Tuberculosis Diagnosis Adults and Children

Publication Date: December 8, 2016

Key Points

Key Points

TB disease remains one of the major causes of morbidity and mortality in the world.

The emergence of drug-resistant tuberculosis has become apparent over the past 2 decades—in particular, multidrug-resistant tuberculosis (MDR-TB; resistant to isoniazid and rifampin) and extensively drug-resistant tuberculosis (XDR-TB; resistant to isoniazid and rifampin, plus any fluoroquinolone and at least 1 of 3 injectable second-line drugs [ie, amikacin, kanamycin, or capreomycin]).

Transmission

  • Mycobacterium tuberculosis (Mtb) is transmitted from person to person via the airborne route. Several factors determine the probability of Mtb transmission:
    1. Infectiousness of the source patient: A positive sputum smear for acid-fast bacilli (AFB) or a cavity on chest radiograph are strongly associated with infectiousness.
    2. Host susceptibility of the contact.
    3. Duration of exposure of the contact to the source patient.
    4. The environment in which the exposure takes place. A small, poorly ventilated space provides the highest risk.
    5. Infectiousness of the Mtb strain.
  • Those who are household contacts and are exposed to patients who are smear positive have higher rates of both infection and disease.
  • Medical procedures that generate aerosols of respiratory secretions, such as sputum induction and bronchoscopy, entail significant risk for Mtb transmission unless proper precautions are taken.

Diagnosis

...agnosis...

...ng for Latent Tuberculosis Infection...

...recommends performing an interferon-γ...

...he panel suggests performing an IGRA rathe...

...ests performing an IGRA instead of a TST in indiv...

...panel suggests a second diagnostic t...

...uggests performing a TST rather than an IGRA in he...


...for TB Disease...

...mends that acid-fast bacilli (AFB) sm...

...uggests that both liquid and solid mycobac...

...el suggests performing a diagnostic nucleic ac...

...el recommends performing rapid molecular drug s...

...uggests mycobacterial culture of respiratory s...

...ests sputum induction rather than flexible broncho...

...suggests flexible bronchoscopic sampling, rath...

...suggests that postbronchoscopy sputum...

...l suggests flexible bronchoscopic sampling, r...

...el suggests that cell counts and chemis...

...panel suggests that adenosine deaminase l...

...gests that free IFN-γ levels be measure...

...panel suggests that AFB smear microscopy be perf...

...e panel recommends that mycobacterial c...

...nel suggests that NAAT be performed, rathe...

...ts that histological examination be performed,...

...el recommends a culture isolate from each my...

...Essential Laboratory Tests for the Detection of...

...1. Paradigm for Evaluation of Those with LTB...

.... Summary of Recommendations for Testing for LTBI...