Summary
Definition
History and exam
Other diagnostic factors
- night sweats
- pleuritic chest pain
- hemoptysis
- psychological symptoms
- abnormal chest auscultation
- asymptomatic
- dyspnea
- clubbing
- erythema nodosum
Risk factors
- exposure to infection
- birth in an endemic country
- HIV infection
- immunosuppressive medications
- malignancy
- silicosis
- ESRD
- apical fibrosis
- intravenous drug use
- malnutrition
- alcoholism
- diabetes
- high-risk congregate settings
- low socioeconomic status or black/Hispanic/Native-American ancestry
- age
- tobacco smoking
Diagnostic investigations
1st investigations to order
- CXR
- sputum acid-fast bacilli (AFB) smear
- sputum culture
- CBC
- nucleic acid amplification tests (NAAT)
Investigations to consider
- gastric aspirate
- bronchoscopy and bronchoalveolar lavage (BAL)
- tuberculin skin testing (TST)
- interferon-gamma release assays (IGRAs)
- empiric treatment
- susceptibility testing
- genotyping
- HIV test
- CT of chest
- Xpert MTB/RIF
Treatment algorithm
Contributors
Authors VIEW ALL
Associate Professor
Division of Pulmonary, Critical Care, and Sleep Medicine
Department of Medicine
University of Washington
Seattle
WA
Disclosures
DJH declares that he has no competing interests.
Professor of Medicine
Division of Pulmonary, Critical Care, and Sleep Medicine
Department of Medicine
University of Washington
Seattle
WA
Disclosures
MN declares that he has no competing interests.
Peer reviewers VIEW ALL
Professor
Division of Infectious Diseases
University of Colorado at Denver and Health Sciences Center
Denver
CO
Disclosures
WB declares that he has no competing interests.
Consultant Chest Physician
Llandough Hospital
Llandough
Penarth
South Wales
Disclosures
IC declares that he has no competing interests.
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