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Re: OB-GYN-L digest 5438 From: Raymond Stephen (stephen.raymond@dhhs.tas.gov.au) Sun Feb 25 15:41:04 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Blanch Donovan: "Greece is reported to demand that diving instructors speak Greek even if their clients do not." Previous message: Robert J. Carpenter, Jr. MD, JD: "Re: Applying NICHD Terminology and other factors to EFM Interpretation" Absolutely agree that she must go on TB treatment now. As to who should supervise that treatment will depend on local rules and established specialists. A suggestion of a hysterectomy has been made. If she doesn't respond quickly to treatment and continues to have other symptoms suggesting a hysterectomy then it would be reasonable, but not necessarily required straight off. Investigate where it might have come from as there may well be another person requiring TB treatment in her list of contacts. Also check other sites of infection - lungs, kidneys and peritoneum. Provided that it is not a multiply resistant organism, the result of treatment should be good but it will take time - at least 6 months, and probably more, on treatment. Steve ________________________________ From: ob-gyn-l@obgyn.net on behalf of Dr Eberhard Lisse -- ________________________________ Sent: Sun 25/02/2007 6:43 PM To: Multiple recipients of list OB-GYN-L Subject: Re: OB-GYN-L digest 5438 She must go on TB treatment, *NOW*. And perhaps the county TB department is best geared to work her (and her family, coworkers, neighbours etc) up. I would however like to hear more of the history. Steve? BTW, here in Namibia, where we have in some areas the highest TB incidence in the world, but state "doctors" who can't count (or don't want to), they have recently changed the protocol so that if you have three positive sputums you don't need CxR any more. I think this is rubbish, and you still need the full workup, but treatment must start, I agree. el on 2/25/07 5:23 AM Meenan, Anna said the following: > Well, in this town she would be referred immediately to the TB > department at the county health department, where a full TB workup would > be done and appropriate meds started by the TB doc. > > Just curious....is this suburb she comes from in the US or elsewhere? > > Anna Meenan, MD, FAAFP > >> Interesting Case: >> 42 yo suburban housewife has EMB in office immediately [...] >> EMB results received yesterday......tuberculous granulomatous >> endometritis with pos acid fast stain. >> >> So now what??? -- Dr. Eberhard W. Lisse \ / Obstetrician & Gynaecologist (Saar) CONFIDENTIALITY NOTICE AND DISCLAIMER The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission. If the transmission contains advice, the advice is based on instructions in relation to, and is provided to the addressee in connection with, the matter mentioned above. Responsibility is not accepted for reliance upon it by any other person or for any other purpose. Next message: Blanch Donovan: "Greece is reported to demand that diving instructors speak Greek even if their clients do not." Previous message: Robert J. Carpenter, Jr. MD, JD: "Re: Applying NICHD Terminology and other factors to EFM Interpretation"

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