Tuberculosis

Last updated: Thursday, 17, February, 2011
PresentationAppropriate Tests

Mycobacteria testing as indicated by clinical presentation.

Tuberculin sensitivity testing (Mantoux test) may be helpful in assessing the risk of active infection, but a negative test may be present in active disease eg miliary tuberculosis.

The interferon-gamma release assay for Mycobacterium tuberculosis may be used as an alternative to Mantoux testing. 

The possibility of tuberculosis should be considered early in patients with HIV infection and other forms of immunosuppression (eg steroid therapy, chronic lymphocytic leukaemia), in alcoholics and in those with over-whelming inferctions (eg meningitis).

See also Infection (increased susceptibility)
See also Table 8 Interpretation of the tuberculin sensitivity (Mantoux) test

Pulmonary

Sputum, bronchoscopy brushings, pleural fluid, or gastric lavage - mycobacteria testing.

Lung or pleural biopsy may occasionally be required.

Cough, chronic

Haemoptysis

Pneumonia

Pleurisy

Pleural effusion

Laryngeal infection

See Laryngitis

Extrapulmonary

Osteomyelitis

Skin Infection

Meningitis

Cerebrospinal fluid examination - microscopy and culture incl mycobacteria testing (see also Molecular genetics - microbial); protein, glucose.

Genitourinary

Urine (complete morning specimen) - mycobacteria testing. "Sterile pyuria" is a characteristic finding.

Peritonitis

Peritoneal fluid examination

Pericarditis

Peritoneal fluid examination.

Miliary

Bone marrow aspiration - culture for M. tuberculosis.