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Diagnosis of tuberculosis

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Determine TB LAM Ag and the Fujifilm SILVAMP TB LAM could diagnose 65% of patients with active TB within 24 h. A meta-analysis with 1,595 inpatients and outpatients showed 70% sensitivity and 90% specificity for TB diagnosis in people living with HIV for Fujifilm SILVAMP TB LAM. As of 2020, the test showed a high positive predictive value (95.2%) in HIV-negative outpatients. Large prospective studies are on the way.
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performance of IGRA. A recently published study from the same group also provided evidence that immunosuppressive agents significantly impair the performance of IGRAs, raising concerns about their reliability in immunosuppressed patients. Although IGRA replaced the TST in most of clinical settings its variability as of 2013 was a concern while reading the result
394:(LJ), Kirchner, or Middlebrook media (7H9, 7H10, and 7H11). A culture of the AFB can distinguish the various forms of mycobacteria, although results from this may take four to eight weeks for a conclusive answer. New automated systems that are faster include the MB/BacT, BACTEC 9000, VersaTREK, and the Mycobacterial Growth Indicator Tube (MGIT). The 895:
specificity of 86.3%. In head-to-head comparisons, the sensitivity of IGRAs surpassed TST. However, several subsequent studies have reported higher sensitivity for TST than for IGRAs in patients with active TB; one large 2017 study reported a sensitivity of 90% for TST and only of 81% for the QuantiFERON-TB Gold assay.
333:. These tests vary in which nucleic acid sequence they detect and vary in their accuracy. In the decade of the 2000s, the two most common commercially available tests were the amplified mycobacterium tuberculosis direct test (MTD, Gen-Probe) and Amplicor (Roche Diagnostics). In 2007, a systematic review of NAAT by the 122:. Other parts of the medical history include prior TB exposure, infection or disease and medical conditions that increase risk for TB disease such as HIV infection. Depending on the sort of patient population surveyed, as few as 20%, or as many as 75% of pulmonary tuberculosis cases may be without symptoms. 936:
of 12 cross-sectional or cohort studies that showed a relatively low pooled sensitivity of 45% and specificity of 92% against a microbiological reference standard. Despite the limited sensitivity, test-guided initiation of anti-TB treatment reduced mortality in immunocompromised, hospitalized PLHIV.
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recommended the use of the Alere Determine TB LAM Ag assay for people with HIV and a CD4 count below 100 cells/ÎĽL and in those defined as seriously ill according to WHO criteria (respiratory rate >30 breaths per min, body temperature >39 Â°C, heart rate >120 beats per min, or unable to
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for early secretory antigen target 6 (ESAT-6) and culture filtrate protein 10 (CFP-10) to stimulate host production of interferon-gamma. Because these antigens are only present in few non-tuberculous mycobacteria or not in any BCG vaccine strain, these tests are thought to be more specific than the
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Peter JG, Zijenah LS, Chanda D, Clowes P, Lesosky M, Gina P, et al. (March 2016). "Effect on mortality of point-of-care, urine-based lipoarabinomannan testing to guide tuberculosis treatment initiation in HIV-positive hospital inpatients: a pragmatic, parallel-group, multicountry, open-label,
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A 2012 study at Stanford University confirmed that addition of immune boosters can make the IGRA more reliable in terms of separating positive from negative individuals. A study from the University of Southampton shows that variations in environmental temperatures can have a profound effect on the
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NAA techniques such as polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP) are the basis of molecular diagnosis of TB. To detection of MTB in samples different molecular methods and assays have been defined. Real-time PCR (RT-PCR), microarrays, PURE-LAMP, NGS, and WGS
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Health Technology Assessment Programme concluded that "NAAT test accuracy to be far superior when applied to respiratory samples as opposed to other specimens. Although the results were not statistically significant, the AMTD test appears to perform better than other currently available commercial
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circulating within blood vessels of a patient. The skin patch contains antibodies recognizing the secreted bacterial protein MPB-64 passing through the blood capillaries of the skin creating an immunological response. If the patch detects this secreted bacterial protein, the surrounding skin will
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FDG PET/CT can play several useful roles in patients with confirmed or suspected TB. These roles include detection of active TB lesions, assessment of disease activity, differentiation between active and latent disease, assessment of disease extent (staging), monitoring response to treatment, and
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antigen is a lipopolysaccharide present in mycobacterial cell walls, which is released from metabolically active or degenerating bacterial cells and appears to be present only in people with active TB disease. Urine-based testing have advantages over sputum-based testing because urine is easy to
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directed towards the 5-methylthio-d-xylofuranose (MTX) epitope and a silver amplification technology to enable higher diagnostic sensitivity at high specificity. A 2019 study with 968 HIV+ hospital inpatients found the Fujifilm SILVAMP TB LAM test to have a 28% higher sensitivity than the Alere
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TB, due to their ability to detect latent TB. In a recently published metaanalysis, with data from both developed and developing countries, QuantiFERON-TB Gold In Tube had a pooled sensitivity for active TB of 81% and specificity of 99.2%, whereas T-SPOT.TB had a pooled sensitivity of 87.5% and
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Health Technology Assessment Programme concluded "There is no evidence to support the use of ADA tests for the diagnosis of pulmonary TB. However, there is considerable evidence to support their use in pleural fluid samples for diagnosis of pleural TB, where sensitivity was very high, and to a
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the US Centers for Disease Control and Prevention state that whereas Quantiferon Gold is not affected by BCG inoculation tuberculin tests can be affected. In general the US approach is likely to result in more false positives and more unnecessary treatment with potentially toxic drugs; the UK
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Interferon-Îł (interferon-gamma) release assays (IGRAs) are 21st century tests for tuberculosis. Guidelines for the use of the FDA approved QuantiFERON-TB Gold were released by the CDC in December 2005. In October 2007, the FDA gave approval of QuantiFERON-TB Gold In Tube for use in the United
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Abnormalities on chest radiographs may be suggestive of, but are not necessarily diagnostic of, TB. However, chest radiographs may be used to rule out the possibility of pulmonary TB in a person who has a positive reaction to the tuberculin skin test and no symptoms of the disease.
