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Presented by: Dr. Letshufi DSV 04th August 2016 Pretoria
Case Study Presented by: Dr. Letshufi DSV 04th August 2016 Pretoria
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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.
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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?
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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 ?
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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
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Any questions
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Thank you
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