Case 10 - Harbert, 15 Years Old | PIAC Series

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PIAC Case Series

ANSWERS
Case 10 - Harbert 15 Years Old

Harbert is a 15 y/o Nigerian male with weight loss and cough. Pulmonary TB is suspected.

Questions:

1) What isolation precautions are indicated?

  • What does airborne isolation for TB entail? Why is this different than airborne isolation for varicella/diss zoster?

Answers:

  • AIRBORNE isolation is utilized for diagnosed or suspected pulmonary TB. This involves use of a room with negative airflow and HCW use of a fit-tested N95 mask or PAPR to enter room.
  • Only immune HCW should care for patient with varicella (or disseminated zoster). There is no reliably effective immunity for TB (re-infection can occur) and N-95 mask or PAPR must be used. 

Respiratory Protection Options

N-95 Mask - must be fit-tested by Employee Health prior to use PAPR - no fit testing needed

Question

2) Do HCW or family members need PPD testing?

Answer

If exposure occurred (ie, AIRBORNE precautions were not instituted promptly), PPD testing of exposed HCW is done at 3 months to look for evidence of transmission.  Testing of family and other contacts outside of the health-care setting is carried out by the public health department.

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