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with or without mediastinal or hilar lymphadenopathy or pleural effusions ( tuberculous pleurisy). However, lesions may appear anywhere in the lungs. In disseminated TB a pattern of many tiny nodules throughout the lung fields is common - the so-called miliary TB. In HIV and other
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tests." Xpert ® MTB/RIF and Xpert MTB/RIF Ultra has high specificity in diagnosing extrapulmonary tuberculosis and is accurate in detecting rifampicin resistance. However, clinicians should rely on clinical judgement to diagnose TB meningitis when culture results are negative.
235:, biopsied tissue, etc.). A diagnosis made other than by culture may only be classified as "probable" or "presumed". For a diagnosis negating the possibility of tuberculosis infection, most protocols require that two separate cultures both test negative. 1067:) to detect the "scent" of tuberculosis. A recent study shows that "rats increased pediatric tuberculosis detection by 67.6%" and that training these creatures could help address the current challenges related to the diagnosis of this illness in children. 357:
are assays that applicable for all taxa and genes, but some assays have been designed for correct and specific detection of MTB such as Amplicor MTB, Cobas TaqMan MTB, E-MTD, FluoroType MTB, LPA (Genotype MTB/R), Anyplex MTB, Xpert MTB, and Genedrive MTB
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format to detect the whole blood production of interferon Îł. The distinction between the tests is that QuantiFERON-TB Gold quantifies the total amount of interferon Îł when whole blood is exposed to the antigens(ESAT-6, CFP-10 and TB 7.7(p4)), whereas
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There is disagreement on the use of the Mantoux test on people who have been immunized with BCG. The US recommendation is that in administering and interpreting the Mantoux test, previous BCG vaccination should be ignored; the UK recommendation is that
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is done to assess the patient's general health. It cannot be used to confirm or rule out TB. However, certain findings are suggestive of TB. For example, blood in the sputum, significant weight loss and drenching night sweats may be due to TB.
259:. In cases where there is no spontaneous sputum production, a sample can be induced, usually by inhalation of a nebulized saline or saline with bronchodilator solution. A comparative study found that inducing three sputum samples is more 1918:
Ewer K, Deeks J, Alvarez L, Bryant G, Waller S, Andersen P, et al. (April 2003). "Comparison of T-cell-based assay with tuberculin skin test for diagnosis of Mycobacterium tuberculosis infection in a school tuberculosis outbreak".
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Kang YA, Lee HW, Hwang SS, Um SW, Han SK, Shim YS, et al. (September 2007). "Usefulness of whole-blood interferon-gamma assay and interferon-gamma enzyme-linked immunospot assay in the diagnosis of active pulmonary tuberculosis".
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Guerra RL, Hooper NM, Baker JF, Alborz R, Armstrong DT, Maltas G, et al. (September 2007). "Use of the amplified mycobacterium tuberculosis direct test in a public health laboratory: test performance and impact on clinical care".
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Ferrara G, Losi M, D'Amico R, Roversi P, Piro R, Meacci M, et al. (April 2006). "Use in routine clinical practice of two commercial blood tests for diagnosis of infection with Mycobacterium tuberculosis: a prospective study".
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Lalvani A, Pathan AA, Durkan H, Wilkinson KA, Whelan A, Deeks JJ, et al. (June 2001). "Enhanced contact tracing and spatial tracking of Mycobacterium tuberculosis infection by enumeration of antigen-specific T cells".
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should be used to help interpret positive tuberculin tests, also, the UK does not recommend serial tuberculin skin testing in people who have had BCG (a key part of the US strategy). In their guidelines on the use of
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Tuberculosis should be suspected in adults when a pneumonia-like illness has persisted longer than three weeks, or when a respiratory illness in an otherwise healthy individual does not respond to regular antibiotics.
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An induration (palpable raised hardened area of skin) of more than 5–15 mm (depending upon the person's risk factors) to 10 Mantoux units is considered a positive result, indicating TB infection.
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Steingart KR, Henry M, Ng V, Hopewell PC, Ramsay A, Cunningham J, et al. (September 2006). "Fluorescence versus conventional sputum smear microscopy for tuberculosis: a systematic review".
118:. Systemic symptoms include low grade remittent fever, chills, night sweats, appetite loss, weight loss, easy fatiguability, and production of sputum that starts out mucoid but changes to 436: 2869:
Nakamura RM, Einck L, Velmonte MA, Kawajiri K, Ang CF, Delasllagas CE, et al. (2001-01-01). "Detection of active tuberculosis by an MPB-64 transdermal patch: a field study".
3122: 569:) was a small radiographic image, also called miniature mass radiography (MMR) or miniature chest radiograph. Though its resolution is limited (it doesn't allow the diagnosis of 1782:
Menzies D, Pai M, Comstock G (March 2007). "Meta-analysis: new tests for the diagnosis of latent tuberculosis infection: areas of uncertainty and recommendations for research".
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said in 2015, it began "revolutionizing tuberculosis (TB) control by contributing to the rapid diagnosis of TB disease and drug resistance. The test simultaneously detects
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The diagnosis is particularly challenging in children because they more commonly have extrapulmonary disease and present with less mycobacteria (paucibacillary disease).
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Pelletier-Galarneau M, Martineau P, Zuckier LS, Pham X, Lambert R, Turpin S (May 2017). "18F-FDG-PET/CT Imaging of Thoracic and Extrathoracic Tuberculosis in Children".
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According to a 2007 study from Korea, a high prevalence country of LTBI, QuantiFERON-TB Gold and T-SPOT.TB have good sensitivity but reduced specificity for diagnosing
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Diel R, Loddenkemper R, Nienhaus A (April 2010). "Evidence-based comparison of commercial interferon-gamma release assays for detecting active TB: a metaanalysis".
