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

2. 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.

3. 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?

4. 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 ?

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

6. Any questions

7. Thank you