Isoniazid-resistant cavitary tuberculosis in a physician following isoniazid prophylaxis.
Single-drug prophylaxis is recommended after tuberculin skin test conversion, but not when there is active disease on chest radiograph because resistance develops frequently. Isoniazid-resistant tuberculosis developed in a physician receiving prophylaxis despite "faint left upper lobe soft tissue density" on chest radiograph. Ignoring active disease on chest x-ray renders this strategy counterproductive and cost ineffective.
Karchmer
Tobi B
TB
University of Virginia Health System, Charlottesville 22908, USA.
Phipps
John D
JD
Giannetta
Eve T
ET
Farr
Barry M
BM
D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional; D007538:Isoniazid / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D009169:Mycobacterium tuberculosis / Q000187:drug effects; D013902:Radiography, Thoracic; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission; D014768:Virginia
D000995:Antitubercular Agents; D007538:Isoniazid