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Isoniazid-Resistant Cavitary Tuberculosis in a Physician Following Isoniazid Prophylaxis

Published online by Cambridge University Press:  02 January 2015

Tobi B. Karchmer
Affiliation:
University of Virginia Health System, Charlottesville, Virginia
John D. Phipps
Affiliation:
University of Virginia Health System, Charlottesville, Virginia
Eve T. Giannetta
Affiliation:
University of Virginia Health System, Charlottesville, Virginia
Barry M. Farr*
Affiliation:
University of Virginia Health System, Charlottesville, Virginia
*
Box 473, University of Virginia Health System, Charlottesville, VA 22908

Abstract

Single-drug prophylaxis is recommended after tuberculin skin test conversion, but not when there is active disease on chest radiograph because resistance develops frequently. Isoniazid-resistant tuberculosis developed in a physician receiving prophylaxis despite “faint left upper lobe soft tissue density” on chest radiograph. Ignoring active disease on chest x-ray renders this strategy counterproductive and cost ineffective. '(Infect Control Hosp Epidemiol 2002;23:622-625).

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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References

1.Sudre, P, ten Dam, G, Kochi, A. Tuberculosis: a global overview of the situation today. Bull World Health Organ 1992;70:149159.Google ScholarPubMed
2.Riley, LW. Drug-resistant tuberculosis. Clin Infect Dis 1993;17(suppl 2):S442S446.CrossRefGoogle ScholarPubMed
3.Fischl, MA, Daikos, GL, Uttamchandani, RB, et alClinical presentation and outcome of patients with HIV infection and tuberculosis caused by multiple-drug-resistant bacilli. Ann Intern Med 1992;117:184190.CrossRefGoogle ScholarPubMed
4.Goble, M, Iseman, MD, Madsen, LA, Waite, D, Ackerson, L, Horsburgh, CR Jr. Treatment of 171 patients with pulmonary tuberculosis resistant to isoniazid and rifampin. N Engl J Med 1993;328:527532.Google Scholar
5.Frieden, TR, Sterling, T, Pablos-Mendez, A, Kilburn, JO, Cauthen, GM, Dooley, SW. The emergence of drug-resistant tuberculosis in New York City. N Engl J Med 1993;328:521526.Google Scholar
6.Marshall, G, Crofton, JW, Cruickshank, R, et alThe treatment of pulmonary tuberculosis with isoniazid. BMJ 1952;2:735746.Google Scholar
7.Alford, RH, Wallace, RJ. Antimycobacterial agents. In: Mandell, GL, Bennett, JE, Dolin, R, eds. Principles and Practice of Infectious Diseases, 4th ed. New York: Churchill Livingstone; 1995:389400.Google Scholar