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Smear-positive pulmonary tuberculosis — SCE Respiratory MCQ

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EasyTuberculosis and NTMSmear-positive pulmonary tuberculosisSCE Respiratory

A 46-year-old man has cough, fever, night sweats and weight loss. Chest radiograph shows right upper-lobe cavitation, sputum smear is positive for acid-fast bacilli and nucleic acid testing confirms Mycobacterium tuberculosis with no rifampicin resistance detected. He lives in shared accommodation. Baseline liver function is normal. What is the most appropriate management?

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Correct answer: C — Rifampicin, isoniazid, pyrazinamide and ethambutol with notification and contact tracing

Smear-positive pulmonary TB requires standard four-drug treatment, public health notification and contact tracing while full sensitivities are awaited. Two-drug therapy from the start risks undertreatment during the intensive phase. Infection-control measures are vital but do not replace treatment.

Reference: NICE NG33 Tuberculosis; UKHSA TB guidance