Diagnosis of Pulmonary Tuberculosis: What Every GP Should Know

LetsTalkTB_1Authors: Madhukar Pail MD, PhD-Author and Series Editor
Number of pages: 6
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Overview: India has the highest burden of tuberculosis (TB) in the world, and every GP will need to consider TB as a differential diagnosis in persons with cough lasting two weeks or more, or with unexplained chronic fever and/or weight loss. Sputum is the most important sample for laboratory testing. Although blood is a popular sample in theIndian privatesector, there is no accurate blood test for active TB. Blood-based antibody tests (e.g., IgG/lgM ELISA orrapid tests) and interferon-gamma release assays (e.g., TB Gold) are not accurate and should not be used for pulmonary TB diagnosis. In fact, the Government of India has recently banned the use of serodiagnostic tests for TB. There are three internationally accepted sputum tests for active TB:sputum smear microscopy for acid-fast bacilli; nucleic acid amplification test(e.g., GeneXpert); and culture. Chest radiography is useful but cannot provide a conclusive diagnosis on its own, and needs to be followed by sputum testing.

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