[SEOBowhntr]

I recently had a patient admitted to my unit, a thin 50-ish female with known history of COPD, who was admitted with increasing SOB over the last couple of weeks. She reports that she has been coughing up mostly yellow sputum for about 2 weeks, and has had chills and night sweats. Upon getting further information, she tells the nurse that she had a POSITIVE TB SKIN TEST 3 months ago, and because of her CHEST X-RAY being "QUESTIONABLE," the doc started her on INH. Her daughter reports she "coughs her head off," and has gotten worse over the last several months.

So do you isolate her or not????

[KulRN]

well depends on how long this patient's been on INH...As far as I know, patients who have been tested positive for TB test can no longer be on isolation once they've been on INH/antibiotics for at least two weeks and/or patient is responding to treatment ( decreased cough, improvement in general health, weight gain..)...Family members should also be tested for possible exposure and may need INH as well....These symptoms should be reported to the Doctor immediately so necessary testing and isolation order be started...

[SEOBowhntr]

admitted with increasing SOB over the last couple of weeks. She reports that she has been coughing up mostly yellow sputum for about 2 weeks, and has had chills and night sweats. Upon getting further information, she tells the nurse that she had a POSITIVE TB SKIN TEST 3 months ago,

All classic signs of Latent TB becoming ACTIVE TB. Note initially, the sputum may be yellow and creamy, not bloody as is the classic sign we usually hear. And the INH was started within a few days of the report of a positive TB test, and the CXR. Also patient was NOT on the DOT (Directly Observed Therapy).