Key Points

• Eighty percent of TB cases come from 22 high-burden nations, and one third of cases occur in India alone.

• Sputum cultures can confirm the diagnosis of TB, but they also are important for identifying patterns of drug resistance.

• Polymerase chain reaction techniques looking for genetic polymorphisms can provide more rapid diagnosis of drug-resistant TB.

• Latent infection (positive skin test in asymptomatic patient with normal chest radiograph) is treated with 6 to 9 months of isoniazid or 4 months of rifampin.

• Treatment of active pulmonary TB requires a multidrug regimen for 6 to 12 months; cultures should be negative in 80% of patients within 2 months.

Tuberculosis is caused by infection with Mycobacterium tuberculosis, transmitted by airborne exposure from close contact with infected patients. Pulmonary infection is the most common form, although extrapulmonary TB from hematogenous spread (meningitis, peritonitis, renal or adrenal TB, spinal TB [Pott's disease], others) can occur in young children, elderly people, persons in high-endemic areas, and patients with impaired immunity or malnutrition.

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