Drug Resistant Tuberculosis

Clinical Diagnosis of Drug Resistant Tuberculosis

Author(s): Rafael Laniado-Laborín

Pp: 18-21 (4)

DOI: 10.2174/9781681080666115010006

* (Excluding Mailing and Handling)

Abstract

This chapter deals with the clinical diagnosis of drug resistant tuberculosis. Clinical detection of drug resistant tuberculosis requires a high index of suspicion by the clinician based in the information obtained from clinical records and the patient’s medical history. Underlying drug resistance must be considered in patients who have been previously treated for TB, especially if there is a history of inadequate treatment regimen, in patients who are not showing significant clinical improvement or lack of bacteriological conversion, in contacts of a known drug resistant case and in chronic cases with a history of multiple treatment regimens. Required information includes a detailed clinical history of past tuberculosis episodes, name, dose and time a particular drug was taken by the patient, adverse reactions while under treatment, previous image studies for comparison purposes and all previous bacteriological studies available from clinical or laboratory records. The initial evaluation must include a thorough physical examination and basic laboratory tests (hemogram, blood chemistry, viral panel for hepatitis and HIV), audiometry, new chest x-rays and obtaining appropriate samples for complete bacteriological studies.

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      • 16. app/Models/Subject.php:238
      • 17. app/Http/Controllers/ChapterController.php:1434
      • 18. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
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      • 14. app/Models/Subject.php:238
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      • 16. app/Models/Subject.php:255
      • 17. app/Http/Controllers/ChapterController.php:1435
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      • 11. app/Models/ContentAccess.php:647
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      • 13. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 14. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
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      • 11. app/Models/ContentAccess.php:647
      • 12. app/Http/Controllers/ChapterController.php:1478
      • 13. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 14. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59072082 and j.to_ip >=59072082 )) and ((j.from_date <= 1740551462 and j.to_date >= 1740551462 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 7613) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59072082 and j.to_ip >=59072082 )) and ((j.from_date <= 1740551462 and j.to_date >= 1740551462 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 7613) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 59072082 and j.to_ip >=59072082 )) and ((j.from_date <= 1740551462 and j.to_date >= 1740551462 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 7613)
      800μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 1723 and `b`.`banner_from_date` <= 1740551462 and `b`.`banner_to_date` >= 1740551462 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.49msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 1723
      • 3: 1740551462
      • 4: 1740551462
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='0471a7a4215f264ec72432b1587a377c'
      260μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Keywords
    1Keywords.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        laY0hCwcwkpa9ciiNWfU1xfbXdTM8uBo8dBnUOj2
        uc_cart_id
        0471a7a4215f264ec72432b1587a377c
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/7613" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/7613
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:16 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        []
        
