Disseminated tuberculosis

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Circulatory system	Coal worker's lungs - chest X-ray	Coal workers pneumoconiosis, complicated	Coal workers pneumoconiosis - stage II
Coal workers pneumoconiosis - stage II #2	Erythema multiforme, circular lesions - hands	Erythema nodosum associated with sarcoidosis	Miliary tuberculosis
Sarcoid, stage II - chest X-ray	Tuberculosis, advanced - chest X-rays	Tuberculosis in the kidney	Tuberculosis in the lung

Miliary tuberculosis; Tuberculosis - disseminated; Extrapulmonary tuberculosis

The goal of treatment is to cure the infection with antitubercular drugs. These drugs include: pyrazinamide, isoniazid (INH), rifampin, ethambutol, ethionamide, para-aminosalicylic acid (PAS), amikacin, and streptomycin. Daily oral doses are continued for 1 year or longer.

For atypical tuberculosis infections, or drug-resistant strains, other drugs may be indicated to treat the infection. A minimum of three drugs are started for treatment.

Hospitalization may be necessary to prevent the spread of the disease to others until the infectious period is over, usually 2-4 weeks after the start of therapy. Normal activity can be continued after the infectious period.

Most disseminated forms of TB respond well to treatment.

All medications used to treat TB have some toxicity. Rifampin, pyrazinamide, and isoniazid may cause a non-infectious liver inflammation. Rifampin may also cause an orange or brown coloration of tears and urine, and can stain contact lenses and undergarments. Ethambutol may reduce visual acuity or cause color blindness.

Other complications include:

• drug resistance
• relapse of the disease
• tuberculous meningitis
• respiratory failure
• adult respiratory distress syndrome (ARDS)

Call your health care provider if known or suspected exposure to TB has occurred. All forms of TB require prompt treatment.

Review Date: 02/13/2006
Reviewed By: Monica Gandhi, M.D., M.P.H., Assistant Professor, Division of Infectious Diseases, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.