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bacteria in a clinical specimen taken from the patient. While other investigations may strongly suggest tuberculosis as the diagnosis, they cannot confirm it.
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Rossi SE, Franquet T, Volpacchio M, Giménez A, Aguilar G (1 May 2005). "Tree-in-bud pattern at thin-section CT of the lungs: radiologic-pathologic overview".
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of IGRAs concluded the tests noted excellent specificity for the tests to distinguish latent TB from prior vaccination. IGRAs are based on the ability of the
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The procedure went out of favor, as the incidence of tuberculosis dramatically decreased, but is still used in certain situations, such as the screening of
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As of 2003, the enzyme-linked immunospot assay (ELISPOT) has been another blood test available in the UK that may replace the skin test for diagnosis.
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The Mantoux skin test is used in the United States and is endorsed by the American Thoracic Society and Centers for Disease Control and Prevention (
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infection (LTBI) is considered for any BCG-vaccinated person whose skin test is 10 mm or greater, if any of these circumstances are present:
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99%. In Smear positive patients high sensitivity 99%, specificity 98%. In smear negative patients low sensitivity 62%, but high specificity 99%.
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Much less expensive than traditional X-Ray, MMR was quickly adopted and extensively utilized in some countries, in the 1950s. For example, in
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for TB involves intradermally injecting PPD (Purified Protein Derivative) tuberculin and measuring the size of induration 48-72 hours later.
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found that use of the MTD test reduced inappropriate tuberculosis therapy. The study found the accuracy of the MTD test as follows: Overall
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from other mycobacteria. Even if sputum smear is negative, tuberculosis must be considered and is only excluded after negative cultures.
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slightly lesser extent for TB meningitis. In both pleural TB and TB meningitis, ADA tests had higher sensitivity than any other tests."
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In patients incapable of producing a sputum sample, common alternative sample sources for diagnosing pulmonary tuberculosis include
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Pulmonary tuberculosis characterized by granulomatous inflammation with necrotizing epithelioid granulomas. Low power view.
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Residents and employees of high-risk congregate settings (e.g., prisons, nursing homes, hospitals, homeless shelters, etc.)
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looking for messenger RNA (mRNA) expression of 3 genes in response to TB. The Xpert MTB Host Response test calculated a
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A tuberculin test conversion is defined as an increase of 10 mm or more within a 2-year period, regardless of age.
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Guidelines for Using the QuantiFERON-TB Gold Test for Detecting Mycobacterium tuberculosis Infection, United States
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University of Washington Molecular Diagnosis, Microbiology Division | PCR-based detection in direct tissue samples
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LAM assay. Compared with the Alere Determine TB LAM Ag assay, the Fujifilm SILVAMP TB LAM assay includes novel
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approach is as sensitive in theory and should also be more specific, because of the use of interferon-Îł tests.
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may appear on the chest CTs of some patients affected by tuberculosis, but it is not specific to tuberculosis.
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Gupta-Wright A, Corbett EL, van Oosterhout JJ, Wilson D, Grint D, Alufandika-Moyo M, et al. (July 2018).
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Medical Examination of Aliens (Refugees and Immigrants) - Division of Global Migration and Quarantine, CDC (
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should be done for acid-fast bacilli if the patient is producing sputum. The preferred method for this is
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Sigal GB, Pinter A, Lowary TL, Kawasaki M, Li A, Mathew A, et al. (December 2018). Miller MB (ed.).
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Children less than 4 years of age, or children and adolescents exposed to adults in high-risk categories
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Drobniewski FA, Caws M, Gibson A, Young D (March 2003). "Modern laboratory diagnosis of tuberculosis".
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Burke and Parnell. Minimal Pulmonary Tuberculosis. 1948. 59:348 Canadian Medical Association Journal.
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Sutherland JS, van der Spuy G, Gindeh A, Thuong NT, Namuganga A, Owolabi O, et al. (2021-09-22).
2736:"Diagnostic accuracy of three urine lipoarabinomannan tuberculosis assays in HIV-negative outpatients" 3639: 3579: 3256: 3229: 2413:"Lateral flow urine lipoarabinomannan assay for detecting active tuberculosis in HIV-positive adults" 1395:
Mousavi-Sagharchi SM, Afrazeh E, Seyyedian-Nikjeh SF, Meskini M, Doroud D, Siadat SD (21 June 2024).
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and microbiological examination (of sputum or some other appropriate sample). It may also include a
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Broger T, Sossen B, du Toit E, Kerkhoff AD, Schutz C, Ivanova Reipold E, et al. (August 2019).
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If a person has had a history of a positive tuberculin skin test, another skin test is not needed.
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Ruhwald M, Aggerbeck H, Gallardo RV, Hoff ST, Villate JI, Borregaard B, et al. (April 2017).
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In active pulmonary TB, infiltrates or consolidations and/or cavities are often seen in the upper
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Kohli M, Schiller I, Dendukuri N, Yao M, Dheda K, Denkinger CM, et al. (January 15, 2021).
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Chakravorty S, Simmons AM, Rowneki M, Parmar H, Cao Y, Ryan J, et al. (August 29, 2017).
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persons, any abnormality may indicate TB or the chest X-ray may even appear entirely normal.
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collect and store, and lacks the infection control risks associated with sputum collection.
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Moore DA, Evans CA, Gilman RH, Caviedes L, Coronel J, Vivar A, et al. (October 2006).
1263:"A systematic review of rapid diagnostic tests for the detection of tuberculosis infection" 994: 680:
The equivalent Mantoux test positive levels done with 10 TU (0.1 ml 100 TU/ml, 1:1000) are
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Many types of microbiological culture are available. Traditionally, cultures have used the
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Shah M, Hanrahan C, Wang ZY, Dendukuri N, Lawn SD, Denkinger CM, et al. (May 2016).
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is an important screening strategy to identify new arrivals who have a high risk for TB.
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Jarvis J, Gao Y, de Graaf H, Hughes S, Allan RN, Williams A, et al. (August 2015).
