a) With respect to the diagnosis of pulmonary tuberculosis, describe what investigations are available in ICU patients and their advantages and limitations. (50% marks)
b) What infection control precautions should be taken when admitting a patient with active pulmonary tuberculosis to the ICU? (50% marks)
Not available.
Investigation | Advantages | Limitations |
Culture |
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AFB identification (ZN stain) |
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Nucleic acid amplification (NAA) |
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Skin tuberculin test |
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Line probe assay |
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Interferon-γ release assays |
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Xray or CT imaging |
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Histology |
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Infection control precautions listed here have been pulled directly from the CDC document, where most people get their infection control guidelines from:
Chapter 73 (pp. 743) Tropical diseases by Ramachandran Sivakumar and Michael E Pelly
Erbes, Reinhard, et al. "Characteristics and outcome of patients with active pulmonary tuberculosis requiring intensive care." European Respiratory Journal27.6 (2006): 1223-1228.
Hepple, P., N. Ford, and R. McNerney. "Microscopy compared to culture for the diagnosis of tuberculosis in induced sputum samples: a systematic review [Review article]." The International Journal of Tuberculosis and Lung Disease16.5 (2012): 579-588.
Hagan, Guy, and Nazim Nathani. "Clinical review: Tuberculosis on the intensive care unit." Critical Care 17.5 (2013): 240.
Ryu, Yon Ju. "Diagnosis of pulmonary tuberculosis: recent advances and diagnostic algorithms." Tuberculosis and respiratory diseases 78.2 (2015): 64-71.