Universität zu Köln

Suarez, Isabelle, Fuenger, Sarah Maria, Kroeger, Stefan, Rademacher, Jessica, Faetkenheuer, Gerd and Rybniker, Jan (2019). The Diagnosis and Treatment of Tuberculosis. Dtsch. Arztebl. Int., 116 (43). S. 729 - 740. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

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Abstract

Background: Around 10 million people worldwide contract tuberculosis every year. According to the World Health Organization (WHO), approximately one-quarter of the worlds population is latently infected with Mycobacterium tuberculosis. In Germany, the incidence of tuberculosis was in decline over several decades but rose in 2015 to 7.3 new cases per 100 000 persons. In 2018, a total of 5429 new cases were documented, corresponding to 6.5 new cases per 100 000 persons. Methods: This article is based on literature retrieved by a selective search in PubMed and on the authors' clinical experience. Results: Tuberculosis involves the lungs in almost 75% of patients but can generally involve any organ. In Germany, the majority of patients come from high-incidence countries. If a patients differential diagnosis includes tuberculosis, the main tests for the detection of the pathogen in sputum and tissue samples are culture (the gold standard), microscopy, and nucleic acid amplification tests. Imaging studies are also used for diagnosis and follow-up. The standard treatment consists of a combination of isoniazid. rifampicin. ethambutol, and pyrazinamide, followed by a combination of isoniazid and rifampicin only. Liver damage is one of the more common adverse effects of this treatment, arising in 2.4% of patients. Multidrug-resistant tuberculosis, which is rare in Germany (around 100 cases per year), should be treated in specialized centers. Conclusion: Rapid diagnosis and targeted treatment are essential to prevent an unfavorable course of the disease as well as its transmission to other individuals. In patients presenting with unclear symptoms. tuberculosis should always be considered as a differential diagnosis. The diagnosis of latent tuberculosis and decision-making regarding its treatment are difficult because of the lack of specific biomarkers and of relevant data from clinical trials.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Suarez, Isabelle UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuenger, Sarah Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroeger, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Rademacher, Jessica UNSPECIFIED UNSPECIFIED UNSPECIFIED Faetkenheuer, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED Rybniker, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-130315
DOI:	10.3238/arztebl.2019.0729
Journal or Publication Title:	Dtsch. Arztebl. Int.
Volume:	116
Number:	43
Page Range:	S. 729 - 740
Date:	2019
Publisher:	DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication:	COLOGNE
ISSN:	1866-0452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ANTITUBERCULOSIS DRUGS; PULMONARY TUBERCULOSIS; GUIDELINES; DISEASE; ADULTS; CT Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13031