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Broger T, Nicol MP, SzĂ©kely R, Bjerrum S, Sossen B, Schutz C, et al. (May 2020).
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Edwards A, Gao Y, Allan RN, Ball D, de Graaf H, Coelho T, et al. (October 2017).
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Dinnes J, Deeks J, Kunst H, Gibson A, Cummins E, Waugh N, et al. (January 2007).
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In 2022, a study reported the use of a fingerstick blood point-of-care triage test by
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can add 3 more weeks." The Xpert MTB/RIF Ultra improves upon the Xpert MTB/RIF test.
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Broger T, Nicol M, Sigal G, Gotuzzo E, Zimmer AJ, Surtie S, et al. (July 2020).
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was used in the United Kingdom until 2005, and is graded on a four-point scale. The
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from the patient's blood are incubated with the antigens. These tests are called
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Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; & Mitchell, Richard N. (2007).
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and are not equivalent. If the patient has been exposed to tuberculosis before,
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completed the development and a first clinical study of the Fujifilm SILVAMP TB
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Cavitation or consolidation of the apexes of the upper lobes of the lung or the
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Persons with nodular or fibrotic changes on CXR consistent with old healed TB
3624: 3043: 2786:"FujiLAM Prospective Evaluation Trial - Full Text View - ClinicalTrials.gov" 3811: 3801: 3786: 3634: 3467: 3457: 3413: 3391: 3209: 3167: 3078: 3062: 3017: 2964: 2939:"Pediatric tuberculosis detection using trained African giant pouched rats" 2890: 2852: 2771: 2720: 2669: 2617: 2539: 2482: 2446: 2374: 2333: 2276: 2232: 2193: 2134: 2095: 2060: 1984: 1940: 1904: 1847: 1803: 1756: 1718: 1677: 1626: 1593:"Microscopic-observation drug-susceptibility assay for the diagnosis of TB" 1577: 1539: 1440: 1381: 1345: 1288: 1240: 1199: 1156: 674: 641: 623: 443: 427: 411: 330: 296: 280: 91: 78: 33: 3085:
Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection
2826: 2087: 2052: 1658: 1513: 1456: 1373: 887:, counts the number of activated T lymphocytes that secrete interferon Îł. 573:, for example) it is sufficiently accurate for diagnosis of tuberculosis. 442:
Pulmonary tuberculosis featuring necrotizing granulomas, high power view,
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Phipps Institute for the Study, Treatment and Prevention of Tuberculosis
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Brown M, Varia H, Bassett P, Davidson RN, Wall R, Pasvol G (June 2007).
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The medical history includes obtaining the symptoms of pulmonary TB:
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The transdermal patch is an experimental method" of detecting active
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Persons with clinical conditions that place them at high risk (e.g.,
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test, another NAAT for TB, became commercially available and, as the
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A definitive diagnosis of tuberculosis can only be made by culturing
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Oxford Immunotec Medical Diagnostics|TB Education and Learning Zone
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Patients with organ transplants and other immunosuppressed patients
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Kik SV, Denkinger CM, Casenghi M, Vadnais C, Pai M (August 2014).
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Is continually exposed to populations where TB prevalence is high.
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Recent arrivals (less than 5 years) from high-prevalent countries
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Other mycobacteria are also acid-fast. If the smear is positive,
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2 genes to differentiate between active TB and other diseases.
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European and Developing Countries Clinical Trials Partnership
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organisms from a specimen taken from the patient (most often
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has an additional TB classification (Class A, B1, or B2) for
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Mycobacterium Tuberculosis Structural Genomics Consortium
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International Union Against Tuberculosis and Lung Disease
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Under the US recommendations, diagnosis and treatment of
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may be visible on an affected patient's chest X-ray. The
479: 426:
Pulmonary tuberculosis featuring necrotizing granulomas,
3027:"Tuberculosis diagnostics: Challenges and opportunities" 2914:"With a little convincing, rats can detect tuberculosis" 2459: 2073: 1590: 1177: 3696:
The Global Fund to Fight AIDS, Tuberculosis and Malaria
2733: 2206: 1358: 907:
In 2014, tests based on the detection of mycobacterial
851:
use these antigens to detect people with tuberculosis.
808:
Was born or has resided in a high TB prevalence country
3114: 2936: 1917: 1260: 928:
walk unaided). This recommendation was informed by a
805:
Was in contact with another person with infectious TB
614:
Two tests are available: the Mantoux and Heaf tests.
2937:
Mgode GF, Cox CL, Mwimanzi S, Mulder C (July 2018).
