CASE PRESENTATION ON PULMONARY TUBERCULOSIS INCLUDES patient demographics, chief complaints, past medical and medication history, personal habits, on examination, laboratory investigations, diagnosis, treatment. disease information includes definition, etiology, clinical presentation, pathophysiology, diagnostic tests, treatment classification, patient counselling, life style modifications.

1. Presented by ;
M . Durga Rohitha
Pharm-D VI year
174T1T0005

2. PATIENT DEMOGRAPHICS ;
A 58 years of female patient was admitted in the general medicine on 21/9/21
. By her chief complaints like cough since 2 months, shortness of breath from
15 days, fever headache body pains from 1 month, loss of appetite from 1
month.
PAST MEDICAL HISTORY ;
Hypertension – since from 15 years
Diabetes mellitus – since from 10 years
PAST MEDICATION HISTORY ;
Not under Rx
PERSONAL HISTORY ;
Nill
FAMILY HISTORY ;
Not known

3. ON EXAMINATION ;
VITALS DAY-1 DAY-2 DAY-3
TEMP( F) 105 100 98.6
BP ( mm/Hg) 160/80 140/80 120/80
PR ( bpm) 86 86 86
RR ( bpm) 24 24 24

4. LABORATORY INVESTIGATIONS :
TEST OBSERVED VALUE NORMAL VALUE
Heamoglobin [gm] 10.2 10-12
Total WBC count [per cumm] 17000 3500-10,000
Neutrophils [%] 82% 40-70
Lymphocytes[%] 14% 15-30
Esinophils [%] 2% 1-6
ESR [mm/hr] 38 0-20
Platelet count[lakh
cells/cumm]
2.4 1-4
FBS [mg/dl] 164 70-110
RBS [mg/dl] Day 1 ; 230
Day 2 ; 200
Day 3 ; 182
110-180

5. CT CHEST PLAIN ;
Impression –
patchy area of consolidation and cavitatory area in right upper lobe.
 Sputum for Active Fast Bacilli (AFB) : +ve

6. DIAGNOSIS
Based on the subjective and objective evidence the patient was a known case of Hypertension and
Diabeties Mellitus and newly diagnosed as TUBERCULOSIS.

7. DISEASE INFORMATION
DEFINITION
Tuberculosis is the infectious disease primarily affecting lungs is most common caused by
MYCOBACTERIUM TUBERCULOSIS. It may spread to any part of the body including meninges, kidney,
bones and lymph nodes.
“Tubercle” - Round nodule/ Swelling
“Osis” - condition
ETIOLOGY
Causative Organisms
Mycobacterium tuberculosis – Humans.
Mycobacterium Bovis- Animals.
Other causative organisms;
 Mycobacterium africanum
 Mycobacterium microti
 Mycobacterium leprae
 Mycobacterium avium
 Mycobacterium asiaticum
TB is an air borne droplet infection caused by the ingestion of the bacterium when the infected person
coughing, sneezing.

11. DIAGNOSIS
TB disease is diagnosed by medical history, physical examination, chest x-
ray, and other laboratory tests.
People suspected of having TB disease should be referred for a complete
medical evaluation , which will include the following;
1. Medical history
2. Physical examination
3. Tests for TB infection
4. Chest radiography
5. Blood tests

12. MANAGEMENT

14. SOAP NOTES ;
 Subjective
• Cough since 1 month
• SOB since from 15 days
• Fever , headache , body pains since 1 month
• Anorexia since 1 month
 Objective
• Total WBC : 17000per cumm
• Neutrophils : 82%
• Lymphocytes : 14%
• ESR : 38 mm/hr
• FBS : 164 mg/dl
• RBS : Day 1 – 230 mg/dl
• Day 2 – 200mg/dl
• Day 3 – 182 mg/dl
 Assessment
• TUBERCULOSIS

15. S.NO G.N DOSE FREQ ROA DAY-1 DAY-2
1. INJ.OFLAXA
CIN
200mg BD IV + +
2. IPRATROPI
UM
BROMIDE +
LEVOSALBU
TAMOL
20mcg
50mcg
TID
NEB
+ +
3. BUDESONI
DE
100mcg + +
4. RIFAMPICI
N
ISONIAZID
PYRAZINA
MIDE
ETHAMBUT
OL
225mg
150mg
750mg
400mg
OD PO
+
+
5. PANTAPRAZ
OLE
40mg OD PO + +
6. PARACETO
MOL
650mg BD PO + +
7. METFORMI 500mg BD PO + +
P
L
A
N

16. GN DOSE FREQ ROA
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
225mg
150mg
750mg
400mg
OD PO
Pantaprazole 40mg OD PO
Paracetamol 650mg BD PO
Metformin 500mg BD PO
Amlodipine 5mg OD PO
DISCHARGE MEDICATION