History & exam
Key factors
- presence of risk factors
- enlarged lymph node
- pleuritic chest pain
- skeletal pain
- headache
- urinary symptoms
- abdominal swelling
- abdominal pain
Other diagnostic factors
- cough
- altered mental status
- neurological symptoms
- hepatomegaly
- abnormal chest examination
- fever
- weight loss of more than 10% body weight
- anorexia
- malaise
- night sweats
- dyspnoea
- asymptomatic
- erythema nodosum
History & exam details
Diagnostic tests
1st tests to order
- chest x-ray
- sputum smear
- sputum culture
- tuberculin skin testing (TST)
- FBC
- lymph node fine-needle aspiration (FNA)
- pleural fluid analysis
- ascitic fluid analysis
- bone films
- CSF analysis
- urinalysis
Tests to consider
- lymph node biopsy
- pleural biopsy
- synovial biopsy
- liver biopsy
- bone marrow biopsy
- nucleic acid amplification test (NAAT)
- blood culture
- peritoneal biopsy
- gastric aspirate
- bronchoscopy
- thoracoscopy
- susceptibility testing
- interferon-gamma release assays (IGRA)
- genotyping
- HIV test
- empiric treatment
- CT scan chest or abdomen
- colonoscopy
Diagnostic tests details
Treatment details
Presumptive
no comorbidity non-pregnant: induction therapy
- antituberculous therapy
- additional antibiotics for suspected resistance
- pyridoxine
- corticosteroids
with comorbidity non-pregnant: induction therapy
-
HIV-positive on antiretrovirals (ARVs)
- antituberculous therapy
- additional antibiotics for suspected resistance
- pyridoxine
- corticosteroids
-
haemodialysis or creatinine clearance <30 mL/minute
- antituberculous therapy
- additional antibiotics for suspected resistance
- pyridoxine
- corticosteroids
-
with/at risk of hepatic injury
- liver-sparing antituberculous therapy
- corticosteroids
-
acute gout
- antituberculous therapy
- additional antibiotics for suspected resistance
- pyridoxine
- corticosteroids
pregnant: induction therapy
- antituberculous therapy
- additional antibiotics for suspected resistance
- pyridoxine
- corticosteroids
Ongoing
no comorbidity non-pregnant: continuation therapy
- antituberculous therapy
- pyridoxine
with comorbidity non-pregnant: continuation therapy
-
HIV-positive on antiretrovirals (ARVs)
- antituberculous therapy
- pyridoxine
-
haemodialysis or creatinine clearance <30 mL/minute
- antituberculous therapy
- pyridoxine
-
with/at risk of hepatic injury
- antituberculous therapy
- pyridoxine
-
acute gout
- antituberculous therapy
- pyridoxine
pregnant: continuation therapy
- antituberculous therapy
- pyridoxine
Treatment details
Last updated: Nov 20, 2012
