Web resources and treatment of TB

THERAPY SIDE-EFFECTS

Given that most patients have to take four antituberculous drugs for months on end, it is not surprising that few patients complete a course of therapy for TB without troublesome side-effects.

This five-page PDF is devoted just to just this topic and discusses the side-effects of the various drugs. It then tells you what to do if adverse effects occur, and most useful of all, there is a symptom-based approach to the management of both minor and major side-effects.

Why go there: you won't need it often, but it is a gem.
Downside: none.
Information from: WHO Regional Office for Europe.
Address: www.ersnet.org/ers/lr/browse/viewPDF.aspx?id_attach=10900

PATIENT INFORMATION

This is an excellent piece of work. The publishers call it a leaflet, but it is a 12-page booklet that can be easily printed out in PDF format. BCG vaccination is clearly explained.

Sensibly, it starts with explaining what TB is, how it is transmitted and the symptoms that occur. The process of vaccination is explained, and there is a rather dispiritingly long list of countries whose citizens need to be particularly wary of TB infection. But the message is positive and upbeat.

This well-presented communication is also available in many other languages.

Why go there: to ensure parents are informed.
Downside: none.
Information from: Public Health Protection Division, Welsh Assembly
Government.
Address: www.cmo.wales.gov.uk/content/work/immunisation/bcg-baby-e.pdf 

GLYCYRRHIZA GLABRA

I didn't think there would be a herbal remedy advocated for treating TB, but I should have known better. There are hundreds of remedies, some costing up to $600. This preparation is more modestly priced, costing £16 for 100ml of tincture. The active ingredient is liquorice root, and it is claimed that it is useful for TB. What always amazes me is the list of other ailments that seemed to be dealt with effectively by this product. In this case, the completely unrelated diseases that can be treated with liquorice root include Lyme disease and prostate enlargement.

Why go there: to be aware patients may take inappropriate therapies.
Downside: so many unsubstantiated claims.
Information from: www.HomeHerbs.com
Address:
www.homeherbs.com/1151763256250819/product/388/55-Licorice_Root.html

- Dr Barnard is a former GP in Fareham, Hampshire

WEBSITE OF THE WEEK

You are not going to become a world expert on TB by looking at these pages, but you will be reminded that TB does not always present with a cough and something obvious on a chest X-ray.

Maybe I have a weakness here, but I don't think TB would be the first thing that would come into my mind if I saw a case such as this (see picture).

The patient has lupus vulgaris, and another image on this page shows scrofuloderma (a broad linear hyperpigmented indurated plaque with fine scaling and crust).

TB can present as a 'silent', cold paravertebral abscess, and here is a picture of just such an abscess, complete with someone giving it a good touch to show it is relatively painless.

Why go there: to be reminded of the diversity of TB.
Downside: there is not enough clinical detail.
Information from: DermAtlas, Johns Hopkins University.
Address: www.dermatlas.com/derm/result.cfm?Diagnosis=1494087972

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