Tuberculosis

Mycobacterium tuberculosis

A 36 year old female walks into a clinic that serves the indigent community presenting with fevers, bloody cough, fatigue and night sweats. She thinks the symptoms started about a month ago and notices that she has lost a lot of weight recently.

Labs: Sputum stain reveals acid fast bacilli and culture reveals a slow growing niacin producing bacterium. Chest x-ray reveals a cavitary nodule in the right upper lobe with involvement of nearby lymph nodes. Patient is PPD positive.

Discussion: The diagnosis of tuberculosis by Mycobacterium tuberculosis is made based on both clinical presentation and labs. Mycobacterium tuberculosis is seen mainly in developing countries. It is declining in developed countries except among AIDS patients. Most common symptoms are cough which could be productive or non-productive. Occasionally, hemoptysis may occur as the first symptom. The disease is also seen as anorexia, weight loss, night sweats, evening rise in temperature, and chest pain. Dyspnea may be seen as a late symptom. Amenorrhea may be common in women.

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