Disease Information for Multiple drug resistant Tuberculosis

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Clinical Manifestations
Clinical Presentation & Variations
AIDS with FUO
Fever in Immune Compromised
Immune Deficient with Pulmonary Infiltrates
Presentation/AIDS Abnormal Chest Xray
AIDS with Fever
Disease Progression
Course/Acute
Course/Acute only
Demographics & Risk Factors
Established Disease Population
Patient/Cachectic
Laboratory Tests
Microbiology & Serology Findings
Microlab/TB Restriction fragment length polymorphism
Abnormal Lab Findings (Non Measured)
QuantiFERON-TB (QFT) Abnormal
Diagnostic Test Results
X-RAY
Xray/Cavitation/Cavitary lung lesion/Chest
Xray/Interstitial infiltrate, acute/Chest
Xray/Multiple cavitary lesions of lungs/Chest
Xray/Thick-walled cavitating lung lesions/multiple/Chest
Associated Diseases & Rule outs
Rule Outs
Pneumocystis Jiroveci/Carinii Pneumonia (PCP)
Associated Disease & Complications
Meningitis, tuberculosis
Multiple resistant bacterial organisms
Necrotizing pneumonia/Lung infection
Pulmonary fibrosis
Tuberculosis
Tuberculosis, disseminated
Tuberculosis, hepatic, miliary
Tuberculosis, pulmonary
Disease Synergy - Causes
Synergy/HIV-Aids
Disease Mechanism & Classification
Specific Agent
AGENT/Acid-fast bacteria (category)
Pathophysiology
Pathophysiology/Necrotizing lung infection
Process
PROCESS/Infection/agent specific (category)
Treatment
Drug Therapy - Indication
RX/Antimicrobial medication/Prolonged treatment
RX/Antituberculosis antibiotic
RX/Ethionamide
Drug Dosage
DRUG/Dose Usually prolonged treatment course
Definition

Multidrug-resistant (MDR) tuberculosis is caused by Mycobacterium tuberculosis bacilli resistant at least to isoniazid and rifampin; The clinical management of MDR tuberculosis with second-line drugs [aminoglycosides, capreomycin, cycloserine, fluoroquinolones, para-aminosalicylic acid (PAS), and thioamides has remained relatively unexplored; Drug Resistance in Patients with Non-MDR Tuberculosis: Tuberculosis due to a mycobacterial strain resistant to a single drug (except when that drug is rifampin) should be treated with first-line agents; In contrast, patients with rifampin-resistant disease should be managed as MDR tuberculosis cases; Non-MDR, polydrug-resistant cases (caused by an isolate resistant to first-line and/or second-line drugs) pose a clinical challenge whose magnitude depends on the level of drug resistance; In these cases, the patient should receive chemotherapy tailored to drug susceptibility results; Treatment regimens should include at least four drugs to which the isolate is susceptible, including rifampin and as many

first-line drugs as possible; High-dose isoniazid treatment may be considered for patients whose susceptibility results indicate an isoniazid minimum inhibitory concentration of 01-02 g/mL [Update by Dr Michael D Iseman/Merck Medicus Search 6/05]

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External Links Related to Multiple drug resistant Tuberculosis
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Wikipedia
Merck
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PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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