculosis (Nayak & Acharjya, 2012). According to Nayak and Acharjya (2012), a person who has been exposed to the bacteria is expected to mount an immune response in the skin containing the bacterial proteins. A positive skin test means an infection with M tuberculosis has occurred, but does not prove tuberculosis disease. However, false positive results can occur with exposure to, or disease of, nontuberculous mycobacteria (Alguire, 2009). In addition, the causes of false positive TB skin test include previous BCG vaccination, incorrect method of skin test administration, incorrect interpretation of reactions, or incorrect bottle of antigen used (Nayak & Acharjya, 2012). Due to the test’s low specificity, most positive reactions in low-risk individuals are false positive (Starke, 1996).
On December 1, 2012, a patient by the name of John Dough walks into the medical assistant’s office. The patient is five foot 11 inches tall, currently he is 70 years old and weighs approximately 211 pounds. The patient has no known allergies does not smoke and has a relatively clean health record. After filling out the patient medical history forms, the patient is seen by the doctor. The patient explains to the doctor that lately he has had trouble lifting object he would not normally have trouble with, as well as walking short distances, and being very fatigued. After further examination the patient explains how he recently found a tick on his back and removed it, but now there is a red bullseye on his back. The physician suggests a blood sample be taken and sent to the laboratory. To help with weakness and fatigue he recommends the patient to get a good nights sleep and drink plenty of fluids to avoid dehydration. He also wants the patient to limit medication intake that could contribute to fatigue such as cold and allergy medicines and make sure to finish all daily exercising three to four hours before bed. The patient schedules a check up two weeks later.
Paul Farmer designed several studies that he used to help create new TB treatment methods, including a study about a system called active case finding, which helps find TB cases more quickly. The previous system of tuberculosis case finding is known as passive case finding. Passive case finding is when tu...
Drug resistance in mycobacterium tuberculosis (TB) has become a severe global health threat. The fight against TB is now facing major challenges due to the appearance of Multi-Drug Resistant Tuberculosis (MDR-TB) and more recently, the virtually untreatable Extensively Drug Resistant Tuberculosis (XDR-TB). MDR-TB are strains that are resistant to both top first-line drugs, Isoniazid and Rifampin, while XDR-TB are MDR-TB strains that are also resistant to any fluoroquinolone and one or more of 3 injectable drugs. With this new resistance, there emerges a great need to find new drugs that are as effective, yet bypass the problem of resistance. One method of research is to find new vulnerabilities of tuberculosis to use as new target sites of drugs. This method is highly expensive (Scheffler, Colmer, Tynan, Demain, & Gullo, 2013), and requires intense and lengthy research just to implicate the new target site. An alternative is to develop new drugs that work on the same already known target as the first-line drugs, but by a different mechanism, thereby bypassing the resistance of the TB to the drug.
...d lymphokines. Lymphokines will attract other inflammatory cells into the site. This response generally peaks in 48 hours after PPD injection. Redness at the injection site and induration resulting from cellular infiltration represent the immune response to the skin test (Nayak, 2012).
One of the first steps to treating Tuberculosis is identifying which form has developed in the body. The two forms that could progress in the body are latent Tuberculosis infection and active Tuberculosis infection (CDC, Morbidity and Mortality Weekly Reports). Latent Tuberculosis is the dormant form of the bacteria, meaning that it is inactive and doesn?t cause an infectious reaction in the body. Even if the latent form enters the body, treatment should be sought (CDC, Morbidity and Mortality Weekly Reports). Latent Tuberculosis can become active Tuberculosis easily though, especially if the immune system is compromised by another infection, like HIV (CDC, Morbidity and Mortality Weekly Reports). Active Tuberculosis infects the body immediately. Symptoms show in the body meaning the bacteria is effecting the cells of the body. Identifying the form is important because treatment is dependent upon it. Testing for TB involves a skin test, usually within seven work-days of contact with the bacteria. Without knowing what is in the body, the drugs won?t be as effective and might even cause drug-resistance.
