Diagnosis for Tuberculosis

Tuberculosis is one of the leading diseases in today's world. In India, it is the 2nd
largest disease and the treatment patterns vary according to the stage and type of
disease.


All individuals with symptoms of TB disease have a positive tuberculin skin test
(TST) or an interferon-gamma release assay (IGRA) which is indicative of M.
tuberculosis infection, should be medically evaluated to exclude TB disease.
A complete medical diagnosis for TB disease includes the following five
components:

1. Medical history: While conducting a medical history, the diagnosing clinician
should ask if any symptoms of TB disease are present; if so, the time duration and if
there has been known exposure to a person with infectious TB disease.
Also imperative whether the person has been diagnosed in the precedent with latent
tuberculosis infection (LTBI) or TB disease. After which these Clinicians should also
in-depth determine if the patient has underlying other medical conditions, especially
diseases like human immunodeficiency virus (HIV) infection or diabetes, that
increase the risk for progression to TB disease in those latently infected with M.
tuberculosis.

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2. Physical examination: A physical examination is an important and essential part of
the evaluation of any patient. These tests can not only confirm or rule out TB
disease, but they can also provide valuable information about the patient’s overall
condition, inform the method of diagnosis, and reveal other factors that may affect
TB disease treatment if diagnosed. This also includes A physical examination is an
essential part of the evaluation of any patient.

3. Test for M. tuberculosis infection: in this test, the Selection of the most suitable
tests for detection of M. tuberculosis disease has to be based on the test availability,
and overall cost-effectiveness of testing for tuberculosis. Currently, there are two
primary methods available for the detection of M. tuberculosis infection which
includes the below-listed tests

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The Tuberculosis tests are:

• Mantoux tuberculin skin test (TST)
• Interferon-gamma release assays (IGRAs)*
QuantiFERON-TB Gold In-Tube test (QFT-GIT)
» T-SPOT®.TB test

4. Chest radiograph: this test is used With pulmonary TB being the most common
form of the disease, and the chest radiograph is useful for diagnosis of TB disease giving direst results. Chest abnormalities can suggest pulmonary TB disease as it affects the lungs. The results given in the posterior-anterior radiograph scan of the chest is the standard view used for the detection of TB-related chest abnormalities. Also with the above tests In some situations, a computerised tomography (CT) scan may provide additional information.

5. Bacteriologic examination of clinical specimens:

The bacteriological tests the Examinations of clinical specimens like the sputum,
urine, and cerebrospinal fluid are of critical diagnostic importance in proving results.
The specimens should be examined and cultured in a laboratory that specializes in
testing for M. tuberculosis.

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The bacteriologic examination has five parts:
• Specimen collection, processing, and reviewing
• AFB smear for the classification and results
• Direct detection of M. tuberculosis in clinical specimen using nucleic acid
amplification (NAA)
• Specimen culturing and identification
• Drug-susceptibility testing

See: Dengue Treatment Procedure

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