D T W Teo1, T W Lim. 1. Department of Anaesthesia, Changi General Hospital, Singapore.
Abstract
INTRODUCTION: Pulmonary tuberculosis (PTB) is prevalent in our population. We report an incident of healthcare workers (HCWs) suspected of being infected by a patient with undiagnosed active PTB in the operating theatre. CLINICAL PICTURE: A 60-year-old patient admitted for intestinal obstruction, underwent an emergency laparotomy. Preoperative chest X-ray (CXR) showed diffuse reticular-nodular shadowing and postoperative sputum was positive for acid-fast bacilli. TREATMENT: The patient was isolated and treated for active tuberculosis. The anaesthetist and her assistants in the operating theatre that day were referred to the infectious disease physician and some were started on tuberculosis prophylaxis. OUTCOME: The patient and the HCWs involved recovered. CONCLUSION: Thus, all PTB-susceptible patients with suggestive CXR should be treated as potentially infective. Adequate personnel protection should include highly efficient facemasks and shields. Risk of patient-to-patient transmission of tuberculosis through the anaesthetic circuit is low if effective bacterial/viral filters are used.
INTRODUCTION:Pulmonary tuberculosis (PTB) is prevalent in our population. We report an incident of healthcare workers (HCWs) suspected of being infected by a patient with undiagnosed active PTB in the operating theatre. CLINICAL PICTURE: A 60-year-old patient admitted for intestinal obstruction, underwent an emergency laparotomy. Preoperative chest X-ray (CXR) showed diffuse reticular-nodular shadowing and postoperative sputum was positive for acid-fast bacilli. TREATMENT: The patient was isolated and treated for active tuberculosis. The anaesthetist and her assistants in the operating theatre that day were referred to the infectious disease physician and some were started on tuberculosis prophylaxis. OUTCOME: The patient and the HCWs involved recovered. CONCLUSION: Thus, all PTB-susceptible patients with suggestive CXR should be treated as potentially infective. Adequate personnel protection should include highly efficient facemasks and shields. Risk of patient-to-patient transmission of tuberculosis through the anaesthetic circuit is low if effective bacterial/viral filters are used.