ugh this to me is pulmonary TB until otherwise proven, even with negative quantiferon. I would def want to get a biopsy of that lung lesion but a cavitary lesion screams TB to me. and with a poor immune system ie CD4 at 40, might just not have an immune system to cause him to feel sick, would worry about IRIS once ART are started but would def want to get a biopsy quickly.
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Angela Kapalko
Physician Assistant Chairperson for AAHIVM
Philadelphia FIGHT CommunityHealth Centers
Philadelphia PA
akapalko@fight.org------------------------------
Original Message:
Sent: 10-05-2021 13:55
From: Elizabeth Horvath
Subject: Testing for tuberculosis vs. other
I have a new patient (refugee from Central America) newly diagnosed w/ B20 with a CD4 of 40 and Quantiferon Negative. His routine CXR was abnormal for cavitary lesion/mass, so f/u CT w/ contrast ordered showing 3 masses suggesting opportunistic infection such as tuberculosis or fungal infection with the radiology report suggesting inflammatory or infectious lesion. The patient's vitals are always normal and he denies any symptoms. What labs would you order for this patient?
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Elizabeth Horvath
Avenue360 Health & Wellness
Houston TX
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