Tuberculosis (TB) Questions & Answers

Updated: Aug 15, 2019
  • Author: Thomas E Herchline, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Questions & Answers

Overview

What is tuberculosis (TB) (consumption)?

What are the signs and symptoms of pulmonary tuberculosis (TB) (consumption)?

What are the symptoms of tuberculous (TB) meningitis?

What are the symptoms of skeletal tuberculosis (TB)?

What are the symptoms of genitourinary tuberculosis (TB)?

What are the symptoms of gastrointestinal tuberculosis (TB)?

What are the physical findings of pulmonary tuberculosis (TB) (consumption)?

What are the signs and symptoms of extrapulmonary tuberculosis (TB)?

Does the absence of significant physical findings exclude active tuberculosis (TB) (consumption)?

Which tests are used to screen for tuberculosis (TB) (consumption)?

Which lab tests should be performed in suspected tuberculosis (TB)?

Which tests are performed to determine drug susceptibility following a positive culture for tuberculosis (TB) (consumption)?

Which radiography findings are diagnostic for tuberculosis (TB) (consumption)?

Which tests should be performed in the diagnosis of extrapulmonary tuberculosis (TB)?

Which infection prevention and control measures should be implemented for patients with active tuberculosis (TB) (consumption)?

What is the initial pharmacologic therapy for tuberculosis (TB) (consumption)?

How is tuberculosis (TB) treated in pregnant women?

How is tuberculosis (TB) treated in children?

How is tuberculosis (TB) treated in patients with HIV infection and AIDS?

What are the treatment options for multidrug-resistant tuberculosis (MDR-TB)?

Which surgical interventions are indicated for multidrug-resistant tuberculosis (MDR-TB)?

What are the CDC treatment recommendations for latent tuberculosis infection (LTBI)?

What is the global burden of tuberculosis (TB) (consumption)?

Which comorbidity has contributed to the emergence and spread of drug-resistant tuberculosis (TB)?

Which infectious agent causes tuberculosis (TB) (consumption)?

What is the most common site for the development of tuberculosis (TB)?

What is the primary screening test for tuberculosis (TB) infection?

What is the usual treatment regimen for tuberculosis (TB) (consumption)?

What are the typical communicable-disease control laws for tuberculosis (TB)?

What is the early history of tuberculosis (TB) (consumption)?

What caused the historical increase in the global prevalence of tuberculosis (TB) (consumption)?

What caused a resurgence of tuberculosis (TB) in the 1980s in the US?

What is the prevalence of coinfection with tuberculosis (TB) and HIV infection/AIDS?

Where is tuberculosis (TB) most prevalent and what factors have contributed to its spread?

What is multidrug-resistant tuberculosis (MDR-TB)?

Which factors contribute to the high prevalence of multidrug-resistant tuberculosis (MDR-TB)?

What is the global proportion of multidrug-resistant tuberculosis (MDR-TB) cases?

What population group has the highest rate of resistant tuberculosis (MDR-TB) in the US?

What is the prevalence of extensively drug-resistant tuberculosis (XDR-TB) in the US?

What is the cure rate for multidrug-resistant tuberculosis (MDR-TB)?

Is directly observed therapy (DOT) effective in reducing the incidence of multidrug-resistant tuberculosis (MDR-TB)?

Is there a standard triage protocol for treatment of tuberculosis (TB) in the emergency department (ED)?

Which emergency department (ED) patients are at increased risk for active tuberculosis (TB)?

What is the incidence of extrapulmonary tuberculosis (EPTB)?

What is the prevalence of cutaneous tuberculosis (TB)?

Which physical findings suggest ocular tuberculosis (TB)?

What are the symptoms of ocular tuberculosis (TB)?

What is the incidence of ocular tuberculosis (TB)?

Where can patients find information on tuberculosis (TB)?

How does M tuberculosis infection occur?

What causes the antigenicity of mycobacteria in tuberculosis (TB)?

What is the pathogenesis of latent tuberculosis infection (LTBI)?

What is the most common site for the development of tuberculosis (TB)?

What are the most common sites of extrapulmonary tuberculosis (TB)?

What is the principal cause of tissue destruction due to M tuberculosis infection?

What is the pathogenesis of tuberculosis (TB)-related uveitis?

What is the pathogenesis of tuberculosis (TB) lesions?

What are the features of early tubercles in tuberculosis (TB)?

What is the disease course of tuberculosis (TB) lesions?

What inhibits the growth of tubercle bacillus in tuberculosis (TB)?

What is the disease course in hosts unable to arrest the initial infection of tuberculosis (TB)?

How do lesions initially develop in tuberculosis (TB)?

How do proliferative lesions develop in tuberculosis (TB)?

