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WORK UPS AND MANAGEMENT. Traditional and New Diagnostic Approaches. Traditional and New Diagnostic Approaches. Diagnosis of TB. A positive culture with or without a positive smear for M. Tuberculosis is the gold standard for the diagnosis of TB

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Diagnosis of tb
Diagnosis of TB

  • A positive culture with or without a positive smear for M. Tuberculosis is the gold standard for the diagnosis of TB

    In the absence of bacteriologic evidence , a child is presumed to have active TB if > 3 crteria are present:

  • Exposure to an adult/Adolescence with active TB (EPIDEMIOLOGIC)

  • Signs and symptoms suggestive of TB (CLINICAL)

  • Positive tuberculin test (IMMUNOLOGIC)

  • Abnormal chest radiograph suggestive of TB (RADIOLOGIC)

  • Other lab findings suggestive of TB (LABORATORY)

Our patient

  • TST – 12 mm induration

  • Chest X –ray showed evidence of primary infection

  • Signs and symptoms of TB

Work ups and management

The heart is not enlarged.

There is slight haziness over the right lung base and the retrocardiac region, with nodular densities over the retrocardiac region, which may be due to lymph nodes. This may represent primary infection.

Both hemidiaphragm and sinuses are normal.

The visualized osseous structures are unremarkable. 11/24/2010

Objectives of drug therapy in tb
Objectives of Drug Therapy in TB:

  • Cure the patient of TB

  • Prevent death from active TB

  • Prevent relapse of TB

  • Prevent the development of drug resistance

  • Decrease transmission

Phases of treatment
Phases of Treatment

  • Intensive Phase

    - efficient killing of actively dividing organisms

    - relief of symptoms

    - terminates transmision

    - prevents emergence of drug resistance

  • Continuation Phase

    - kills irregularly dividing bacilli

    - sterilizes lesions and prevent relapse

Drug administartion
Drug Administartion

  • The optimal dosing frequency for new patients with pulmonary TB is daily throughout the course of therapy.

    Alternative Regimens:

  • A daily intensive phase followed by tree times weekly continuation phase [2HRZE/4H3R3] , provided that each dose is directly observed

  • Three times weekly dosing throughout the therapy [2H3R3Z3E3/4H3R3] , provided that every dose is directly observed.


21 kg

Isoniazid 200 mg/5mL (10 mkd) – 5.5 mL

Rifampicin 200mg/5mL (10 mkd)- 5.5 mL

Pyrazinamide 500 mg/5mL (20 mkd) – 4.5 mL

Ethambutol 400 mg/tab (20 mkd) - 1 tab