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TB Pleural Effusion — SCE Infectious Diseases MCQ

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HardTuberculosisTB Pleural EffusionSCE Infectious Diseases

A patient with drug-susceptible pleural tuberculosis has no CNS, bone or joint involvement and is responding clinically. What total treatment duration is normally used in UK practice?

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Correct answer: A — Six months using the standard initial four-drug phase followed by isoniazid and rifampicin with review after review

The best answer is “Six months using the standard initial four-drug phase followed by isoniazid and rifampicin with review after review”. Pleural disease without a site requiring extension follows the standard six-month drug-susceptible TB regimen. “Three months of isoniazid and rifampicin without an intensive phase” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “Nine months solely because an effusion is extrapulmonary” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “Twelve months as for central-nervous-system tuberculosis” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement. “Eighteen months as for multidrug-resistant tuberculosis” is less appropriate because it does not satisfy the scenario's decisive clinical or jurisdictional requirement.

Reference: NICE NG33 tuberculosis recommendations: https://www.nice.org.uk/guidance/ng33/chapter/Recommendations