Drug-Resistant TB Patient Arrives at National Jewish
JULY 17, 2007
Initial Evaluation and Treatment to Begin Today
A patient with drug-resistant tuberculosis arrived at National Jewish Medical Center today at approximately 7:45 a.m. Mountain time today. The patient walked into National Jewish. He said he felt fine.
Doctors plan to evaluate the patient and expect begin treatment with at least two antibiotics today. Gwen Huitt, MD, is the attending physician on the infectious disease unit. Charles Daley, MD,Head of the Infectious Disease Division, will work closely with Dr. Huitt to evaluate the patient and begin a treatment regimen.
Doctors plan first to take a patient history and administer a basic physical examination. The patient history attempts to determine where he might have contracted the disease with questions about past travel and social contacts. It will also include a complete health history. The physical examination will include evaluations of his heart, lungs, kidneys, and liver, as well as a blood test to evaluate a variety of factors, including kidney and liver function and white blood cell counts. These will serve as baseline measurements so that any changes can be detected. The antibiotics likely to be used can be toxic to the kidneys and liver.
The patient will also get an induced sputum test which will help evaluate how infectious he is. This involves inhaling a salt solution then coughing into a test tube. In a smear test, the collected respiratory secretions will then be smeared on a slide, stained, then examined under a microscope to look for the tuberculosis organism. The respiratory secretions will also be cultured and grown in culture. This test will be done for three days running to confirm initial results.
Later in the day, he will undergo a CT scan and lung X ray.
Dr. Huitt said she expects to begin administering an oral antibiotic and IV antibiotic today. Over the next several days she expects to begin treatment with about 3 more antibiotics. The original choice of antibiotics will be based upon information about drug resistance obtained from the U.S. Centers for Disease Control and Prevention.
The National Jewish reference laboratory already has a sample of the organism infecting the man. It will grow the organism and conduct further tests on drug resistance to further guide treatment choices.
National Jewish will hold a press conference with physicians at 1:30 p.m. mountain time at National Jewish.