The White Plague

Multidrug resistent TB is a potential time bomb...

Hmong refugees often have to be treated before they enter the US.

Luckily, most "positive cases" are positive skin tests or scarring on x rays without active disease...

But one active case could spread it.

Few younger American docs have seen active TB-- I saw a lot in Africa, and still recognize cases.

My last diagnosed case was a Native American lady who had a history of TB and her sputum looked suspicious, and the x rays of her old scars seemed to show the walls of her scars were thicker than her last hospital visit...six weeks later her sputum was positive, and staff went into a panic, since she wasn't isolated at first (once we took sputums, we started treatment, and usually you aren't infectious after two weeks of treatment).

Ironically, they were more mad at me than the patient...like it was my fault she had tb.

Go figure