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Wed, 26 Feb 2025 06:31:02 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IlUzT3ZIMU5HbEwyOC9GYnM0TzdtTXc9PSIsInZhbHVlIjoiN0tueEhqU2NhM2RDUVRHc3VRbHN4empGYzVFS0JVUlNYVVlrRmxIajVHTndHWXZxWkJSZHUwc1FvYlkxVDRQbkpWRy9ha3VUSzd6NjlXWEFaVlorZHdVWVRBRHoyRGFaQi9nQjcxTnNZdnBIeG1lbTM2ZWpXVFBobkN6MFhEL1QiLCJtYWMiOiIyMmU0ZTBlNDQ3OTk3OGM4N2Q4YjljNjdiMDc1N2Q0OTQ5NDk4ZGY4N2YzMmZkODk4ZWNmMjcwNzhhYmRhMmM1IiwidGFnIjoiIn0%3D; expires=Fri, 28 Feb 2025 18:31:02 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IlUzT3ZIMU5HbEwyOC9GYnM0TzdtTXc9PSIsInZhbHVlIjoiN0tueEhqU2NhM2RDUVRHc3VRbHN4empGYzVFS0JVUlNYVVlrRmxIajVHTndHWXZxWkJSZHUwc1FvYlkxVDRQbkpWRy9ha" 1 => "alphaeurekaselectnet_session=eyJpdiI6IjNydUZFMkRIdmxUYk03a2I3b0s2VWc9PSIsInZhbHVlIjoiOTZubnhlSThhSGUzYXhyc3FYTU5UbHdnMEZhaEc5amIvNEFsQkM0RlVCL1Q2dXpEL2hnOEdiMWlHRWNkU1k5ZkU0TWxUNmF6YWh0V0xIVGlGNGt0aFhVUDB6SlNhZlpEbUhUZlNmRXprT1NOQmNabTVRK1VuZXdxUmxEamNmQWsiLCJtYWMiOiI1MDMxNzM4N2Y0MTVjOGY5MTRkYmRhYzg0NjJhMjM1YTYwOWYzOWEyMjY1ZGFiNDk1YmNlZGM1ZjRjZjVkZGY1IiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6IjNydUZFMkRIdmxUYk03a2I3b0s2VWc9PSIsInZhbHVlIjoiOTZubnhlSThhSGUzYXhyc3FYTU5UbHdnMEZhaEc5amIvNEFsQkM0RlVCL1Q2dXpEL2hnOEdiMWl" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IlUzT3ZIMU5HbEwyOC9GYnM0TzdtTXc9PSIsInZhbHVlIjoiN0tueEhqU2NhM2RDUVRHc3VRbHN4empGYzVFS0JVUlNYVVlrRmxIajVHTndHWXZxWkJSZHUwc1FvYlkxVDRQbkpWRy9ha3VUSzd6NjlXWEFaVlorZHdVWVRBRHoyRGFaQi9nQjcxTnNZdnBIeG1lbTM2ZWpXVFBobkN6MFhEL1QiLCJtYWMiOiIyMmU0ZTBlNDQ3OTk3OGM4N2Q4YjljNjdiMDc1N2Q0OTQ5NDk4ZGY4N2YzMmZkODk4ZWNmMjcwNzhhYmRhMmM1IiwidGFnIjoiIn0%3D; expires=Fri, 28-Feb-2025 18:31:02 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IlUzT3ZIMU5HbEwyOC9GYnM0TzdtTXc9PSIsInZhbHVlIjoiN0tueEhqU2NhM2RDUVRHc3VRbHN4empGYzVFS0JVUlNYVVlrRmxIajVHTndHWXZxWkJSZHUwc1FvYlkxVDRQbkpWRy9ha" 1 => "alphaeurekaselectnet_session=eyJpdiI6IjNydUZFMkRIdmxUYk03a2I3b0s2VWc9PSIsInZhbHVlIjoiOTZubnhlSThhSGUzYXhyc3FYTU5UbHdnMEZhaEc5amIvNEFsQkM0RlVCL1Q2dXpEL2hnOEdiMWlHRWNkU1k5ZkU0TWxUNmF6YWh0V0xIVGlGNGt0aFhVUDB6SlNhZlpEbUhUZlNmRXprT1NOQmNabTVRK1VuZXdxUmxEamNmQWsiLCJtYWMiOiI1MDMxNzM4N2Y0MTVjOGY5MTRkYmRhYzg0NjJhMjM1YTYwOWYzOWEyMjY1ZGFiNDk1YmNlZGM1ZjRjZjVkZGY1IiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6IjNydUZFMkRIdmxUYk03a2I3b0s2VWc9PSIsInZhbHVlIjoiOTZubnhlSThhSGUzYXhyc3FYTU5UbHdnMEZhaEc5amIvNEFsQkM0RlVCL1Q2dXpEL2hnOEdiMWl" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "laY0hCwcwkpa9ciiNWfU1xfbXdTM8uBo8dBnUOj2" "uc_cart_id" => "0471a7a4215f264ec72432b1587a377c" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/7613" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-26 06:31:02GET/chapter/7613112193