How do exudative lesions develop in tuberculosis (TB)?

What is the etiology of tuberculosis (TB)?

What are the characteristics of Mycobacterium tuberculosis (M tuberculosis)?

How is Mycobacterium tuberculosis transmitted?

How frequently does exposure to Mycobacterium tuberculosis result in active tuberculosis (TB)?

In the US, what percentage of tuberculosis (TB) is caused by reactivation of latent infection?

Does isoniazid-resistant tuberculosis (TB) have higher or lower transmissibility than fully-susceptible TB?

How does Mycobacterium tuberculosis spread to extrapulmonary sites?

Which groups are at increased risk for developing disseminated (primary miliary) tuberculosis (TB)?

Which factors determine the transmissibility of Mycobacterium tuberculosis infection?

Which settings increase the risk for transmission of Mycobacterium tuberculosis infection?

Which factors increase an individual's risk of acquiring active tuberculosis (TB)?

Which medications significantly increase the risk for tuberculosis (TB)?

Does immunosuppressive therapy increase the risk for tuberculosis (TB)?

What are the possible complications of tuberculosis (TB) in children younger than 5 years?

Do children with tuberculosis (TB) commonly infect other children?

Are there genetic factors related to tuberculosis (TB)?

What role does the NRAMP1 gene have in tuberculosis (TB)?

What role does the SP110 gene have in tuberculosis (TB)?

What role does the CISH gene have in tuberculosis (TB)?

What role does the IRGM gene have in tuberculosis (TB)?

What role does the IFNG gene have in tuberculosis (TB)?

What role does the IFNGR1 gene have in tuberculosis (TB)?

What role does the TIRAP gene have in tuberculosis (TB)?

What role does the CD209 gene have in tuberculosis (TB)?

What is the incidence of tuberculosis (TB) in the US?

Which groups have the highest incidence of tuberculosis (TB) in the US?

What is the racial predilection of tuberculosis (TB) in the US?

How many deaths occur annually from tuberculosis (TB) in the US?

What is the global prevalence of tuberculosis (TB)?

What trends have been identified by the WHO in the global disease burden of tuberculosis (TB)?

Which countries make up the majority of the global incidence of tuberculosis (TB)?

How does the incidence of tuberculosis (TB) vary among foreign-born and native-born minorities in the US?

Does the incidence of tuberculosis (TB) differ between men and women?

Does the incidence of tuberculosis (TB) vary among different age groups?

What is the prognosis of tuberculosis (TB) (consumption)?

What are the poor prognostic markers of tuberculosis (TB)?

Presentation

Which factors increase the risk of developing tuberculosis (TB) (consumption)?

What are classic features of active pulmonary tuberculosis (TB) (consumption)?

What is the presentation of tuberculosis (TB) (consumption) in elderly individuals?

What are the signs and symptoms of extrapulmonary tuberculosis (TB)?

What is the presentation of tuberculous (TB) meningitis?

What are the signs and symptoms of skeletal tuberculosis (TB)?

What are the signs and symptoms of genitourinary tuberculosis (TB)?

What are the signs and symptoms of GI tuberculosis (TB)?

Which physical findings suggest tuberculosis (TB) (consumption)?

Which physical findings suggest extrapulmonary tuberculosis (TB)?

Which physical findings suggest lymphadenopathy in tuberculosis (TB)?

Does the absence of any significant physical findings exclude active tuberculosis (TB)?

DDX

Which conditions should be included in the differential diagnosis of pulmonary tuberculosis (TB)?

Which conditions should be included in the differential diagnosis of extrapulmonary tuberculosis (TB)?

Which conditions should be included in the differential diagnosis of cutaneous tuberculosis (TB)?

What are the differential diagnoses for Tuberculosis (TB)?

Workup

Which tests are used to screen for tuberculosis (TB) infection?

Which lab tests are performed in suspected tuberculosis (TB)?

What is the role of acid-fast bacilli (AFB) staining in the diagnosis of tuberculosis (TB)?

When are imaging studies indicated in the diagnosis of tuberculosis (TB)?

What is the role of technetium-99m (99m Tc) methoxy isobutyl isonitrile SPECT scanning in the diagnosis of tuberculosis (TB)?

Is radiography useful in the diagnosis of multidrug-resistant tuberculosis (MDR-TB)?

Which tests are used to diagnose extrapulmonary tuberculosis (TB)?

Which factors make ocular tuberculosis (TB) especially difficult to diagnose?

What is the histopathology of extrapulmonary tuberculosis (TB)?

Which symptoms suggest tuberculous (TB) meningitis or tuberculoma, and what tests are performed to confirm diagnosis?

Which testing is needed when vertebral (Pott disease) or brain involvement is suspected in tuberculosis (TB)?

