Presented by: Dr. Letshufi DSV 04th August 2016 Pretoria

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Presentation transcript:

Presented by: Dr. Letshufi DSV 04th August 2016 Pretoria Case Study Presented by: Dr. Letshufi DSV 04th August 2016 Pretoria

Linda Referred by district hospital with history 38 years old with two children 10 yrs. & 4years) Referred by district hospital with history Cough, productive for 1/12 Steady weight loss Night sweat No previous history of TB Younger sister had MDR TB RVD reactive on HAART for 2 years. Fixed dose combination tablets. GXP: Rifampicin resistant TB 20 June 2014.

Questions Which confirmatory test is to be done? Blood tests to be done prior initiation of therapy? Construct a regimen for this patient? What adjustment would you make on the ARV Regimen and why? Name the monthly test to be done for monitoring?

Questions Conti……… What is culture conversion and how is it determined ? Would you change your regimen based on LPA no - 2 and why? Which drug is stopped if patient develops profound hearing loss ? What is the diagnosis according to drug sensitivity testing ? What is the approach to the two children ?

LINDA FOLLOW UP H – Resistant Mutation Kat G and inh A 1. LPA 25.06.2014 R – Resistant H – Resistant Mutation Kat G and inh A 2. LPA : 25.07.2014 R - Sensitive H – Sensitive 3. Culture 25.08.2014 Negative 4. Culture 25.09.2014 Negative 5. Drug Sensitivity Testing 25.06.2014 Rifampicin - resistant Ofloxacin - Resistant Isoniazid - Negative Kanamycin – Sensitive 6. Culture 25.10.2014 Negative

Any questions

Thank you