Tuberculosis Warning: You are not logged in. Your IP address will be publicly visible if you make any edits. If you log in or create an account, your edits will be attributed to your username, along with other benefits.Anti-spam check. Do not fill this in! === Active tuberculosis === Diagnosing active tuberculosis based only on signs and symptoms is difficult,<ref name=DiagP2011>{{cite journal | vauthors = Bento J, Silva AS, Rodrigues F, Duarte R | title = [Diagnostic tools in tuberculosis] | journal = Acta Médica Portuguesa | volume = 24 | issue = 1 | pages = 145–54 | date = 2011 | doi = 10.20344/amp.333 | pmid = 21672452 | s2cid = 76156550 | doi-access = free }}</ref> as is diagnosing the disease in those who have a weakened immune system.<ref name=Clinic2009>{{cite journal | vauthors = Escalante P | s2cid = 639982 | title = In the clinic. Tuberculosis | journal = Annals of Internal Medicine | volume = 150 | issue = 11 | pages = ITC61-614; quiz ITV616 | date = June 2009 | pmid = 19487708 | doi = 10.7326/0003-4819-150-11-200906020-01006 }}</ref> A diagnosis of TB should, however, be considered in those with signs of lung disease or [[constitutional symptoms]] lasting longer than two weeks.<ref name=Clinic2009/> A [[chest X-ray]] and multiple [[sputum culture]]s for [[acid-fast bacilli]] are typically part of the initial evaluation.<ref name=Clinic2009/> [[Interferon gamma release assay|Interferon-γ release assays]] (IGRA) and tuberculin skin tests are of little use in most of the developing world.<ref>{{cite journal | vauthors = Metcalfe JZ, Everett CK, Steingart KR, Cattamanchi A, Huang L, Hopewell PC, Pai M | title = Interferon-γ release assays for active pulmonary tuberculosis diagnosis in adults in low- and middle-income countries: systematic review and meta-analysis | journal = The Journal of Infectious Diseases | volume = 204 | issue = suppl_4 | pages = S1120-9 | date = November 2011 | pmid = 21996694 | pmc = 3192542 | doi = 10.1093/infdis/jir410 }}</ref><ref name="Sester 100–11">{{cite journal | vauthors = Sester M, Sotgiu G, Lange C, Giehl C, Girardi E, Migliori GB, Bossink A, Dheda K, Diel R, Dominguez J, Lipman M, Nemeth J, Ravn P, Winkler S, Huitric E, Sandgren A, Manissero D | display-authors = 6 | title = Interferon-γ release assays for the diagnosis of active tuberculosis: a systematic review and meta-analysis | journal = The European Respiratory Journal | volume = 37 | issue = 1 | pages = 100–11 | date = January 2011 | pmid = 20847080 | doi = 10.1183/09031936.00114810 | doi-access = free }}</ref> IGRA have similar limitations in those with HIV.<ref name="Sester 100–11"/><ref>{{cite journal | vauthors = Chen J, Zhang R, Wang J, Liu L, Zheng Y, Shen Y, Qi T, Lu H | display-authors = 6 | title = Interferon-gamma release assays for the diagnosis of active tuberculosis in HIV-infected patients: a systematic review and meta-analysis | journal = PLOS ONE| volume = 6 | issue = 11 | pages = e26827 | year = 2011 | pmid = 22069472 | pmc = 3206065 | doi = 10.1371/journal.pone.0026827 | veditors = Vermund SH |editor1-link=Sten H. Vermund | bibcode = 2011PLoSO...626827C | doi-access = free }}</ref> A definitive diagnosis of TB is made by identifying ''M. tuberculosis'' in a clinical sample (e.g., sputum, [[pus]], or a [[Tissue (biology)|tissue]] [[biopsy]]). However, the difficult culture process for this slow-growing organism can take two to six weeks for blood or sputum culture.<ref>{{cite book | author = Special Programme for Research & Training in Tropical Diseases |title=Diagnostics for tuberculosis: global demand and market potential|year=2006|publisher=World Health Organization (WHO)|location=Geneva|isbn=978-92-4-156330-7|page=36|url=https://books.google.com/books?id=CFPpcCef4yQC&pg=PA36|url-status=live|archive-url=https://web.archive.org/web/20150906202315/https://books.google.com/books?id=CFPpcCef4yQC&pg=PA36|archive-date=6 September 2015}}</ref> Thus, treatment is often begun before cultures are confirmed.<ref name=NICE2011/> [[Nucleic acid amplification test]]s and [[adenosine deaminase]] testing may allow rapid diagnosis of TB.<ref name=DiagP2011/> Blood tests to detect antibodies are not [[sensitivity and specificity|specific or sensitive]], so they are not recommended.<ref>{{cite journal | vauthors = Steingart KR, Flores LL, Dendukuri N, Schiller I, Laal S, Ramsay A, Hopewell PC, Pai M | display-authors = 6 | title = Commercial serological tests for the diagnosis of active pulmonary and extrapulmonary tuberculosis: an updated systematic review and meta-analysis | journal = PLOS Medicine | volume = 8 | issue = 8 | page= e1001062 | date = August 2011 | pmid = 21857806 | pmc = 3153457 | doi = 10.1371/journal.pmed.1001062 | doi-access = free | veditors = Evans C }}</ref> Summary: Please note that all contributions to Christianpedia may be edited, altered, or removed by other contributors. 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