When are urinalysis and urine cultures indicated in the diagnosis of tuberculosis (TB)?

Which tests should be performed if tuberculosis (TB) is suspected during pregnancy?

Which diagnostic tests are indicated for suspected congenital tuberculosis (TB)?

How is postnatal tuberculosis (TB) in infants contracted?

Which chest radiographic findings may suggest tuberculosis (TB) in children?

When is HIV testing indicated in patients with tuberculosis (TB)?

Among HIV-positive patients, who is at increased risk for developing tuberculosis (TB)?

Which tuberculosis (TB) screening test should be performed prior to initiation of antiretroviral therapy (ART) in patients with HIV infection?

Which tests should be performed in patients with tuberculosis (TB) and HIV infection?

What are the increased health risks for patients with tuberculosis (TB) and HIV infection?

What is the role of a sputum smear in the diagnosis of tuberculosis (TB)?

How are sputum samples collected in patients with suspected tuberculosis (TB)?

What is the role of Ziehl-Neelsen staining in the diagnosis of tuberculosis (TB)?

How often are culture-positive specimens associated with a negative smear result for tuberculosis (TB)?

What can be used to differentiate tuberculosis (TB) with negative sputum smears from latent TB infection (LTBI)?

What is the role of nucleic acid amplification tests (NAAT) in the diagnosis of tuberculosis (TB)?

What are the CDC recommendations for use of nucleic acid amplifications in the diagnosis of pulmonary tuberculosis (TB)?

How accurate is nucleic acid amplification testing (NAAT) in diagnosing tuberculosis (TB)?

Which test is the most specific for tuberculosis (TB)?

What is the role of acid-fast bacilli (AFB) cultures in the diagnosis of tuberculosis (TB)?

Are broth cultures available for use in clinical labs for the diagnosis of tuberculosis (TB)?

What is the role of blood cultures in the diagnosis of tuberculosis (TB)?

When is drug susceptibility testing indicated in the diagnosis of tuberculosis (TB)?

What is the efficacy of DNA sequencing analysis for detecting drug-resistant tuberculosis (TB)?

What is the efficacy of automated molecular testing for the detection of tuberculosis (TB)?

What is the role of microscopic-observation drug susceptibility (MODS) and thin-layer agar (TLA) assays in the diagnosis of multidrug-resistant tuberculosis (MDR-TB)?

Which rapid drug susceptibility tests are used to diagnose multidrug-resistant tuberculosis (MDR-TB)?)?

What is the role of chest radiography in the diagnosis of tuberculosis (TB)?

When is chest radiography used to screen for sarcoidosis in patients with suspected tuberculosis (TB)?

Which chest radiography findings suggest tuberculosis (TB)?

In a symptomatic patient with normal chest radiographic findings, is tuberculosis (TB) excluded?

How do radiographic findings differentiate primary tuberculosis (TB) from reactivation TB?

Which chest radiographic findings suggest reactivation tuberculosis (TB)?

Which chest radiographic findings suggest tuberculosis (TB) with HIV infection?

Which chest radiographic findings suggest healed tuberculosis (TB)?

Which chest radiographic findings suggest miliary tuberculosis (TB)?

Which chest radiographic findings suggest pleural tuberculosis (TB)?

What is the primary screening test for tuberculosis (TB) infection?

How is the Mantoux tuberculin skin test with purified protein derivative (PPD) administered in patients with suspected tuberculosis (TB)?

What are the population-based criteria for purified protein derivative (PPD) positivity in tuberculosis (TB) testing?

What are the population-based criteria for purified protein derivative (PPD) positivity in tuberculosis (TB) testing for patients who have received the Bacillus Calmette–Guérin (BCG) vaccine?

What is the role of interferon-gamma release assay (IGRA) in the diagnosis of tuberculosis (TB)?

Are interferon-gamma release assays (IGRA) effective for the diagnosis of tuberculosis (TB)?

What are the advantages and disadvantages of interferon-gamma release assays (IGRA)?

What is the accuracy of tuberculin skin testing and interferon-gamma release assay (IGRA) for tuberculosis (TB) infection?

What are the highest positive and negative likelihood ratios for latent tuberculosis infection (LTBI)?

How accurate is skin testing in predicting the subsequent development of tuberculosis (TB)?

Which tests may be more reliable than skin testing for identifying patients who will progress to active tuberculosis (TB)?

Treatment

Which infection prevention and control measures should be implemented for patients with active tuberculosis (TB) (consumption)?

What is the initial empiric treatment of tuberculosis (TB)?

What baseline assessments are required for patients with tuberculosis (TB) who receive pyrazinamide or long-term ethambutol therapy?

How long should drug therapy for tuberculosis (TB) be continued?

