[Tuberculosis]

Internist (Berl). 2019 Nov;60(11):1155-1175. doi: 10.1007/s00108-019-00685-z.
[Article in German]

Abstract

Tuberculosis is a bacterial infectious disease that is usually transmitted by inhalation of droplets containing the bacteria. The World Health Organization (WHO) estimates that approximately 10 million patients were newly diagnosed with tuberculosis in 2017. Rapid diagnosis relies on a combination of imaging and microbiological, molecular, and, rarely, immunological tests. Genotypic methods enable early diagnosis and allow highly accurate prediction of drug resistance. Phenotypic (culture-based) methods are the diagnostic gold standard. Standard management of patients with pan drug-susceptible pulmonary tuberculosis includes a combination of rifampicin, isoniazid, ethambutol and pyrazinamide for 2 months followed by rifampicin and isoniazid for additional 4 months, which leads to cure rates of >80%. With individualized treatment schemes, similar cure rates can be achieved for patients with multidrug-resistant tuberculosis.

Keywords: Interferon-γ release tests; Mycobacterium tuberculosis; Tuberculosis therapy; Tuberculosis, multidrug-resistant; Tuberculosis, pulmonary.

MeSH terms

  • Antitubercular Agents / therapeutic use*
  • Ethambutol / therapeutic use
  • Humans
  • Isoniazid / therapeutic use
  • Mycobacterium tuberculosis / isolation & purification*
  • Pyrazinamide / therapeutic use
  • Rifampin / therapeutic use
  • Tuberculosis / diagnosis*
  • Tuberculosis / drug therapy*
  • Tuberculosis / microbiology
  • Tuberculosis, Multidrug-Resistant / diagnosis*
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Tuberculosis, Multidrug-Resistant / microbiology

Substances

  • Antitubercular Agents
  • Pyrazinamide
  • Ethambutol
  • Isoniazid
  • Rifampin