Diagnosis of TB. Learning Objectives. List the 4 principle components of a TB evaluation Describe the criteria which differentiate PTB+ from PTB- Describe the 3 major indications for culture and DST. Common Sites of TB Disease. Lungs Pleura Central nervous system Lymphatic system
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disease (e.g., diabetes)
Acid-fast bacilli (AFB) (shown in red) are tubercle bacilli
Any pulmonary TB case that does not meet the definition of being smear-positive. This includes:
1. Patients with three negative smear results and radiological findings and doctor’s decision to treat for TB
2. Patients with negative smear results and a positive culture result for M. tuberculosis
3. Patients who are unable to produce sputum and with highly suspicious radiological and clinical findings and doctor's decision to treat for TB
Arrow points to cavity in
patient's right upper lobe.
Colonies of M. tuberculosis
growing on media
Guidance of National Tb Programmes for the Management of TB in Children WHO/HTM/TB/2006.371
Risk Factors For Children Include:
The presence of three or more of the following should strongly suggest a diagnosis of TB:
(The presentation in infants may be more acute, resembling acute severe pneumonia and should be suspected when there is a poor response to antibiotics. In such situations, there is often an identifiable source case, usually the mother.)