2245: 1639: 1781: 1047:In 2018, the international nonprofit organization 985:Transcriptomic host response, polygenic risk score 398:culture may be a faster and more accurate method. 3377:Microscopic Observation Drug Susceptibility assay 1452: 1450: 396:Microscopic Observation Drug Susceptibility assay 3854: 2147: 1692: 1690: 690:Greater than 15 mm induration (Heaf 3 to 5) 487:like this one in the patient's right upper lobe. 1551: 1549: 970:Global Health Innovative Technology Fund (GHIT) 510:and peritoneal surfaces are thickened (arrows). 72:diagnosed by finding Mycobacterium tuberculosis 2037: 1633: 1447: 1256: 1254: 1252: 1250: 818: 3666:Center for Global Infectious Disease Research 3152: 2297: 1687: 1120: 255:), which is more sensitive than conventional 2594:(12): e01338–18, /jcm/56/12/e01338–18.atom. 2031: 1955: 1911: 1862: 1775: 1584: 1546: 2871:Scandinavian Journal of Infectious Diseases 2417:The Cochrane Database of Systematic Reviews 1818: 1352: 1308:The Cochrane Database of Systematic Reviews 1247: 1206: 547:identification of potential biopsy target. 102:, other scans and X-rays, surgical biopsy. 3661:Campaign for Access to Essential Medicines 3159: 3145: 2298:Gaur RL, Pai M, Banaei N (November 2013). 1640:Akce M, Bonner S, Liu E, Daniel R (2014). 1458:Centers for Disease Control and Prevention 1095:(8th ed.). Saunders Elsevier. pp. 516-522 182: 171: 162:Centers for Disease Control and Prevention 47: 3052: 3042: 3007: 2954: 2842: 2761: 2751: 2710: 2700: 2659: 2607: 2529: 2436: 2364: 2323: 2266: 2183: 2173: 1894: 1667: 1657: 1616: 1529: 1430: 1412: 1335: 1278: 1230: 1138: 1087: 1085: 1083: 1081: 1079: 946:Foundation for Innovative New Diagnostics 766:Persons with no known risk factors for TB 695:CDC classification of tuberculin reaction 483:Tuberculosis creates cavities visible in 150:U.S. Citizenship and Immigration Services 903:Lipoarabinomannan (LAM) detection assays 635: 627: 490: 478: 3532:Extensively drug-resistant tuberculosis 2981: 1868: 1796:10.7326/0003-4819-146-5-200703060-00006 603: 458:Acid fast bacilli, Ziehl–Neelsen stain. 303:Nucleic acid amplification tests (NAAT) 266: 132: 14: 3855: 3706:International Congress on Tuberculosis 1121:Togun TO, Kampmann B (February 2024). 1076: 1012: 779:Tuberculin skin test after BCG vaccine 598: 3140: 2864: 2862: 2740:The Journal of Clinical Investigation 2629: 2627: 2148:Gaur RL, Suhosk MM, Banaei N (2012). 1042: 474: 3024: 1029: 815:These have been reviewed in detail. 684:0–4 mm induration (Heaf 0 to 1) 617: 565:(from the name of its inventor, Dr. 327:transcription-mediated amplification 311:or gene probe tests can distinguish 32:For an overview of the disease, see 3537:Totally drug-resistant tuberculosis 2911: 1597:The New England Journal of Medicine 27:Methods for diagnosing tuberculosis 24: 2974: 2859: 2624: 1114: 997:based on the expression levels of 911:(LAM) antigen in urine emerged as 763:15 mm or more is positive in 720:10 mm or more is positive in 371:Mycobacterium tuberculosis complex 188:Distinctive clusters of colorless 105: 90:A complete medical evaluation for 25: 3879: 3103: 1053:Sokoine University of Agriculture 755:syndromes, low body weight, etc.) 703:5 mm or more is positive in 3701:Global Plan to Stop Tuberculosis 3527:Multidrug-resistant tuberculosis 3270: 3166: 2588:Journal of Clinical Microbiology 2353:The European Respiratory Journal 2304:Journal of Clinical Microbiology 2115:The Lancet. Respiratory Medicine 1749:10.1053/j.semnuclmed.2016.12.003 1017:In 2007, a systematic review of 687:5–14 mm induration (Heaf 2) 451: 435: 419: 403: 319:Nucleic acid amplification tests 2930: 2905: 2802: 2778: 2727: 2676: 2640:The Lancet. Infectious Diseases 2575: 2546: 2497: 2453: 2404: 2381: 2340: 2291: 2239: 2200: 2141: 2102: 2067: 2017: 1999: 1763: 1558:The Lancet. Infectious Diseases 1489: 1180:The Lancet. Infectious Diseases 3360:Interferon gamma release assay 3262:Post-tuberculosis lung disease 2461:randomised controlled trial". 2429:10.1002/14651858.cd011420.pub2 1388: 1320:10.1002/14651858.CD012768.pub3 1295: 1171: 1127:The Lancet Infectious Diseases 1105: 732:Mycobacteriology lab personnel 561:A variant of the chest X-Ray, 550: 463: 13: 1: 3868:Respiratory system procedures 3827:Tuberculosis in human culture 3671:Cure Cottages of Saranac Lake 3656:Adirondack Cottage Sanitarium 2652:10.1016/S1473-3099(19)30001-5 2522:10.1016/s0140-6736(18)31267-4 2475:10.1016/s0140-6736(15)01092-2 2268:10.1136/thoraxjnl-2016-209397 2127:10.1016/S2213-2600(16)30436-2 1977:10.1016/S0140-6736(00)05115-1 1933:10.1016/S0140-6736(03)12950-9 1840:10.1016/S0140-6736(06)68579-6 1570:10.1016/S1473-3099(03)00544-9 1192:10.1016/S1473-3099(06)70578-3 1140:10.1016/s1473-3099(23)00517-0 1070: 632:Injecting a Mantoux skin test 541: 263:than three gastric washings. 