Reference no: EM133537064

HPI: CG is a 46-year-old man who presents to the medical clinic complaining of a 2-month history of a persistent cough that has become productive over the past 3 weeks. He also complains of fever, malaise, and a 6-kg (13-lb) weight loss over the past 2 months.

PMH: Type 2 diabetes mellitus (noninsulin-dependent diabetes mellitus, NIDDM)-not well controlled; hypertension (HTN) × 5 years-not controlled.

FH: Mother, age 82, alive and well, lives with CG. Father died of alcoholic liver disease10 years ago. One brother, age 53, lives with the patient, currently undergoing chemotherapy treatment for lung cancer.

SH: Born and raised in India until the age of 19 when he moved to Los Angeles, California. Single, one daughter. He had a 20-year history of alcohol abuse but has been sober for 5 years. He owns his own import/export business and travels internationally to India and parts of China.

Meds: Lisinopril 20 mg daily; amlodipine 5 mg daily; metformin 500 mg twice daily. Patient reports that he tries to be compliant with his therapies and takes them regularly except when he travels he often forgets; over the past 2 months, he has only gone 3 to 4 days without medication.

Questions:

1. What information in the history is suggestive of TB?

2. What factors place this patient at increased risk of acquiring TB?

3. Which signs, symptoms, and other findings are consistent with active TB infection?