Etiology

* Microscopic examination of infected material ("smear") detects about 8 to 10 x

10 mm /organisms of specimen using the older AFB (acid-fast bacillus) stain. The newer auraminerhodamine fluorsecent technique is one-third more sensitive. A smear-

negative patient still can grow M tuberculosis on culture, which is more sensitive than either staining technique. Unfortunately, culture is much slower than staining due to the doubling time of the bacilli of about 20 hours. Further, microscopic examination cannot determine which of over 90 mycobacterial species is present. The usual practice is to assume the worst (TB) until confirmed by genetic probe or positive culture.

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