Question

A 32-year-old man presents with 3 weeks of productive cough, night sweats, weight loss and haemoptysis. He migrated from a high TB prevalence country and has not had BCG vaccination. Chest X-ray shows cavitating lesions in the upper lobes. What is the most appropriate next step?

Accepted Answer

Isolate the patient and arrange urgent sputum samples for acid-fast bacilli

Answer

Start broad-spectrum oral antibiotics and review in 1 week

Answer

Refer urgently to respiratory clinic but no immediate action

Answer

Start standard quadruple anti-tuberculous therapy in the community without further tests

Answer

Reassure and arrange routine outpatient CT scan

Practice question

A 32-year-old man presents with 3 weeks of productive cough, night sweats, weight loss and haemoptysis. He migrated from a high TB prevalence country and has not had BCG vaccination. Chest X-ray shows cavitating lesions in the upper lobes. What is the most appropriate next step?