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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
Systemic Symptoms of TB
Fever
Chills
Night sweats
Appetite loss
Weight loss
Fatigue
Evaluation for TB
1.HIV test
2.Medical history
3.Physical examination
4.Bacteriologic or histologic
exam
(Chest radiograph if
indicated)
Medical History
HIV status
Symptoms of disease
History of TB exposure, infection, or disease
Past TB treatment
Demographic risk factors for TB
Other medical conditions that increase risk for TB
disease (e.g., diabetes)
Symptoms of Pulmonary TB
Productive, prolonged cough
(duration of 2-3 weeks)
Chest pain
Hemoptysis (bloody sputum)
Signs may vary based on HIV status
AFB smear-microscopy
Chest Radiograph
Diagnosis of PTB solely on basis of
CXR not encouraged
May have unusual appearance in
HIV-positive persons
CXR is helpful in HIV+, smearnegative patients
Cannot confirm diagnosis of TB
Cultures
Should be requested for ALL
retreatment patients
Relapse
Failure
Return after default
Colonies of M.
tuberculosis
growing on media
Diagnosis in Children
1. Patient history
Contact to PTB+
Symptoms consistent with TB
HIV test
2. Clinical Exam
3. TST
4. Bacteriological confirmation
5. Investigations for PTB and EPTB
Guidance of National Tb Programmes for the Management of TB in Children
WHO/HTM/TB/2006.371