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Clinical investigations from the RACP

Investigating patients for tuberculosis

Hazel Goldberg

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Abstract

The challenge for all health carers – and particularly GPs – is to know when to consider tuberculosis in the differential diagnosis, what initial tests to order and where to refer the patient for management.

Key Points

  • Australia has one of the lowest incidence rates for tuberculosis in the world, with fewer than 1000 cases per year.
  • Delays in diagnosis have negative implications for the individual and the community.
  • Think of tuberculosis when an overseas-born patient has a chronic cough, systemic symptoms or a neck lump.
  • Chest x-ray and sputum examination for tuberculosis are the initial important tests to perform.
  • Sputum that is negative on a direct smear for tuberculosis organisms does not exclude the diagnosis of tuberculosis.
  • Refer all patients with suspected tuberculosis to tuberculosis centres or specialists experienced in this condition for shared care, notification and contact screening.

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