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Case Conferences

   

June 25, 2014

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Joined 2014-05-06

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Case Description: If you missed our most recent TB Case Discussion, you can view it on-demand HERE. Click “Read More…” for a complete list of archived cases.


Speaker: Dr. Maunank Shah

     
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Total Posts: 14

Joined 2014-05-07

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These are interesting cases.
1st case:
a.Even with many exposures since 2005 this patient who has been on steroids for a long period of time,tests positive for LTBI in 2013.Should we look at more recent exposures.
b. An individual on steroids driving a patient with MDR TB amounts to significant exposure. Being a health care professional did she take any precautions? Routinely we consider household contacts to be at considerable risk of TB, but travelling with an open case of TB could pose similar risk with individuals close to each other, varying degrees of ventilation(windows open or closed/AC on or off),overcrowding in public transport, poor cough etiquette. How much risk will a single exposure in such circumstances pose for acquiring TB?
2nd case
1. Was any work up done to identify the cause of hypogonadism (which appears to be secondary hypogonadism). Could this be related to the fibrotic disease?

     
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Total Posts: 24

Joined 2014-05-05

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what about phenotyping of this patient ?

     
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Joined 2014-05-06

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the second case i think is a case of tubercular extradural cord compression with myeloraduculopathy and arachnoiditis.we do get cases of psoas abscess extending right upto the hip joint specially in poorly controlled diabetics.the omentalal thickening helps to confirm diagosis.such patients we treat with full course of anti Tb treatment and only if compressive symptoms are present surgical intervention is done


the first case i feel is the episode of multiple sclerosis to be treated with steroids or immunolobulin.We screen all such patient for active TB on symptoms,xray chest and USG and do not advocate any LTB treatment but ask for frequent follow ups to watch for appearance of active TB if any.we do see cases of severe posttubercular fibrosis of lungs ,pericardium and mediastinum .they require surgical intervention as these are considered as sequele untill there is evidence of active disease

                      dr anita basavaraj,BJGMC,pune