Tuberculosis is preventable and generally curable, but can be fatal if left untreated. Patients with HIV infection can develop active Tb from either latent infection activated by immune suppression, or from primary exposure to the organism. Multiple systems may be involved, including the bone marrow, lymphatic system, CNS, liver, genito-urinary tract and blood. A further caution to providers is that anergy may mask Mtb on skin tests. Note that for an HIV-infected patient, an induration response of 5mm at the PPD site is considered a positive test.
Symptoms are non-specific.
Patient may complain of persistent fever, night sweats, weight loss, fatigue, anorexia, productive cough, dyspnea. Culture of sterile sites is diagnostic. Sputum smear is presumptive . Order PPD tuberculin skin test and anergy profile. Obtain chest X-ray.