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In Smear positive patients high sensitivity 99%, specificity 98%. In smear negative patients low sensitivity 62%, but high specificity 99%. NAA techniques such as polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP) are the basis of molecular diagnosis of TB.
The results of this test must be interpreted carefully. The person's medical risk factors determine at which increment (5 mm, 10 mm, or 15 mm) of induration the result is considered positive. [12] A positive result indicates TB exposure. 5 mm or more is positive in An HIV-positive person; Persons with recent contacts with a TB patient
In people with smear-positive pulmonary TB (without HIV co-infection), after 5 years without treatment, 50–60% die while 20–25% achieve spontaneous resolution (cure). TB is almost always fatal in those with untreated HIV co-infection and death rates are increased even with antiretroviral treatment of HIV. [168]
Negative reaction to tuberculin skin test 1: TB exposure No evidence of infection: History of exposure Negative reaction to tuberculin skin test 2: TB infection No disease: Positive reaction to tuberculin skin test Negative bacteriologic studies (if done) No clinical, bacteriologic, or radiographic evidence of TB 3: TB, clinically active
However, when Xpert TB was used as an add-on for cases of negative smear microscopy the sensitivity was only 67% and specificity 99%. [9] In a clinical study conducted the sensitivity of the MTB/RIF test on just 1 sputum sample was 92.2% for culture-positive TB; 98.2% for smear+ and culture-positive cases; and 72.5% for smear-negative, culture ...
If there is any question of active TB, sputum smears must be obtained. Therefore, any applicant might have findings grouped in this category, but still have active TB as suggested by the presence of signs or symptoms of TB, or sputum smears positive for AFB. [2] The main chest X-ray findings that can suggest inactive TB are: [2] 1.
There is evidence supporting some deviations from the standard regimen when treating pulmonary TB. Sputum culture-positive patients who are smear-negative at the start of treatment do well with only four months of treatment (this has not been validated for HIV-positive patients); sputum culture-negative patients do well on only three months of ...
The equivalent Mantoux test positive levels done with 10 TU (0.1 mL 100 TU/mL, 1:1000) are 0–4 mm induration (Heaf 0-1) 5–14 mm induration (Heaf 2) >15 mm induration (Heaf 3-4) The Mantoux test is preferred in the United States for the diagnosis of tuberculosis; multiple puncture tests, such as the Heaf test and Tine test, are not recommended.