Respiratory Diseases and the Fire Service

Pneumonias................................................................................................ 42
Pneumonia........................................................................................... 43
Mortality and Severity Assessment..................................................... 44
Common Organisms Responsible For
Community-Acquired Pneumonias................................................... 39
Hospital-Acquired Pneumonia........................................................... 49
Other Lung Infections................................................................................ 49
Lung Abscess........................................................................................ 49
Pleural Effusions and Empyema......................................................... 50
References.................................................................................................. 50
Chapter 2-3 • Tuberculosis: A Primer For First Responders......................... 53
Introduction............................................................................................... 53
Epidemiology of TB.................................................................................... 54
Pathogenesis, Transmission, Infection & Proliferation........................... 56
Host Immune Response...................................................................... 57
Progression From Infection to Active Disease................................... 57
Clinical Aspects of TB Disease............................................................ 58
Evaluation of Persons With Suspected Active TB Disease................ 58
Diagnostic Microbiology .................................................................... 59
Treatment of Patients With Active TB Disease.................................. 59
Drug-Resistant TB................................................................................ 60
Latent TB Infection .............................................................................. 60
Diagnostic Tests For TB Infection............................................................. 61
Tuberculin Skin Test (TST).................................................................. 61
Blood Tests (e.g. Quantiferon® - TB Gold).......................................... 62
Populations Who Should Be Tested For LTBI.................................... 63
Interpretation of LTBIs: Causes of False Positive and
False Negative TST Reactions.............................................................. 66
BCG Vaccinated Individuals................................................................ 66
Vaccination With Live Attenuated Vaccines...................................... 66
Anergy .................................................................................................. 67
Two-Step Tuberculin Skin Testing............................................................ 68
Clinical Evaluation For Latent TB Infection............................................. 68
Medical History and Physical Examination....................................... 68
Chest X-Ray.......................................................................................... 69
Sputum Examinations ........................................................................ 69
Considerations of Pregnant Women .................................................. 70
LTBI Treatment Regimens......................................................................... 70
Isoniazid............................................................................................... 70
Rifampin............................................................................................... 74
Rifampin & PZA Combination............................................................ 74
Contacts to Multidrug Resistant TB (MDRTB) Cases.............................. 75
Treatment of Close Contacts With A Prior Positive
Test For TB Infection............................................................................ 75
Monitoring Patients During Treatment.............................................. 75
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Respiratory Diseases and the Fire Service