| Table
4: |
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Approach
to a Patient with LTBI
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Clinical
Evaluation -- Cough, chest pain, hemoptysis, fever, chills, night
sweats, anorexia, weight loss, fatigue
Past Medical History -- TB treatment or exposure
Social History -- Demographic factors increasing the risk of
acquiring TB or resistant strainsHIV status (voluntary testing and
counseling should be offered routinely))
Chest Radiograph -- postero-anterior and lateral
Sputum (3 specimens) -- For: patients with symptoms (even if
chest radiograph is normal), or patients with radiologic abnormalities
(images compatible with old, fibrotic changes)
Obtain baseline laboratory testing (for: HIV-infected patients, pregnant
and post-partum women, those with liver disease, and those who use
alcohol regurlaly)
Those without clinical, radiologic, or microbiologic evidence of active
disease: LTBI therapy (those with abnormal liver
function tests at baseline require continuous monitoring) |
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