A 38-year-old man comes to the physician because of a 1-month history of fever and a cough productive of a moderate amount of yellowish sputum. He has had a 6-kg (13-lb) weight loss during this period. He emigrated from the Middle East around 2 years ago. His father died of lung cancer at the age of 54 years. He has smoked one pack of cigarettes daily for 18 years. His only medication is a daily multivitamin. He appears malnourished. Sputum cultures grow acid-fast bacilli that are susceptible to most antimycobacterial drugs in vitro. Isoniazid monotherapy in this patient would most likely result in:

Question

A 38-year-old man comes to the physician because of a 1-month history of fever and a cough productive of a moderate amount of yellowish sputum. He has had a 6-kg (13-lb) weight loss during this period. He emigrated from the Middle East around 2 years ago. His father died of lung cancer at the age of 54 years. He has smoked one pack of cigarettes daily for 18 years. His only medication is a daily multivitamin. He appears malnourished. Sputum cultures grow acid-fast bacilli that are susceptible to most antimycobacterial drugs in vitro.  Isoniazid monotherapy in this patient would most likely result in:

Quizplus · Accepted Answer

Eductional Objective: Active tuberculosis is never treated with drug monotherapy due to the fast emergence of mycobacterial antibiotic resistance from rapid, selective gene mutations.  Isoniazid monotherapy may be used for patients who have a positive PPD and a negative chest x-ray (ie, no evidence of clinical disease).

A 38-Year-Old Man Comes to the Physician Because of a 1-Month