Step III Is a Ghon Complex considered a negative CXR?

[jakesaw]

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OK, often the case is that an asymptomatic patient (+/- BCG vaccine) presents with a positive PPD and negative CXR. 9 months INH. Got it.

What if the CXR is described as a single Ghon Complex with no further lung involvement (and the patient is asymptomatic)? Is this an indication for the full cocktail, or just 9 mo. INH?

Thanks.

J/S

 

[jakesaw]

After reading my question I'm pretty sure that a Ghon Complex would not be a negative CXR, but still would like to know what the treatment if that is the only manifestation (no further lung or systemic involvement). Thanks again.

 

[Idiopathic]

So, its primary TB and should be treated as such. If PPD were positive with this CXR, it would call for pretty aggressive therapy from me. Id go for combination chemotherapy regardless of whether the culture was positive or not

 

[jakesaw]

Thanks

 

[jakesaw]

Ok, I just came across a very similar question on usmleworld. So here's an update:

Patient had BCG vaccine (which was actually irrelevant) and positive ppd.
CXR shows upper lobe fibrosis but no evidence of active tubercular infection. So the CXR is abnormal. He is asymptomatic (no sputum culture).

According to usmleworld, the diagnosis is latent tubercular infection and the treatment is 9 months INH, nothing more.

 

[Idiopathic]

keeping in mind that your question initially was a bout ghon complex or primary tb and this is a totally different situation.

 

[jakesaw]

keeping in mind that your question initially was a bout ghon complex or primary tb and this is a totally different situation.

thanks