History & exam

Key factors

  • presence of risk factors
  • cough
  • fever
  • anorexia
  • weight loss
  • malaise

Other diagnostic factors

  • night sweats
  • pleuritic chest pain
  • haemoptysis
  • psychological symptoms
  • abnormal chest auscultation
  • asymptomatic
  • dyspnoea
  • clubbing
  • erythema nodosum

History & exam details

Diagnostic tests

1st tests to order

  • CXR
  • sputum acid-fast bacilli (AFB) smear
  • sputum culture
  • FBC
  • nucleic acid amplification tests (NAAT)

Tests to consider

  • gastric aspirate
  • bronchoscopy and bronchoalveolar lavage (BAL)
  • tuberculin skin testing (TST)
  • interferon-gamma release assays (IGRAs)
  • empirical treatment
  • susceptibility testing
  • genotyping
  • HIV test
  • CT of chest
  • Xpert MTB/RIF

Diagnostic tests details

Treatment details

Presumptive

latent TB: non-pregnant HIV-negative

  • anti-tuberculosis treatment for latent infection

latent TB: non-pregnant HIV-positive

  • anti-tuberculosis treatment for latent infection

latent TB: pregnant

  • anti-tuberculosis treatment for latent infection

Acute

active TB HIV-negative non-pregnant: no hepatic dysfunction

  • multidrug resistance not suspected
    • initial phase therapy
    • continuation phase therapy
  • multidrug resistance
    • speciality consultation

active TB HIV-positive non-pregnant: no hepatic dysfunction

  • multidrug resistance not suspected
    • initial phase therapy
    • continuation phase therapy
  • multidrug resistance
    • speciality consultation

active TB pregnant

  • speciality consultation

active TB non-pregnant: pre-existing or drug-induced hepatic dysfunction

  • speciality consultation

Ongoing

recurrent TB

  • speciality consultation

Treatment details

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