Infectious Diseases Question 13

A 28-year-old man is evaluated after being informed his roommate at a homeless shelter was diagnosed with pulmonary tuberculosis. He reports no fever, cough, night sweats, or weight loss. Medical history is significant for injection drug use, most recently 2 weeks ago, although he reports no known infectious complications in the past. Medical history is otherwise unremarkable, and he takes no medications.

On physical examination, vital signs are normal. BMI is 22. Track marks secondary to injection drug use are present bilaterally on the antecubital fossa, without tenderness, warmth, erythema, or fluctuance. Cardiopulmonary examination and all other examination findings are normal.

A tuberculin skin test induces 7-mm induration.

Chest radiograph is normal.

Which of the following is the most appropriate next step in the management of this patient?

A  Chest CT

B  Isoniazid

C  Isoniazid, rifampin, pyrazinamide, and ethambutol

D  No further intervention

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