Last reviewed: June 2020
Last updated: April  2020

Summary

Definition

History and exam

Key diagnostic factors

  • underlying lung disease
  • chronic productive cough
  • dyspnoea
  • weight loss
  • fatigue
  • fever
  • lymphadenopathy
  • immunocompromised
  • hot tub use

Other diagnostic factors

  • age under 5 years
  • middle-to-old age
  • night sweats
  • abdominal pain
  • diarrhoea
  • ronchi/crackles
  • hepatomegaly
  • splenomegaly
  • thin body habitus
  • pectus excavatum
  • scoliosis
  • systolic click and murmur

Risk factors

  • underlying lung diseases
  • smoking
  • excessive alcohol use
  • older men
  • post-menopausal women
  • hot tub use
  • HIV/AIDS
  • severe immunosuppression
  • genetic cytokine defects

Diagnostic investigations

1st investigations to order

  • FBC with differential
  • LFT
  • chest x-ray
  • sputum culture
  • blood culture
More 1st investigations to order

Investigations to consider

  • high-resolution CT (HRCT) scanning
  • bone marrow aspirate for culture
  • bronchoscopy/bronchial lavage
  • lung biopsy
  • lymph node biopsy
More investigations to consider

Emerging tests

  • polymerase chain reaction
More emerging tests

Treatment algorithm

Contributors

Zelalem Temesgen

Professor of Medicine

Executive Director

Mayo Clinic Center for Tuberculosis

Director

HIV Program

Director

Global HIV Education Initiative

Mayo Clinic

Rochester

MN

Disclosures

ZT declares that he has no competing interests.

Dr Temesgen would like to gratefully acknowledge Dr Dereje S. Ayo, a previous contributor to this topic.

Peer reviewersVIEW ALL

Assistant Professor

Division of Pulmonary, Allergy, Critical Care and Sleep Medicine

Ohio State University Medical Center

Columbus

OH

Disclosures

JPP declares that he has no competing interests.

Director

Infectious Diseases Unit

Annunziata Hospital

Cosenza

Italy

Disclosures

SV declares that he has no competing interests.

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