TB Infection Control in Health Care Settings.TB Epidemiologic Studies Consortium plus icon.TB Treatment of Persons Living with HIV.Treatment Regimens for Latent TB Infection (LTBI).Deciding When to Treat Latent TB Infection.Diagnosing latent TB infection and TB disease.TB Screening and Testing of Health Care Personnel.Updated Guidelines for the Use of Nucleic Acid Amplification Tests in the Diagnosis of Tuberculosis.Guidelines for the investigation of contacts of persons with infectious tuberculosis and Guidelines for using the QuantiFERON ®-TB Gold test for detecting Mycobacterium tuberculosis infection, United States. Centers for Disease Control and Prevention.ATS, CDC, and Infectious Diseases Society of America.(PDF) Am J Respir Crit Care Med 2000 161. Diagnostic standards and classification of tuberculosis in adults and children. American Thoracic Society (ATS) and CDC.Susceptibility results from laboratories should be promptly reported to the primary health care provider and the state or local TB control program. Drug susceptibility patterns should be repeated for patients who do not respond adequately to treatment or who have positive culture results despite 3 months of therapy. It is crucial to identify drug resistance as early as possible to ensure effective treatment. tuberculosis isolate should be tested for drug resistance. Drug Resistanceįor all patients, the initial M. Laboratories should report positive results on smears and cultures within 24 hours by telephone or fax to the primary health care provider and to the state or local TB control program, as required by law. Culture examinations should be completed on all specimens, regardless of AFB smear results. tuberculosis confirms the diagnosis of TB disease. (However, a positive culture is not always necessary to begin or continue treatment for TB.) A positive culture for M. Therefore, a culture is done on all initial samples to confirm the diagnosis. Acid-fast microscopy is easy and quick, but it does not confirm a diagnosis of TB because some acid-fast-bacilli are not M. The presence of acid-fast-bacilli (AFB) on a sputum smear or other specimen often indicates TB disease. However, a chest radiograph may be used to rule out the possibility of pulmonary TB in a person who has had a positive reaction to a TST or TB blood test and no symptoms of disease. These abnormalities may suggest TB, but cannot be used to definitively diagnose TB. Lesions may appear anywhere in the lungs and may differ in size, shape, density, and cavitation. Chest RadiographĪ posterior-anterior chest radiograph is used to detect chest abnormalities. The TB blood test measures the patient’s immune system reaction to M. The test is read within 48 to 72 hours by a trained health care worker, who looks for a reaction (induration) on the arm. The Mantoux tuberculin skin test is performed by injecting a small amount of fluid called tuberculin into the skin in the lower part of the arm. Additional tests are required to confirm TB disease. The Mantoux tuberculin skin test (TST) or the TB blood test can be used to test for M. Physical ExaminationĪ physical exam can provide valuable information about the patient’s overall condition and other factors that may affect how TB is treated, such as HIV infection or other illnesses. Also, clinicians should determine whether the patient has medical conditions, especially HIV infection, that increase the risk of latent TB infection progressing to TB disease. It is also important to consider demographic factors (e.g., country of origin, age, ethnic or racial group, occupation) that may increase the patient’s risk for exposure to TB or to drug-resistant TB. Medical HistoryĬlinicians should ask about the patient’s history of TB exposure, infection, or disease. How Do You Evaluate Persons Suspected of Having TB Disease?Ī complete medical evaluation for TB includes the following: 1. If TB disease is in other parts of the body (extrapulmonary), symptoms will depend on the area affected. If TB disease is in the lungs (pulmonary), symptoms may include: TB disease should be suspected in persons who have the following symptoms: TB is a disease caused by Mycobacterium tuberculosis. Diagnosis of Tuberculosis Disease When Should You Suspect Tuberculosis (TB)?
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