2815:Clinical Infectious Diseases 2702:10.1371/journal.pmed.1003113 2175:10.1371/journal.pone.0048027 1737:Seminars in Nuclear Medicine 1267:Health Technology Assessment 1219:Clinical Infectious Diseases 1003:dual-specificity phosphatase 658: 231:, but may also include pus, 7: 3817:Tuberculosis classification 3200:Extrapulmonary tuberculosis 2982:Lalvani A (November 2003). 2007:"The Science behind T-SPOT. 1869:Lalvani A (November 2003). 1784:Annals of Internal Medicine 869:QuantiFERON-TB Gold In-Tube 845:QuantiFERON-TB Gold In-Tube 819:Interferon-Îł release assays 504:extrapulmonary tuberculosis 253:auramine-rhodamine staining 146:Tuberculosis classification 10: 3884: 3792:List of tuberculosis cases 3311:Mycobacterium tuberculosis 2225:10.1016/j.jinf.2015.04.004 1414:10.1186/s13568-024-01730-3 1061:African giant pouched rats 940:In 2019, an international 834:Mycobacterium tuberculosis 709:Recent contacts of TB case 662: 621: 607: 554: 467: 385: 224:Mycobacterium tuberculosis 191:Mycobacterium tuberculosis 84:Mycobacterium tuberculosis 31: 3754: 3681:Glen Lake Children's Camp 3648: 3640:Edward Livingston Trudeau 3580:Friedrich Franz Friedmann 3545: 3519: 3481: 3407: 3320: 3279: 3268: 3257:Giant multinucleated cell 3230:Tuberculous lymphadenitis 3174: 2883:10.1080/00365540152029846 2366:10.1183/09031936.00027714 999:guanylate-binding protein 925:World Health Organization 374:(MTBC) and resistance to 323:polymerase chain reaction 238: 209: 199: 181: 68: 46: 41: 3762:Tuberculosis elimination 3341:Löwenstein–Jensen medium 3071: 3000:10.1136/thorax.58.11.916 2213:The Journal of Infection 1887:10.1136/thorax.58.11.916 1646:Case Reports in Medicine 502:tuberculosis, a form of 81:is diagnosed by finding 3767:2007 tuberculosis scare 3547:History of tuberculosis 3350:Chest photofluorography 3290:Mycobacterium africanum 3044:10.4103/0970-2113.99112 1093:Robbins Basic Pathology 954:University of Cape Town 915:for tuberculosis (TB). 749:end-stage renal disease 249:fluorescence microscopy 172:Microbiological studies 3842:World Tuberculosis Day 3832:Tuberculosis radiology 3726:National Jewish Health 3322:Tuberculosis diagnosis 3235:Tuberculous meningitis 3184:Pulmonary tuberculosis 932:systematic review and 840:tuberculin skin test. 824:States.For diagnosing 645: 633: 511: 488: 470:Tuberculosis radiology 289:fine needle aspiration 257:Ziehl–Neelsen staining 166:B notification program 42:Tuberculosis diagnosis 18:Tuberculosis diagnosis 3822:Tuberculosis in China 3716:Millennium Foundation 3428:4-Aminosalicylic acid 3335:Auramine phenol stain 3281:Mycobacterium species 3177:associated conditions 3133:) for detection of TB 2912:Law YH (2018-05-16). 2088:10.1378/chest.09-2350 2053:10.1378/chest.06-2805 2025:"How T-SPOT.TB Works" 1514:10.1128/mBio.00812-17 1374:10.1378/chest.06-2959 978:monoclonal antibodies 962:University of Alberta 944:consortium including 663:Further information: 639: 631: 622:Further information: 608:Further information: 555:Further information: 494: 482: 380:drug resistance tests 194:form in this culture. 3772:Baumgarten-Tangl law 3686:Glen Lake Sanatorium 3304:Mycobacterium caprae 3240:Miliary tuberculosis 3215:Canga's bead symptom 3175:Symptoms, signs and 3131:Ocimum Bio Solutions 3025:Nema V (July 2012). 2600:10.1128/JCM.01338-18 2316:10.1128/JCM.01627-13 1711:10.1148/rg.253045115 1609:10.1056/NEJMoa055524 995:polygenic risk score 867:Îł in response. The 726:Injection drug users 610:Tuberculin skin test 604:Tuberculin skin test 567:Manuel Dias de Abreu 341:A 2007 before-after 267:Alternative sampling 164:(CDC). The (Class) 139:physical examination 133:Physical examination 100:tuberculin skin test 3736:Stop TB Partnership 3691:Glenn Dale Hospital 3330:Ziehl–Neelsen stain 3297:Mycobacterium bovis 3247:Latent tuberculosis 3120:Spoligo typing kits 2827:10.1093/cid/ciab839 2166:2012PLoSO...748027G 1659:10.1155/2014/436568 1065:Cricetomys ansorgei 1019:adenosine deaminase 1013:Adenosine deaminase 1007:KrĂĽppel-like factor 913:point-of-care tests 799:latent tuberculosis 706:HIV-positive person 599:Immunological tests 343:observational study 325:(PCR) technique or 178: 3590:Philip D'Arcy Hart 3125:2012-01-09 at the 2956:10.1038/pr.2018.40 2943:Pediatric Research 2790:clinicaltrials.gov 2516:(10144): 292–301. 