Potter Beth, Rindfleisch Kirsten, Kraus Connie K
University of Wisconsin Medical School, Madison, Wisconsin, USA.
Am Fam Physician. 2005 Dec 1;72(11):2225-32.
Although the overall incidence of tuberculosis has been declining in the United States, it remains an important public health concern, particularly among immigrants, homeless persons, and persons infected with human immunodeficiency virus. Patients who present with symptoms of active tuberculosis (e.g., cough, weight loss, or malaise with known exposure to the disease) should be evaluated. Three induced sputum samples for acid-fast bacillus smear and culture should be obtained from patients with findings of tuberculosis or suspicion for active disease. If the patient has manifestations of extrapulmonary tuberculosis, smears and cultures should be obtained from these sites. Most patients with active tuberculosis should be treated initially with isoniazid, rifampin, pyrazinamide, and ethambutol for eight weeks, followed by 18 weeks of treatment with isoniazid and rifampin if needed. Repeat cultures should be performed after the initial eight-week treatment.
尽管美国结核病的总体发病率一直在下降，但它仍然是一个重要的公共卫生问题，尤其是在移民、无家可归者以及感染人类免疫缺陷病毒的人群中。出现活动性结核病症状（如咳嗽、体重减轻或已知接触过该疾病后出现不适）的患者应接受评估。对于有结核病表现或疑似活动性疾病的患者，应采集三份诱导痰样本进行抗酸杆菌涂片和培养。如果患者有肺外结核表现，应从这些部位采集涂片和培养样本。大多数活动性结核病患者应首先使用异烟肼、利福平、吡嗪酰胺和乙胺丁醇治疗八周，必要时随后使用异烟肼和利福平治疗18周。在最初八周治疗后应进行重复培养。
