How Can Tuberculosis Be Diagnosed?

Tuberculosis 

Tuberculosis, or TB, is an infectious disease caused by the bacteria Mycobacterium tuberculosis. The bacteria spreads through the air from person to person and mainly attacks the lungs, but it can affect other areas of the body.


Diagnosis of tuberculosis can be a complex process. Doctors first consider a person`s medical history and possible exposure to a person with an active illness. After that, a series of screenings and tuberculosis tests may be needed to confirm tuberculosis and make treatment decisions.
 
Latent tuberculosis infections are asymptomatic and have a low number of bacteria, so they can only be detected by a few screening tests.
 
The first test used to detect tuberculosis is called the tuberculin skin test, also known as the Mantu test or PPD (purified protein derivative). A solution of M. tuberculosis is injected into the uppermost layer of skin on the forearm. Then return within 48 or 72 hours to inspect the injection site. If you have a red raised ridge that is larger than 5 to 15 millimeters, you may be infected with tuberculosis. 

But this test is not a perfect science. The results may be incorrect and will display false positives or false positives. (5.11)

Blood tests can provide more meaningful results. The interferon-gamma release assay (IGRA) test measures the body's immune response to the presence of M. tuberculosis. After taking a blood sample, a test is done in the laboratory. If the initial screening is positive, further tests are needed to diagnose active tuberculosis.

 A clinical test can determine the strain of M. tuberculosis that a person has and which antibiotic is most effective. Imaging provides more information about where the disease is and how it affects the body.
Diagnostic tests used for tuberculosis include: (5,11)

Diagnostic tests used for TB include: (5,11)
  • Sputum sample: Sputum is the mucus that comes out when you cough. Sputum samples can be tested directly for M. tuberculosis in the laboratory. 
  • Molecular tests: These help detect the genetic material of the bacterium and determine which antibiotic is most effective. 
  • Biopsy: A biopsy of a lung, lymph node, or other tissue can be cultured to grow bacteria and make them easier to see under a microscope. 

 Imaging tests used for tuberculosis include:

  • A chest x-ray may be done to look for signs of tuberculosis in the lungs. 
  • Computed Tomography (CT) Scans CT scans can be used to look for tuberculosis in the spine or to better see the lungs when x-rays are obscured. 
  • Magnetic Resonance Imaging (MRI) If a doctor thinks that a tuberculosis infection has spread to these areas, an MRI of the spine or brain may be done. 
  • Bone Scan scintigraphy These can be used to see the difference between cancerous lesions and lesions caused by tuberculosis.

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