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Pulmonary tuberculosis infection control — SCE Acute Medicine MCQ

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ModeratePublic Health and Health PromotionPulmonary tuberculosis infection controlSCE Acute Medicine

A 37-year-old man presents with weight loss, night sweats and cough with occasional haemoptysis. Chest radiograph shows right upper-zone cavitation. He has recently arrived from a high-incidence country and is producing sputum. What is the most appropriate next step in management?

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Correct answer: A — Isolate and send sputum for acid-fast bacilli smear, culture and PCR

Cavitating upper-zone disease with systemic symptoms requires respiratory isolation and microbiological testing for pulmonary TB. Infection control should not wait for confirmation because smear-positive disease is transmissible. Steroids without excluding TB could worsen infection. The pearl is that public health actions begin at suspicion, not after culture positivity.

Reference: NICE NG33 Tuberculosis; UKHSA TB guidance