Additional Tests

Morning sputum collections have the highest yield of organisms.2,10,19 Daily sputum collections over three consecutive days improve the yield of positive results. Sputum induction with aerosolized hypertonic saline may produce a diagnostic sample in patients unable to produce sputum. Bronchoscopy or aspiration of gastric fluid via a nasogastric tube may be attempted in selected patients, the latter being used more often in children.19 For patients with suspected extrapulmonary TB, samples of draining fluid, biopsies of the infected site, or both may be attempted. Blood cultures are posit-

19 25 29

ive occasionally, especially in AIDS patients who have low CD4 counts. ' ' Table 75-1 Criteria for Tuberculin Positivity by Risk Group

Réaction G roatrr Than nr Equal la Réaction Grratrr Than gr Equal TP AtldlDll Greater Than or Equal ID

5 mm of Induration ID mm 6f Induration IS mm of Iftrfurailan

Réaction G roatrr Than nr Equal la Réaction Grratrr Than gr Equal TP AtldlDll Greater Than or Equal ID

5 mm of Induration ID mm 6f Induration IS mm of Iftrfurailan

HlVfUdke persan

ftucerit immigranls (ut>. w 11nn the tat 5 ytui-J Irom Peisons with no rfck factors fa fB

hfgfrjyevalwite coirtrtsi

Rocent conUtls ci TB case patients

:njix tkxi diug useis

\ it^i i[k ilwugei oofhisl ijifofliaph

Knldmns and fnnpkj)Wi* of the faioiAHng high-

consistent wlthprior TB

ntV congregate settings. pmsons and Jails, nursing

Jiidothfl tcng-Kftn fotlllti« lor the fktoityt

hfnpir.iK and otter hetilrhrare facilities residential

tail Ki Icjh |)Jtici it 1 ■■vil li Aids, <*xJ ftotnelesi

ihrittn

i'jl kifll Willi ("(DU |rji^pljril 1 jnJ oChvn

MyiObiKH.fBklgyhbofjltjfy personnel

immuno4mp[WSW<l piilcm: GeiiHvinii

l^iicm »iih rhe folo«rng ciifKJi condition rhj:

the equivalent of greater than or equal

place them at hKp risk.sillco&ls, d«beles meHus,

to 15 mgAJay 01 niHJnüone Itx 1 finonth

ilvcn* ftnji failure, sonne heriwiotoglc dtoufcrs

or

leukemic, inrt lymphoftiMl, mhei sfiiiflf:

malignancies Ipg;, carcinoma the liead or neck

and lungi, *tigh( isw oi qrejrer ihan <x

to itHtof ifJMl body Height, gastrectomy, anil

¡pjunoileal bypjst

thllcfien ^ojnijei than 4 yevt of or infants.

chiLJien. and adolescents exposed to adults at

hlgikihk

nfck ui re in (xnicftiMiLywdwirh cot 1*0410«^ j intiiMiOi nim i«yivü öowand loivjoi durjiic«

tor pnom who otherwise rt lew ii&anfl are teftwi ü iheitvK'aiii^nicn^Kgdlnoffieiifi ihsn or ihiiiîI 10 mm rf

Induration-is considered positive. Finm ft?f. in

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