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Jordan Safirstein, MD Headshot

This is Getting TB Ridiculous

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One day after his third sputum culture came back negative, the grandstanding has hit a fever pitch. Regardless of the microbiology or the actual facts of the case, politicians had their time in the TB spotlight yesterday as the House of Representatives launched missives against the federal authorities in charge of stopping the Mycobacterial terrorist.

In referring to the agent who allowed Mr. Speaker to cross over into the United States from Canada, Rep. Dan Lungren (R-Calif.) said, "I hope you'll consider firing this person and anyone else involved."

Nice. As if a thorough investigation and "administrative leave" was not enough for the agent with almost 20 years experience, now a politician is calling for his head. Way to take a stand, Rep. Lundgren! You're doing a wonderful thing by jumping on the bandwagon and calling for someone's job. Ahhh, democracy.

But the pedestal was not left empty for long as the patient was also called to task: "Mr. Speaker obviously wanted to have his wedding cake and eat it, too, and that is unfortunate because he put a lot of people at risk," said Rep. Al Green (D-Texas). Ooooh, witty and caustic.

I know we keep harping on this and maybe we are not reading the right material (which I'm sure will be pointed out to us by our ever-astute readers) but where is the evidence that he is infective?

What we know is that he has three negative sputum cultures.

What has been reported in some place is that he has a lower lobe mass seen on chest x-ray (CXR) -- which, by the way, is not typical of TB pulmonary radiographic presentation.

We have also read in prior reports that there is a "smear positive." From where? And when? Did they repeat it? Could it have been an error?

At this point, we have moved far away from the actual clinical scenario and what is real and not real. The politicians have grabbed hold of this story and turned it into a story of international bio-terror concerns and the safety of our travel and our borders.

Doctors are even jumping in to say they did not tell him he was not infective, they told him he was not highly infective. Way to go guys, stick to your guns.

And all the while Mr. Speaker sits in a hospital room with a mask on watching the world turn his case into a public forum. What ever happened to HIPAA laws?

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