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Old 03-26-2012
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Question Canadian farmer with 15 mm PPD!

A 30-year-old Canadian immigrant farmer consults with symptoms of night sweats, low-grade fever, cough, and fatigue. He does notsmoke. He has a history of asthma.The chest x-ray required for immigration was normal five months ago. He received the BCG vaccine as a child. The skin test for tuberculosis is positive at 15 mm. The most likely diagnosis is

a. Influenza
b. Brucellosis
c. Aspergillosis
d. Mycobacterium bovis
e. Mycobacterium tuberculosis
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Old 03-26-2012
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E?

What's the source of this question?
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Old 03-26-2012
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Reactivation Tuberculosis ?
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Old 03-26-2012
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He alrady got his bcg vaccine, so the ppd will be positive.

Since he's a farmer and has low grade fever with night sweats, i'll go with brucella
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Old 03-26-2012
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Since he already had the BCG, D. and E. are less likely. He can be having a false positive due to the vaccine used outside the USA. Going by the history of he being a farmer, I would say Brucellosis too, thinking that he ingested contaminated milk. Aspergillosis is in immunocompromised patients and influenza I dont like it.
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Old 03-26-2012
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The answer is d. Clinical symptoms caused by M.bovis are indistinguishable from those of M. tuberculosis. This patient is unlikely to have been in contact with someone with active TB, given that he lives in rural areas. His occupation, however, may lead to contact with M. bovis. Brucellosis may also cause fever, sweats, fatigue, but is not associated with cough. The incubation period generally does not exceed two months.
came across it in pre-test,found it a little weird, so posted it!
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Old 04-14-2012
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Quote:
Originally Posted by johnvega98 View Post
Since he already had the BCG, D. and E. are less likely. He can be having a false positive due to the vaccine used outside the USA. Going by the history of he being a farmer, I would say Brucellosis too, thinking that he ingested contaminated milk. Aspergillosis is in immunocompromised patients and influenza I dont like it.

BCG is protective against extrapulmonary TB than pulmonary TB.
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