BACKGROUND Environmental exposure is a likely risk factor for the development of pulmonary Mycobacterium avium complex (MAC) disease. The influence of environmental exposure on the response to antimicrobial treatment and relapse is unknown. METHODS We recruited 72 patients with pulmonary MAC disease (male [female], 18 [54]; age, 61.7 ± 10.3 years) who initiated and completed standard three-dr...

In the January 1991 issue of Chest, Baughman et al’ reported the utility of bronchoscopy with bronchoalveolar lavage (BAL) in the diagnosis of Mycobacterium tuberculosis infections, and they concluded that BAL is useful for this indication. However, the M tuberculosis infection was diagnosed with only BAL in one of 29 cases, when BAL and bronchial wash specimens were obtained together. In a pro...

Background. Tuberculosis (TB) disease diagnosis in Vietnam relies on symptom screening, chest radiography (CXR), and acid fast bacilli (AFB) sputum smear which have a poor sensitivity in HIV patients. We evaluated the performance of clinical algorithms in screening and diagnosing AFB smear-negative TB in HIV patients. Methods. We enrolled 399 HIV-positive patients seeking care at a HIV clinic i...

STUDY OBJECTIVE To assess the role of transbronchial needle aspiration (TBNA) in diagnosing intrathoracic tuberculous lymphadenitis (TB-LA). METHODS In a tertiary referral center for thoracic medicine and surgery, using a CT scan as a guide, transbronchial aspirates were obtained with a 19-gauge flexible histology needle in consecutively enrolled patients with sputum smears negative for acid-...

Early diagnosis of tuberculosis (TB) and prompt initiation of treatment are essential for an effective tuberculosis control programme. In many resource limited settings microscopic diagnosis is still the pivotal tool in the diagnosis of pulmonary TB. This study aimed at evaluating laboratory microscopic diagnosis of tuberculosis in a tertiary hospital in Mwanza, Tanzania. This retrospective hos...

BACKGROUND Sputum microscopy is the only diagnostic for tuberculosis (TB) available at peripheral levels of health service in resource-poor countries. Its sensitivity is reduced in high HIV-prevalence settings. Sodium hypochlorite (NaOCl) specimen sedimentation prior microscopy and light-emitting diode (LED)-fluorescence microscopy (FM) can individually improve performance of microscopy. This s...

PROBLEM In Mozambique, pulmonary tuberculosis is primarily diagnosed with sputum smear microscopy. However this method has low sensitivity, especially in people infected with human immunodeficiency virus (HIV). Patients are seldom tested for drug-resistant tuberculosis. APPROACH The national tuberculosis programme and Health Alliance International introduced rapid testing of smear-negative sp...

SETTING Designated microscopy centres (DMC) and additional microscopy centres (AMC) performing sputum acid-fast bacilli (AFB) microscopy, the District TB Centre (DTC) and a reference laboratory (RL). OBJECTIVES To ascertain the feasibility of adopting lot sampling of AFB smears and to assess the performance of MCs employing Senior Tuberculosis Laboratory Supervisors (STLS) with no knowledge a...

Background Microscopic examination of acid-fast-stained sputum smears is the current standard of care in the United States to determine airborne infection isolation (AII) of inpatients with presumptive pulmonary tuberculosis (PTB). However, nucleic acid amplification testing (NAAT) with the Xpert MTB/RIF assay (Xpert) may be more efficient and less costly. Methods This prospective observation...