ABSTRACT
The resurgence of tuberculosis has been of increasing concern to public health. Laryngeal and cutaneous tuberculosis have long been regarded as two of the most infectious forms of the disease. In this article, we re-emphasize the public health consequences of a case of laryngeal TB, which must be considered in the differential diagnosis of a patient with persistent fever, cough, weight loss, and hoarseness.
Subject(s)
Public Health , Tuberculosis, Laryngeal/diagnosis , Adult , Cough/etiology , Diagnosis, Differential , Female , Fever/etiology , Hoarseness/etiology , Humans , Tennessee/epidemiology , Tuberculosis, Laryngeal/pathology , Tuberculosis, Laryngeal/transmission , Weight LossABSTRACT
Rifampin is a potent inducer of hepatic enzymes and is well documented to cause many clinically significant drug interactions. Studies in normal volunteers have shown its ability to decrease circulating levels of thyroid hormone, while having no effect on thyroid-stimulating hormone (TSH). Reports of rifampin's effects on patients on hormone replacement in the clinical setting are of interest since we believe only one such case has been described. We report the case of a man, stable on levothyroxine, who exhibited significantly elevated TSH levels during therapy with rifampin. Thyroid-stimulating hormone levels returned to baseline 9 days after discontinuance of rifampin.
Subject(s)
Rifampin/adverse effects , Thyroxine/adverse effects , Drug Interactions , Enzyme Induction/drug effects , Humans , Hypothyroidism/drug therapy , Liver/enzymology , Male , Middle Aged , Rifampin/administration & dosage , Surgical Wound Infection/drug therapy , Thyrotropin/blood , Thyroxine/administration & dosageABSTRACT
Potential religious discrimination poses troubling problems for today's personnel manager, who must be careful not to run afoul of legal constraints.
