Q: I am a 23 years old man suffering from cough, breathlessness and malaise for the last four weeks. I have lost four kg weight, but have no history of night sweats or haemoptysis. On examination, I was found to have mild fever (37.8 degree Celsius) but had no evidence of anaemia or clubbing. Crepitations were audible over the lung apices; there were no other physical signs. My haemoglobin and white cell count were normal. The chest X-ray showed bilateral upper - and middle - lobe shadowing but no hilar enlargement. But sputum was found to contain acid-fast bacilli and Mycobacterium tuberculosis was subsequently cultured. The Mantoux test was strongly positive. What is the diagnosis? What is the treatment for the same?

A:Tuberculosis, which is confirmed by finding acid-fast bacilli and Mycobacterium, if untreated constitutes a major problem. A patient needs instantaneous management with appropriate medications for the present symptoms and the future expectation of untreated disease. Tuberculosis is one of the most serious conditions and is easily spread in the community. Thus skilled management by a physician and community health services should be instituted. Multiple drug therapy with a combination of isoniazid and other pills will be required every day for a long period of many months or even 18 months in a severe case. The goal is to contain this infection with the appropriate management on an established regimen that is available from health care societies or local specialists who are familiar with TB using protocols that have been established by the World Health Organization and the American Thoracic Society. Note: TB is a major illness and must be treated even if it involves patient separation from freedom if the patient opposes therapy. Local agencies may issue restraining orders if patients do not comply. Referral to the internet information may be needed to guide the management of procedures that are universally approved.