2469:(10024): 1187–97. 1043:Using trained rats 958:Rutgers University 857:interferon Îł tests 830:systematic reviews 786:interferon-Îł tests 646: 634: 512: 489: 475:Chest X-ray and CT 243:Sputum smears and 176: 3850: 3849: 3355:GeneXpert MTB/RIF 2821:(12): 2136–2141. 2753:10.1172/JCI140461 2746:(11): 5756–5764. 1971:(9273): 2017–21. 1927:(9364): 1168–73. 1834:(9519): 1328–34. 1101:978-1-4160-2973-1 1051:was working with 1030:Transdermal Patch 991:Cepheid (company) 909:lipoarabinomannan 618:Mantoux skin test 392:Löwenstein-Jensen 219: 218: 160:developed by the 76: 75: 16:(Redirected from 3875: 3620:Mario Raviglione 3274: 3220:Prosector's wart 3205:Caseous necrosis 3161: 3154: 3147: 3138: 3137: 3066: 3056: 3046: 3021: 3011: 2969: 2968: 2958: 2934: 2928: 2927: 2925: 2924: 2909: 2903: 2902: 2866: 2857: 2856: 2846: 2806: 2800: 2799: 2797: 2796: 2782: 2776: 2775: 2765: 2755: 2731: 2725: 2724: 2714: 2704: 2680: 2674: 2673: 2663: 2631: 2622: 2621: 2611: 2579: 2573: 2572: 2570: 2569: 2560:. Archived from 2550: 2544: 2543: 2533: 2501: 2495: 2494: 2457: 2451: 2450: 2440: 2408: 2402: 2401: 2399: 2398: 2393: 2385: 2379: 2378: 2368: 2344: 2338: 2337: 2327: 2295: 2289: 2288: 2270: 2252: 2243: 2237: 2236: 2204: 2198: 2197: 2187: 2177: 2145: 2139: 2138: 2106: 2100: 2099: 2071: 2065: 2064: 2035: 2029: 2028: 2021: 2015: 2014: 2003: 1997: 1996: 1959: 1953: 1952: 1915: 1909: 1908: 1898: 1866: 1860: 1859: 1822: 1816: 1815: 1779: 1773: 1767: 1761: 1760: 1732: 1723: 1722: 1694: 1685: 1681: 1671: 1661: 1637: 1631: 1630: 1620: 1588: 1582: 1581: 1553: 1544: 1543: 1533: 1493: 1487: 1486: 1484: 1483: 1477: 1471:, archived from 1466: 1454: 1445: 1444: 1434: 1416: 1392: 1386: 1385: 1356: 1350: 1349: 1339: 1299: 1293: 1292: 1282: 1280:10.3310/hta11030 1258: 1245: 1244: 1234: 1210: 1204: 1203: 1175: 1169: 1168: 1142: 1118: 1112: 1109: 1103: 1089: 843:The blood tests 791:QuantiFERON Gold 536:tree-in-bud sign 532:tree-in-bud sign 521:immunosuppressed 455: 439: 423: 407: 273:gastric washings 186: 179: 175: 51: 39: 38: 21: 3883: 3882: 3878: 3877: 3876: 3874: 3873: 3872: 3853: 3852: 3851: 3846: 3837:Tygerberg score 3750: 3644: 3610:Charles Mantoux 3600:George M. Heath 3570:Christopher Dye 3565:Albert Calmette 3560:Hermann Brehmer 3555:Manuel de Abreu 3541: 3515: 3477: 3411: 3403: 3316: 3275: 3266: 3176: 3170: 3165: 3127:Wayback Machine 3106: 3074: 3069: 2977: 2975:Further reading 2972: 2935: 2931: 2922: 2920: 2910: 2906: 2867: 2860: 2807: 2803: 2794: 2792: 2784: 2783: 2779: 2732: 2728: 2695:(5): e1003113. 2681: 2677: 2632: 2625: 2580: 2576: 2567: 2565: 2552: 2551: 2547: 2502: 2498: 2458: 2454: 2423:(5): CD011420. 2409: 2405: 2396: 2394: 2391: 2387: 2386: 2382: 2345: 2341: 2296: 2292: 2261:(10): 946–949. 2250: 2244: 2240: 2205: 2201: 2146: 2142: 2107: 2103: 2072: 2068: 2036: 2032: 2023: 2022: 2018: 2005: 2004: 2000: 1960: 1956: 1916: 1912: 1867: 1863: 1823: 1819: 1780: 1776: 1768: 1764: 1733: 1726: 1695: 1688: 1638: 1634: 1603:(15): 1539–50. 1589: 1585: 1554: 1547: 1494: 1490: 1481: 1479: 1475: 1464: 1455: 1448: 1393: 1389: 1357: 1353: 1314:(1): CD012768. 1300: 1296: 1259: 1248: 1225:(11): 1415–20. 1211: 1207: 1176: 1172: 1119: 1115: 1110: 1106: 1090: 1077: 1073: 1045: 1032: 1015: 987: 905: 821: 781: 697: 667: 661: 626: 620: 612: 606: 601: 559: 553: 544: 477: 472: 466: 459: 456: 447: 440: 431: 424: 415: 408: 388: 313:M. tuberculosis 305: 293:mediastinoscopy 269: 241: 195: 174: 135: 108: 106:Medical history 64: 54:M. tuberculosis 37: 28: 23: 22: 15: 12: 11: 5: 3881: 3871: 3870: 3865: 3848: 3847: 3845: 3844: 3839: 3834: 3829: 3824: 3819: 3814: 3809: 3804: 3799: 3794: 3789: 3784: 3779: 3774: 3769: 3764: 3758: 3756: 3752: 3751: 3749: 3748: 3743: 3738: 3733: 3728: 3723: 3718: 3713: 3708: 3703: 3698: 3693: 3688: 3683: 3678: 3673: 3668: 3663: 3658: 3652: 3650: 3646: 3645: 3643: 3642: 3637: 3632: 3627: 3622: 3617: 3615:Richard Morton 3612: 3607: 3602: 3597: 3592: 3587: 3582: 3577: 3575:Marcos Espinal 3572: 3567: 3562: 3557: 3551: 3549: 3543: 3542: 3540: 3539: 3534: 3529: 3523: 3521: 3517: 3516: 3514: 3513: 3512: 3511: 3506: 3501: 3493: 3487: 3485: 3479: 3478: 3476: 3475: 3470: 3465: 3460: 3455: 3450: 3445: 3440: 3435: 3430: 3425: 3419: 3417: 3405: 3404: 3402: 3401: 3400: 3399: 3394: 3389: 3379: 3374: 3373: 3372: 3367: 3357: 3352: 3347: 3337: 3332: 3326: 3324: 3318: 3317: 3315: 3314: 3307: 3300: 3293: 3285: 3283: 3277: 3276: 3269: 3267: 3265: 3264: 3259: 3254: 3249: 3244: 3243: 3242: 3237: 3232: 3227: 3225:Lupus vulgaris 3222: 3217: 3212: 3207: 3197: 3196: 3195: 3193:Ghon's complex 3180: 3178: 3172: 3171: 3164: 3163: 3156: 3149: 3141: 3135: 3134: 3117: 3112: 3105: 3104:External links 3102: 3101: 3100: 3087:2000 ATS/CDC ( 3082: 3073: 3070: 3068: 3067: 3022: 2978: 2976: 2973: 2971: 2970: 2929: 2904: 2858: 2801: 2777: 2726: 2675: 2646:(8): 852–861. 