Summary

  • Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis, which most commonly involves the lungs (pulmonary) but may affect any other organ (extrapulmonary).
  • Epidemiologic risk factors include birth in high TB-prevalent countries, exposure at place of residence/work in an institutional setting, and homelessness.
  • Diagnosis may be delayed as a result of nonspecific clinical manifestations that progress slowly and the low sensitivity of acid-fast bacilli (AFB) smear on extrapulmonary specimens.
  • Microbiologic proof is the key to diagnosis and treatment, and tissue biopsy is frequently required. Other supportive findings are granulomas and positive AFB stain on pathology, and chest x-ray findings.
  • Initial therapy is a 4-drug regimen of isoniazid, rifampin, pyrazinamide, and ethambutol; treatment lasts for at least 6 months.

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