Question: A 44-year-old man presented to the TB Clinic with symptoms of progressive shortness of breath and cough with greenish sputum productio

Tuberculosis Case Study

"A 44-year-old man presented to the TB Clinic with symptoms of progressive shortness of breath and cough with greenish sputum production. His sputum test results showed that he had atypical TB (Mycobacterium Avium Complex MAC infection). He was HIV negative at this time. Past history revealed that he was in good health till 1991 when he was diagnosed to have active typical tuberculosis (TB) and treated successfully with the regular TB drugs at that time.

As he showed clinical signs of disease, he was prescribed other antibiotics specific for this infection. It was recommended that he take these medications for at least a year with regular medical follow-up. Due to the cost of the medicines and personal financial constraints, he was not compliant with his medications and took only some of his medications intermittently. He complained of subjective fever, night sweats, weight loss, shortness of breath on exertion and chest pain during his follow-up. Although he periodically sought medical attention due to persistent symptoms, his treatment regimen was unsatisfactory due to compliance and availability issues.

The patient's chest X-ray showed progressive deterioration. (He himself described his condition as “being eaten inside”.) Attempts to obtain medications from various social services sources were temporarily successful and when he took the prescribed medicines for two months at a stretch, he showed clinical improvement. Later, once again due to financial constraints and lack of availability of all medicines, he took some of his medications some of the time, and not only deteriorated clinically but subsequently developed resistant and multidrug-resistant disease (MDRMAC)." https://www.medschool.lsuhsc.edu/tb/casestudy01.aspxLinks to an external site.



Instructions:

Consider the above case study and answer each of the following questions with a 50-word response (total 400- words). Utilize headings for each question. Proper grammatical style and academic vocabulary are required. In-text citations, as well as a reference page, should be included.

1. What are the steps in diagnosing TB in the 44-year-old man who presents in the case study?
2. Describe the first-line medications used to treat TB.
3. Present the second-line medications used to treat TB.
4. Which of the first-line medications might cause the patient to exhibit hepatitis and peripheral neuropathy? 5
Describe the medication for the treatment of neuropathy.
5. What are patient teaching points regarding the drug- Rifampin?
6. How may the CNL help the non-compliant patient with his treatment regimen?
7. Why would the patient require a periodic eye exam?
8. What is the course of action for multi-drug resistance disease?