Empirical treatment of tuberculosis: TB or not TB?

BMJ Case Rep. 2018 Jul 10:2018:bcr2018224166. doi: 10.1136/bcr-2018-224166.

Abstract

Of the 8.6 million new cases of tuberculosis (TB) that occur globally each year, a quarter occur in India. We describe the case of a 38-year-old Indian woman who presented with symptoms of hepatitis after being treated empirically with anti-TB therapy for five months. The patient was suspected to have TB after having recurrent episodes of coughing which would improve briefly before her respiratory symptoms returned, which led to her being treated at various healthcare clinics and hospitals. We highlight the challenges the patient faced due to the lack of centralised medical records which would have prevented unnecessary investigations and treatment.

Keywords: drugs and medicines; gastrointestinal system; global health; healthcare improvement and patient safety.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antitubercular Agents / adverse effects*
  • Chemical and Drug Induced Liver Injury / diagnosis
  • Chemical and Drug Induced Liver Injury / etiology*
  • Continuity of Patient Care
  • Diagnostic Errors
  • Electronic Health Records
  • Female
  • Humans
  • India
  • Radiography
  • Rural Population
  • Tuberculosis, Pulmonary / diagnosis
  • Tuberculosis, Pulmonary / drug therapy*
  • Unnecessary Procedures

Substances

  • Antitubercular Agents