Which of the following patients needs to be staed on multidrug therapy for TB?

A 17 year old with a lymph node biopsy growing Mycobacterium tuberculosis * Active tuberculosis at any site (the presence of culturable organisms or evidence of progressive disease) mandates multidrug therapy. * For patients with latent tuberculosis infection, treatment with a single drug will suffice to kill the small number of organisms. * The calcified granulomas in patient (a) are a sign of old disease; he does not need new treatment unless he becomes symptomatic. * The patients (c) and (d) have had low-risk exposures and would not be treated unless there was evidence of a change in skin tests.