This conference centers on an older man with diabetes and heavy smoking history who presented with worsening cough, weight loss, night sweats, and large-volume hemoptysis in the setting of prior cavitary pulmonary tuberculosis. Chart review and health department collateral revealed a much more complicated history than the patient initially reported, including multiple prior TB treatment courses, difficulty with directly observed therapy, and concern for drug resistance.
The teaching portion focuses on the history of tuberculosis, treatment of drug resistant TB, the pill burden associated with prolonged treatment, how the 2025 guidelines shorten some durations, and the possible role of endobronchial valves