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Latent TB (LTB)
Active TB (ATB)
37 years old indian female patient came to your office worried about her 16 weeks pregnancy as her husband developed open active TB. Recently she complained from night fever and morning wet cough Her Mantoux test was positive for TB and she was negative for HIV infection. What is the best next step in management?
How is POSITIVE?
More than 15 mm
in low risk pop
General population with regular BCG vaccination
More than 10 mm
in high risk pop
HIV -ve drug abusers
Residents of long term care facilities ( mental institutions, prisons)
chronic deblitating illness
More than 5 mm
in highest risk pop
HIV +ve drug abusers
Contact with open active TB
Old healed TB on chest xRay
WE WILL DO NOTHING
is it Active or Latent?
= we have a case of TB with pregnancy ... ok what's next?
it may reveal open active TB, old healed Tb or otherwise normal figure
for acid fast bacilli
Signs and symptoms
HIV positive or negative?
Old healed TB
Send for culture and sensitivity first
starting from the second trimester
More than 35 years
Less than 35 years
Isoniazide plus vitamin B6
Isoniazide + vitamine B6 for 6 months from the second trimester
INH + vitamin B6 for 6 months postpartum
Neonate of INH taking mother should receive a course of vitamin B6
Neonate should be applied for full TB screening and assessment
: very rare ( part of miliary TB)
: Contact with mother
: cranial nerve 8 damage, group D
all other medications: between B and C group, posses some hazards
BUT UNTREATED TB IS MUCH MORE HAZARDOUS
Effect of TB on pregnancy:
Effect of pregnancy on TB: