Management of Pulmonary Tuberculosis- A Family Case Study

Abstract

Background: Tuberculosis (TB) is a chronic, necrotizing infection which is caused by the Mycobacterium tuberculosis bacillus. It is spread primarily through an airborne route when an individual with pulmonary tuberculosis coughs, talks or sneezes. Close contacts are predisposed to contacting the disease. It is therefore important to trace and treat family members of all index cases because of the highly infectious nature of the disease.

Patients, Methods and Results: The index patient was a 35 year old civil servant who had smear positive pulmonary tuberculosis. His immediate family was screened. His youngest child whom was known to be the closest to him was found to have active Pulmonary Tuberculosis (PTB). The older child had a positive tuberculin skin test but no other evidence of active infection. They were all treated according to the Nigerian national guideline for Tuberculosis management. Family medicine tools including the Family circle, Family life cycle, Home visits and Family counseling were used in the management of this case. This case emphasizes the need for a thorough contact tracing, family involvement in care, home visits and individualization in the management of pulmonary tuberculosis. It also emphasizes the practical application of family medicine tools in the family physician's evaluation of patients and families.

Conclusion: Early identification and prompt treatment of all index cases of PTB together with a thorough search for close family contacts, family counseling and home visits by healthcare workers can help to reduce the scourge of PTB in Nigeria.

Key Words: Pulmonary Tuberculosis , Family, Family Case Study