TOPIC: Coordinating Care in the Specialist Setting – Tuberculosis Meningitis History of the Patient: This is the case of a 48 year old, female patient named MJ, who presented with complaints of three month history of headache, tiredness, and fever. MJ was self – medicating with Paracetamol 500 mg on as needed basis for fever and Mefenamic Acid 500 mg for body malaise and headache…
Background: Tuberculosis meningitis is an infection caused by Mycobacterium tuberculosis that initially starts as an infection in the lungs, and progressively develops in the bloodstream once the bacteria have multiplied. In TB meningitis, Mycobacterium tuberculosis eventually spread through the meninges of the brain or the spinal cord (Meningitis UK, 2009). It is the most destructive form of meningitis, and the key to its management lies on its prompt diagnosis (Haldar, et al., 2009). Meningitis UK (2009) stated that TB meningitis is formed when small abscesses called tubercles bursts in the meninges. This condition is considered as fatal when treatment is delayed. Tuberculosis is the severest form of Mycobacterium tuberculosis and is the leading cause of fatality around the world. Mycobacterium tuberculosis starts as a solitary communicable agent that commonly affects the lungs, even though almost every organ in the body is involved (Newton, 1994, Thwaites, et al. 2004, and WebHealthCentre, 2009). Looking back, tuberculosis had already existed even before the Neolithic period. The only treatment available till the early 20th century was to rest in the open air in a place known as specialised sanitoria (WebHealthCentre, 2009). ...
980s, a steady decline of cases was observed among developed countries; however, this was reversed due to the combination of several factors that includes social, economical, and historic. All of which were responsible for urban homelessness, intravenous abuse of drugs, a rising neglect of control programs on tuberculosis, and recently, epidemic of AIDS (WebHealthCentre, 2009). According to Thwaites, et al., (2004), in spite of being treated with antituberculosis chemotherapy, tuberculous meningitis oftentimes results to death or severe neurologic deficits. Although uncommon in the developed countries like the United Kingdom (UK), there are still about 300 cases of TB meningitis that has been reported in the year 2007 (Meningitis UK, 2009). And despite of optimal treatment, Nardell (2009) stated that TB meningitis is possibly fatal in about 25 percent of cases. Assessment: Based on the history and presenting signs and symptoms, MJ is suspected to have a Tuberculous Meningitis. MJ presented with complaints typical for Tuberculous Meningitis during its early stage of development, which is called the prodromal period. MJ’s complaints of headache, tiredness, and fever and later on, altered levels of consciousness are typical for Tuberculous Meningitis. Ramachandran (2011) stated in his article, that nonspecific symptoms for tuberculous meningitis during the prodromal period include fatigue, malaise, myalgia, and fever. Ramachandran added that in the elderly, more common symptoms of TB meningitis presents in the form of headache and changes in the mental status and all of the symptoms mentioned by Ramachandran are presented by the patient, MJ at the time of admission. Identifications and Investigations: In managing TB meningitis, arriving at a rapid and accurate diagnosis ...
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The process of learning for health professionals and for students is a crucial element of the health service delivery. For health professionals, it is important to establish clear learning abilities in the practice in order to establish effective practices in health care. Nurses play an important role in improving the learning environment in the nursing and health practice.
In the worst clinical presentation, tuberculosis presents with serious necrotic to caseating granulomatous lesions in the lungs and other extra-pulmonary organs, such as the brain and liver. Granuloma formation is considered as a protective mechanism against a more serious spread of the bacteria to surrounding healthy tissues and organs.
It can spread from one person to another through different ways, but generally air happens to be the prominent method for the spread of Tuberculosis. The germs of TB known as bacilli, enters into air, when a TB patient sneezes, talks or spits. This way the germs can enter into another healthy person's body during inhalation.
Study shows that city dwellers or people in places where carrier agents of the bacterium are more likely to thrive, and alcoholics are at high risk of developing the disease (Health Encyclopedia Online, 2001). The immune system may be too weak to resist against the bacteria (Health Encyclopedia Online, 2001).
Note that the incidence rate of TB varies across countries. However, the disease is much more prevalent in developing countries than in advanced economies. To illustrate this fact, according to the WHO Report (Global Tuberculosis Control 2006), South Africa posted the highest incidence of TB with 718 cases per 100,000 people in 2004.
The author of the essay gives a detailed information of the origin, symptoms and treatment of Pulmonary tuberculosis. According to the text,most people who are exposed are asymptomatic, the body may be infected with the bacterium but the immune system often prevents the manifestation of the disease and the bacterium remains in inactive state and is not contagious.
The author states that racism in most incidences is a manifestation of lack of intelligence that would otherwise demonstrate to an individual that there is no difference between them and another person from a different race. Initially, the antagonism was directed towards individuals from different tribes.
One can stay with the T.B bacteria for a long time in the body without developing the symptoms of the disease provided that they have strong humane system. However groups such as people with HIV or elderly adults the TB bacteria can become active. In their
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