Clinical Highlights for TB

1- The diagnosis of infant tuberculosis (TB) is complicated by the lack of a clear response to a tuberculin skin test, the absence of a gold standard diagnostic test, and difficulty in collecting respiratory specimens.

2- In areas where TB is not endemic, the decision to treat is often a clinical judgment aided by the presence of at least 2 of the following criteria:

a) Known contact with an adult index case.

b) A positive tuberculin test result as evidence of latent TB.

c) Suggestive signs on chest radiographs.

3- Clinicians must maintain a high index of suspicion when evaluating patients with a neck mass or abscess and include TB in the differential diagnosis of such lesions. This is specially true in immigrants and in patients who are HIV-positive, among whom there is an increased incidence of TB.

4- In HIV-negative children younger than 12 years, mycobacterial cervical lymphadenopathy is usually caused by a nontuberculosis strain, whereas mycobaterial lymphadenitis in patients older than 12 years usually indicates TB.