Diagnosis of tuberculosis in adults and children

Evidence-based guidelines on the diagnosis and classification of tuberculosis (TB) in adults and children were prepared by a joint task force of the American Thoracic Society (ATS), the Centers for Disease Control and Prevention (CDC), and the Infectious Disease Society of America (IDSA) (1). The task force employed a multidisciplinary committee to develop clinical recommendations based on the following considerations: the balance of desirable consequences vs. undesirable consequences (harms, cost, and resource use), quality of evidence, patient preferences, and feasibility. The recommendations are based on systemic evidence syntheses or, when published evidence was unavailable, the collective clinical experience of the committee. This summary is prepared for practicing clinicians. TB continues to be one of the major causes of morbidity and mortality in the world because of the continued presence of a large reservoir of individuals with latent TB and the increasing emergence of drug-resistant TB. These guidelines target clinicians in high-resource countries in which there is a low incidence of TB disease and latent TB, such as the United States. World Health Organization guidance may be more suitable for countries with medium and high TB incidence. Clinicians should use caution and always consider unique individual clinical circumstances such as country of birth, history of Bacillus Calmette-Guerin (BCG) vaccination, and immunosuppression when interpreting these recommendations.