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

...gnosis

...for Latent Tuberculosis Infection (LTBI)...

The panel recommends performing an inter...

...panel suggests performing an IGRA rather th...

...sts performing an IGRA instead of a TST in individ...

...nel suggests a second diagnostic test if the init...

...el suggests performing a TST rather tha...


...sting for TB Disease...

...nel recommends that acid-fast bacill...

...sts that both liquid and solid mycobacterial cult...

...el suggests performing a diagnostic n...

...panel recommends performing rapid...

...panel suggests mycobacterial culture of resp...

...sts sputum induction rather than flexible...

...e panel suggests flexible bronchoscopic...

...e panel suggests that postbronchoscopy sputum...

...suggests flexible bronchoscopic sampling,...

...e panel suggests that cell counts a...

...panel suggests that adenosine deaminase...

...anel suggests that free IFN-γ levels be...

...ests that AFB smear microscopy be performed, r...

...he panel recommends that mycobacterial cul...

...el suggests that NAAT be performed, rather than n...

...he panel suggests that histological...

...anel recommends a culture isolate fro...

...ssential Laboratory Tests for the Detection of...

...adigm for Evaluation of Those with LTBI Based...

...Summary of Recommendations for Tes...