Mantoux PPD skin test; two is a Chest X-ray which is given after the Skin test
Hepatitis B is a DNA viral infection that causes damage and inflammation to the liver. It was first discovered in 1965 by Dr. Baruch Blumberg. The HBV virus is very contagious and is even thought to be the most serious form of viral hepatitis and the most common viral infection on Earth. “HBV is 100 times more infectious than HIV.” (Green, 2002, pg. 7) The virus can survive for about one week outside the body on a dry surface. According to Green (2002, pg. 7), “One in twenty Americans has been infected with the virus at some point in their lives.” Between the ages of 15-39 is when 75% of new HBV infections occur, according to Green (2002, pg.8).
Tuberculosis (TB) is an infection that can attack any part of the body, but it is normally found in the lungs (Huether, McCance, Brashers and Rote, 2008). TB is an infection caused by an acid-fast bacillus also known as Mycobacterium tuberculosis (Huether et al. 2008) It is one of the leading causes of death in Asia, China, India, Indonesia and Pakistan (Huether et al. 2008). The 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' of the 'Secondary' of the These countries show that in most cases the incidence rate is highest in young adults, and are usually the result of re-infection in recent infections. The spread of TB is attributed to the emigration of infected people from high-prevalent countries, substance abuse, poverty, transmission in crowd places, and the lack of proper medical care for the infected individuals (Huether et al. 2008).
Bacterial resistance to antibiotics has presented many problems in our society, including an increased chance of fatality due to infections that could have otherwise been treated with success. Antibiotics are used to treat bacterial infections, but overexposure to these drugs give the bacteria more opportunities to mutate, forming resistant strains. Through natural selection, those few mutated bacteria are able to survive treatments of antibiotics and then pass on their genes to other bacterial cells through lateral gene transfer (Zhaxybayeva, 2011). Once resistance builds in one patient, it is possible for the strain to be transmitted to others through improper hygiene and failure to isolate patients in hospitals.
...macrophage to kill bacteria that might have escaped from granuloma. Latent TB is characterized by absence of disease activity. It can be detected by TBT and Interferon-γ release assay (IGRA) and chest x-rays. The chest x-ray usually result normal due to the inactivity of the disease. TNF-α helps contain latent TB infection and keeps it from becoming active TB. Patient that have been treated withTNF antagonist are at greater risk of reactivation of LTBI to active TB
Its epidemiological importance is illustrated by World Health Organization Prevention of Tuberculosis includes better living conditions, proper nutrition, and positive health practices” (Fogel, 2015, p.530). Positive health practices include covering nose and mouth when coughing and frequent hand washing. Bacille Calmette-Gurin (BCG) vaccine tends to be given in other countries. Tuberculosis is known as one of the main causes of mortality in the world. This communicable disease is a serious public health conundrum. “The disease still puts a strain on public health, being only second to HIV/AIDS in causing high mortality rates” (Matteelli, Roggi, & Carvalho, 2014, p.
Primary tuberculosis is the initial infection of the host, usually being mild and asymptomatic. A healthy person recently infected with the mycobacterium may exhibit flu-like symptoms and has no reason to suspect tuberculosis. Left untreated, the bacilli infect and multiply within pulmonary alveolar macrophages, migrating to the hilar lymph nodes. An immune response is exhibited by the T-helper cells, and inflammation develops at multiple sites. A person may test positive in the tuberculin skin test at this point, and a chest x-ray may shows opacities in the lungs.
The patient has high temperature, and extreme sweating as well as visible chills on body.
7.) Shiel, Jr., MD, FACP, FACR , William C.. Tuberculosis Skin Test. 18 Sept 2005 MedicineNet, Inc.. 23 July 2006 .
According to the Malaysian Medical Association (MMA), close to half of foreign workers who underwent medical tests last year are infected with the contagious airborne disease tuberculosis (TB). Local daily The Star reported today MMA president Dr H. Krishna Kumar (12 March 2015) as saying that illegal foreign workers who do not go for medical screenings are the biggest factor behind the rise in TB cases, noting that medical tests found last year that 17,981 foreign workers are infected with TB, or 47 per cent of those tested. Thus, I strongly agree that over reliance on foreign workers can cause contagious diseases to be spread in the host countries. (Dr H. Krishna Kumar,