TB Case Discussion

Hosted by Dr. Maunank Shah, this case-based webcast brings together clinicians caring for patients with active tuberculosis to discuss diagnostic and therapeutic challenges. Participants include clinical TB experts from the Johns Hopkins University Division of Infectious Diseases, University of California—Los Angeles and LA County TB program, Harvard University-Beth Israel, and local and regional health departments.

TB Case Conference (2017-09-06)

Drs. Maunank Shah and Ruvandhi Nathavitharana
Case Review: 62 yo, previously healthy male from Cape Verde; presented to PCP in Dec 2015; abscesses on chest, back & axilla.

TB Case Conference (2017-08-02)

Dr. Caitlin Reed
Clinicians face management dilema with 30yo Ugandan male in US x 1yr who presents with dry cough, weakness, weight loss and fever

TB Case Discussion (2017-05-17)

Dr. Maunank Shah
Clinicians faced diagnostic challenges when a 60 year-old man presented with fever and respiratory distress with hypoxia.

TB Case Discussion (2017-03-22)

Dr. Maunank Shah
58 year-old traveler from Philippines arrived 3 weeks prior to presentation; 2-3 weeks of productive cough

TB Case Discussion (2016-09-07)

Dr. Maunank Shah
56 y/o Filipino male presents w/3 day hx of hemoptysis and 10lb wt loss over 1 yr. CT chect shows scarring w/ traction bronchiectasis in Bilat UL, groundglass opacties in RUL, BLL. HIV-negative

TB Case Discussion (2015-11-25)

Maunank Shah, MD PhD
22 year old woman from Zambia: Living in the US since 2011 and going to school, lives with sister and bofriend, all from Zambia, interns 20-30 hours a week at an accounting firm.

TB Case Discussion (2015-06-17)

Dr. Ruvandhi Nathavitharana
58 y/o female from the Philippines with new diagnosis of cervical cancer, referred to ID clinic early April 2015 due to pulmonary nodules discovered on PET CT.

TB Case Discussion (2015-04-15)

Dr. Caitlin Reed
57 yo homeless US born M presented to OSH with weakness, productive cough, dyspnea x 1 wk on 2/17/15. CXR: mod large R pleural effusion with consolidation.

TB Case Discussion (2015-01-21) - Case 1

Dr. Ruvandhi Nathavitharana
44 year old Filipino male with a history of 2 renal transplants. Presents with fevers, dry cough and abdominal pain. Reports some blood in sputum and pleuritic pain. Differential Diagnosis? Further work up? Empiric therapy?

TB Case Discussion (2015-01-21) - Case 2

Dr. Michelle Haas
50 year old woman, PMH of diabetes, HbA1c of 12.6 who presented to her PCP with 2 months of cough on 8/12/14. ROS: fatigue. PMH: known prior +TST, seen in TB clinic 14 years prior, LTBI treatment not recommended (age <35 years and in the US >5 years at that time).

TB Case Discussion (2014-12-10) - Case 1

Dr. Caitlin Reed
80 yo F presenting to ED with worsening SOB x few months. Exercise tolerance decreased from 150 to 50 ft in last week. Dry cough. No fevers, chills, NS, wt loss, hemoptysis.

TB Case Discussion (2014-12-10) - Case 2

Dr. Caitlin Reed
60 yo M, Mexican immigrant, with PMHx gout, hypothyroidism, BPH, OA. Presented with easy bruising, petechiae, gingival bleed. No constitutional sx. Meds: Terazosin, Allopurinol, Levothyroxine, Tramadol.

TB Case Discussion (2014-11-12)

Dr. Maunank Shah
37 y/o man from Honduras presented to outside hospital with hemoptysis. Chest Xray showed bilateral infiltrates. AFB smear-positive (3+). GeneXpert Positive (Rif sensitive).

Tuberculosis Case Conference (2014-09-24) - Case 1

Dr. Maunank Shah
69 y/o M from Indonesia in US for 2 years. CC: Fevers and Cough.

TB Case Discussion (2014-09-24) - Case 2

Dr. Maunank Shah
79 y/o presents with Afib with RVR. Echo reveals EF 54% with mod pericardial effusion. Normal BP and converts with amiodarone.

Tuberculosis Case Conference (2014-08-27)

Dr. Teeb Al-Samarrai
34 year-ld Indian woman with history of smear and culture negative TB treatment in India and US 2006-2007. Subsequent progressive respiratory decline secondary to presumed interstitial lung disease. Now s/p lung transpant in June 2014.

Tuberculosis Case Conference (2014-06-25)

Dr. Maunank Shah
If you missed our most recent TB Case Discussion, you can view it on-demand HERE . Click "Read More..." for a complete list of archived cases.

Tuberculosis Case Conference (2014-05-28)

Dr. Caitlin Reed
No PMHx, presents with L draining ear x two wks, not improving with Amoxicillin, 3 days increasing SOB. Hear the discussion and more!

Tuberculosis Case Conference (2014-05-07)

Maunank Shah, MD and Caitlin Reed, MD
43 y/o with SLE on low dose steroids/plaquenil, treated for TB in Peru in 2000, received 'pulmonary M. fortuitum' tx in 2012, presented 1/2014 cough and "pneumonia" on CXR.

Tuberculosis Case Conference (2014-03-05)

38 yo M, Armenian ethnicity, started on Remicade in July 2013 for tx of Ankylosing Spondylitis. received RIF and subsequently INH for tx of LTBI (+TST, CXR with old granulomatous dz) starting July 2013.

Tuberculosis Case Conference (2014-02-05)

Drs. Maunank Shah and Caitlin Reed
62 yo homeless male presents with cough, NS, anorexia, dyspnea, 15lb wt loss x 3 mos, generalized weakness x 1 wk; found to have Hgb 7.5, stool FOBT+.

Tuberculosis Case Conference (2013-12-18)

Drs. Maunank Shah and Caitlin Reed
Twelve year old female from India recently immigrated presents with one week of mild headache and malaise. No fevers, chills, cough, wieght loss, night sweats. Noted to be very irritable with personality changes and went to emergency department.

Tuberculosis Case Conference (2013-10-23)

Drs. Caitlin Reed and Maunank Shah
What is your experience with hypercalcemia during TB treatment? Is this a component of IRIS in HIV-infected patients with disseminated TB after initiating ART? Does Vitamin D deficiency put a patient at increased risk for active TB? Is Vitamin D supplementation safe in TB Patients?

Tuberculosis Case Conference (2013-09-25)

Drs. Maunank Shah and Caitlin Reed
Issues raised in this session included the usage of flouroquinolone based regimens and management of TB in patients with underlying liver disease and the diagnosis and management of TB relapse.

Tuberculosis Case Conference (2013-06-26)

Dr. Maunank Shah
Symptoms/radiography resolved 3 weeks later and no systemic symptoms. Would anyone have started empiric MDR-TB therapy for ‘pleural TB’? LTBI therapy? Regimen? Can we rule out early active TB? Risk of further drug-resistance acquisition if given monotherapy? 'Watchful waiting’?

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