Case of Tuberculosis ?MDR
Please find CXR attached below in the previous case She states that she has only taken 4 months of ATT and discontinued it in last one year She even has had episode of pleural effusion which was drained Management Sputum for AFB is positive Sputum for Genxpert MTB/Rif is awaited What further investigation would be needed for her after CBNAAT? How can we decide the drugs to start her on, as CBNAAT only tells resistance to Rifampicin only?
Resistance to rifampicin 90 percent mdr tb Culture and sensitivity Decide line of treatment Pza ethambutol moxifloxacillin Inj kanamycin At least 4 drug2 bacteriostatic2 Bacteriocidal Now new 1 yr course added
As the report of CBNAAT is available ,if there is rifampicin sensitivity start ATT cat 1 If there occurs rifampicin resistance start MDR short regimen,AOL.
Adv AFB culture and sensitivity test. Prefer antitubercular therapy as per sensitivity report.
NEED'S.. AFB.. C AND S..EXAMINATION.. MANAGEMENT AS PER DRUG SENSITIVITY TEST ..
TUBERCULOSIS Advice: Shamana-Shodhana; Chywanprash; then check patient again for Syndromes or cause for further treatment
Still the case is not in MDR stage Hence restart the ATT and if you find poor response add cat2
CULTURE AND CHECK SENSITIVITY IN MDR IP----- 6 MONTHS------6 DRUGS CP------18MONTHS ------4DRUGS Drugs According to Sensitivity .........
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