2623: 2574: 2545: 2496: 2452: 2403: 2380: 2339: 2310:(11): 3521–6. 2290: 2238: 2199: 2160:(10): e48027. 2140: 2121:(4): 259–268. 2101: 2066: 2030: 2016: 1998: 1954: 1910: 1861: 1817: 1774: 1762: 1743:(3): 304–318. 1724: 1705:(3): 789–801. 1686: 1632: 1583: 1545: 1488: 1446: 1387: 1351: 1294: 1246: 1232:10.1086/516782 1205: 1170: 1133:(2): 110–112. 1113: 1104: 1074: 1072: 1069: 1044: 1041: 1036:M.tuberculosis 1031: 1028: 1014: 1011: 986: 983: 904: 901: 820: 817: 813: 812: 809: 806: 780: 777: 773: 772: 771: 770: 767: 761: 760: 759: 756: 741:corticosteroid 733: 730: 727: 724: 718: 717: 716: 713: 710: 707: 696: 693: 692: 691: 688: 685: 660: 657: 619: 616: 605: 602: 600: 597: 552: 549: 543: 540: 476: 473: 468:Main article: 465: 462: 461: 460: 457: 450: 448: 441: 434: 432: 425: 418: 416: 409: 402: 387: 384: 304: 301: 268: 265: 240: 237: 217: 216: 213: 207: 206: 203: 197: 196: 187: 173: 170: 134: 131: 107: 104: 74: 73: 70: 66: 65: 52: 44: 43: 26: 9: 6: 4: 3: 2: 3880: 3869: 3866: 3864: 3861: 3860: 3858: 3843: 3840: 3838: 3835: 3833: 3830: 3828: 3825: 3823: 3820: 3818: 3815: 3813: 3810: 3808: 3805: 3803: 3800: 3798: 3795: 3793: 3790: 3788: 3785: 3783: 3780: 3778: 3775: 3773: 3770: 3768: 3765: 3763: 3760: 3759: 3757: 3753: 3747: 3744: 3742: 3739: 3737: 3734: 3732: 3729: 3727: 3724: 3722: 3719: 3717: 3714: 3712: 3709: 3707: 3704: 3702: 3699: 3697: 3694: 3692: 3689: 3687: 3684: 3682: 3679: 3677: 3674: 3672: 3669: 3667: 3664: 3662: 3659: 3657: 3654: 3653: 3651: 3649:Organizations 3647: 3641: 3638: 3636: 3633: 3631: 3628: 3626: 3623: 3621: 3618: 3616: 3613: 3611: 3608: 3606: 3603: 3601: 3598: 3596: 3595:F. R. G. Heaf 3593: 3591: 3588: 3586: 3583: 3581: 3578: 3576: 3573: 3571: 3568: 3566: 3563: 3561: 3558: 3556: 3553: 3552: 3550: 3548: 3544: 3538: 3535: 3533: 3530: 3528: 3525: 3524: 3522: 3518: 3510: 3507: 3505: 3502: 3500: 3497: 3496: 3495:Experimental 3494: 3492: 3489: 3488: 3486: 3484: 3480: 3474: 3471: 3469: 3466: 3464: 3461: 3459: 3456: 3454: 3453:Thioacetazone 3451: 3449: 3446: 3444: 3441: 3439: 3436: 3434: 3431: 3429: 3426: 3424: 3421: 3420: 3418: 3415: 3410: 3406: 3398: 3395: 3393: 3390: 3388: 3385: 3384: 3383: 3380: 3378: 3375: 3371: 3368: 3366: 3363: 3362: 3361: 3358: 3356: 3353: 3351: 3348: 3346: 3342: 3338: 3336: 3333: 3331: 3328: 3327: 3325: 3323: 3319: 3313: 3312: 3308: 3306: 3305: 3301: 3299: 3298: 3294: 3292: 3291: 3287: 3286: 3284: 3282: 3278: 3273: 3263: 3260: 3258: 3255: 3253: 3250: 3248: 3245: 3241: 3238: 3236: 3233: 3231: 3228: 3226: 3223: 3221: 3218: 3216: 3213: 3211: 3208: 3206: 3203: 3202: 3201: 3198: 3194: 3190: 3187: 3186: 3185: 3182: 3181: 3179: 3173: 3169: 3162: 3157: 3155: 3150: 3148: 3143: 3142: 3139: 3132: 3128: 3124: 3121: 3118: 3116: 3113: 3111: 3108: 3107: 3098: 3094: 3090: 3086: 3083: 3080: 3076: 3075: 3064: 3060: 3055: 3050: 3045: 3040: 3037:(3): 259–66. 3036: 3032: 3028: 3023: 3019: 3015: 3010: 3005: 3001: 2997: 2994:(11): 916–8. 2993: 2989: 2985: 2980: 2979: 2966: 2962: 2957: 2952: 2949:(1): 99–103. 2948: 2944: 2940: 2933: 2919: 2915: 2908: 2900: 2896: 2892: 2888: 2884: 2880: 2876: 2872: 2865: 2863: 2854: 2850: 2845: 2840: 2836: 2832: 2828: 2824: 2820: 2816: 2812: 2805: 2791: 2787: 2781: 2773: 2769: 2764: 2759: 2754: 2749: 2745: 2741: 2737: 2730: 2722: 2718: 2713: 2708: 2703: 2698: 2694: 2690: 2689:PLOS Medicine 2686: 2679: 2671: 2667: 2662: 2657: 2653: 2649: 2645: 2641: 2637: 2630: 2628: 2619: 2615: 2610: 2605: 2601: 2597: 2593: 2589: 2585: 2578: 2564:on 2022-10-05 2563: 2559: 2555: 2549: 2541: 2537: 2532: 2527: 2523: 2519: 2515: 2511: 2507: 2500: 2492: 2488: 2484: 2480: 2476: 2472: 2468: 2464: 2456: 2448: 2444: 2439: 2434: 2430: 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Index

Tuberculosis diagnosis
Tuberculosis

stained red
sputum
Tuberculosis
Mycobacterium tuberculosis
tuberculosis
chest X-ray
tuberculin skin test
productive
hemoptysis
purulent
physical examination
Tuberculosis classification
U.S. Citizenship and Immigration Services
immigrants
refugees
Centers for Disease Control and Prevention

Mycobacterium tuberculosis
Gram
Shape
Mycobacterium tuberculosis
sputum
CSF
cultures
fluorescence microscopy
auramine-rhodamine staining
Ziehl–Neelsen staining

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