M Tuberculosis (MTB)

Sites

  • Lungs, GI/GU tracts, pericardium, bones, cns, lymph nodes, bone marrow and/or widely disseminated

Etiology

  • Mycobacteria

Risk Factors

  • HIV +
  • ETOh
  • Dialysis
  • Homeless
  • Chronic kidney, liver, lung dz
  • Immunocompromised for other reason→ steroid
  • TNF inhibitors, other
  • Though can occur in anyone, reactivating sometimes years after initial exposure
  • Extra-pulm TB increases in HIV+ w/CD4 < 350

Symptoms

  • Sub-acute
  • Cough
  • Hemoptysis
  • Weight loss
  • Sweats
  • Fatigue
  • Focal to site of main infection

Physical Exam Findings

  • Can be chronically ill appearing
  • Lung findings of crackles, diminished breath sounds
  • Adenopathy (called scrofula if in head and neck region)
  • Bone pain or sinus track if boney involvement (called Pott's disease if affects spine)
  • Abnormalities over any other affected area

Links