Clinical Presentation
The most common symptom of pulmonary tuberculosis is productive cough for ≥2 weeks that may be accompanied by both or either respiratory symptom (eg shortness of breath, chest pains, hemoptysis), and constitutional symptoms (eg loss of appetite, unexplained weight loss, fever, night sweats, fatigue).
Tuberculosis - Pulmonary_Initial Assesment
Tiền sử bệnh
It is important to ask about the history of previous treatment with anti-TB drugs, which has a higher risk for drug resistance, including MDR-TB.
Khám thực thể
On physical examination, patients with active pulmonary tuberculosis may present with both systemic (eg weight loss, fever, tachypnea, tachycardia) and respiratory findings. Pulmonary examination may reveal dullness to percussion or decreased tactile fremitus due to pleural thickening or pleural effusion; crackles on auscultation; egophony in areas of pulmonary consolidation; and rhonchi or wheezing when there is endobronchial extension of the infection.
Screening
Tuberculosis infection screening may be done in individuals at risk for new infection (ie close contacts of patients with untreated TB disease, healthcare workers who may have TB exposure), those at high risk of reactivation (ie progression to TB disease) if infected due to underlying conditions (eg immunοcοmрrоmiѕеd individuals), or those living in or having transferred to an area where tuberculosis is prevalent. Tuberculin skin test (TST) and Interferon-Gamma Release Assays (IGRAs) may be used to screen for TB infection.