Family Medicine, Internal Medicine and Surgery Case 10
Iowa Lutheran Family Medicine Residency Program

PIAC Case Series

Case 10 - Harbert, 35 years old

Harbert is a 35 y/o Nigerian male with weight loss and cough. Pulmonary TB is suspected.


1) What isolation precautions are indicated?

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


  • 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


2) Do HCW or family members need PPD testing?


 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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