When is directly observed therapy (DOT) indicated in the treatment of tuberculosis (TB)?

How should active tuberculosis (TB) be monitored?

What is the treatment for patients with tuberculosis (TB) who are actively seizing or who have overdosed on antimycobacterial medication?

How should pregnant women with active tuberculosis (TB) be treated?

When is preventive treatment for tuberculosis (TB) recommended in women who are pregnant?

What are the risks of isoniazid therapy in pregnant and postpartum women with tuberculosis (TB)?

Should women breastfeed during preventive therapy for tuberculosis (TB)?

Does tuberculosis during pregnancy increase the risk of preterm birth?

How is tuberculosis (TB) treated in children?

What is the duration of treatment for postnatal tuberculosis (TB)?

How is isoniazid administered in the treatment of tuberculosis (TB) in children?

How is rifampin administered in the treatment of tuberculosis (TB) in children?

What is the role of ethambutol in the treatment of tuberculosis (TB) in children?

How does the treatment regimen for tuberculosis (TB) differ in patients with HIV infection?

What is immune reconstitution inflammatory syndrome (IRIS) in patients receiving treatment for tuberculosis (TB) and HIV infection?

What are the benefits of early antiretroviral therapy (ART) in patients with HIV infection and tuberculosis (TB)?

What is the treatment length and recurrence rate of treatment for tuberculosis (TB) in patients with HIV infection?

Which medication reduces complications in the treatment of tuberculous meningitis?

When is treatment initiated when multidrug-resistant tuberculosis (MDR-TB) is suspected?

What are the benefits of combining isoniazid and rifampin in the treatment of multidrug-resistant tuberculosis (MDR-TB)?

Which drugs should be used when initiating multidrug-resistant tuberculosis (MDR-TB) treatment?

Which medications are used for the treatment of multidrug-resistant tuberculosis (MDR-TB)?

Which agent can be substituted for rifampin in multidrug-resistant tuberculosis (MDR-TB) treatment?

Which factors increase the likelihood of successful multidrug-resistant tuberculosis (MDR-TB) treatment?

How long should treatment be continued for multidrug-resistant tuberculosis (MDR-TB)?

Is bedaquiline (Sirturo) effective for the treatment of multidrug-resistant tuberculosis (MDR-TB)?

What are the CDC guidelines for the use of bedaquiline in the treatment of multidrug-resistant tuberculosis (MDR-TB)?

How is the diagnosis of extensively drug-resistant tuberculosis (XDR-TB) established?

According to the CDC, which groups have the highest risk for pyrazinamide-resistant tuberculosis (TB)?

When is surgical resection of an infected lung indicated in the treatment of multidrug-resistant tuberculosis (MDR-TB)?

What are the possible complications of surgical resection in multidrug-resistant tuberculosis (MDR-TB)?

Is rifapentine (Priftin) an effective treatment for latent tuberculosis infection (LTBI)?

What are the CDC guidelines for the treatment of latent tuberculosis infection (LTBI)?

How effective is self-administered therapy versus directly observed therapy in the treatment of latent tuberculosis infection (LTBI)?

How is isoniazid plus rifapentine administered in the treatment of latent tuberculosis infection (LTBI)?

When are longer isoniazid plus rifapentine regimens indicated in the treatment of latent tuberculosis infection (LTBI)?

When are isoniazid plus rifapentine regimens contraindicated in the treatment of latent tuberculosis infection (LTBI)?

How does combination isoniazid plus rifapentine therapy compare to isoniazid alone for treatment of latent tuberculosis infection (LTBI)?

Should children with latent tuberculosis infection (LTBI) receive isoniazid therapy?

When is treatment indicated for individuals exposed to multidrug-resistant tuberculosis (MDR-TB)?

What is the recommended treatment for patients with HIV infection and latent tuberculosis infection (LTBI)?

Does the Bacillus Calmette–Guérin (BCG) vaccine offer protection against tuberculosis (TB)?

Does isoniazid prophylaxis reduce the risk of tuberculosis (TB) in children?

Which specialist consultations are indicated in the treatment of tuberculosis (TB)?

What are the possible post-treatment complications of tuberculosis (TB)?

What is the relapse rate in patients who have completed therapy for tuberculosis (TB)?

What are the most common post-treatment complications of tuberculosis (TB)?

What are the adverse effects of antibiotic therapy in tuberculosis (TB)?

Medications

What are the basic therapeutic principles for the treatment of tuberculosis (TB)?

What is the initial treatment of new cases of tuberculosis (TB)?

What is the efficacy of shorter tuberculosis (TB) drug regimens compared to standard 6-month regimens?

Which medications in the drug class Antitubercular agents are used in the treatment of Tuberculosis (TB)?