Health Questions and Answers

Question: What is the initial work-up for a TB symptomatic?


  • The initial work-up of choice for a TB symptomatic is the sputum microscopy. All patients who present with cough of two weeks or more should preferably have three, but, at the least two sputum specimens sent for sputum microscopy for Acid Fast Bacilli (AFB)
  • Sputum microscopy is still the most efficient way of identifying cases of tuberculosis.
  • Sputum smear for AFB is available, accessible, affordable, with results rapidly available, correlates well with infectiousness.
  • While there is new evidence that the third sputum specimen usually contributes minimally to the diagnosis of active tuberculosis, three sputum specimens are still recommended until the same findings are validated in the local settings.

Mendoza MT and Narciso CP. The reliability of sputum AFB microscopy. Phil J Microbiol Infect Dis 1987; 16: 30-35

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