Last reviewed: 16 Apr 2021
Last updated: 04 May 2021

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

Investigations to consider

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

Emerging tests

  • polymerase chain reaction

Treatment algorithm

Contributors

Zelalem Temesgen

Professor of Medicine

Director, Mayo Clinic Center for Tuberculosis – A World Health Organization – Collaborating Center in Digital Health and Precision Medicine

Director, HIV Program

Consultant, Division of Infectious Diseases

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.

Disclosures

DSA declares that he has no competing interests.

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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