RT Book, Section A1 Raviglione, Mario C. A2 Jameson, J. Larry A2 Fauci, Anthony S. A2 Kasper, Dennis L. A2 Hauser, Stephen L. A2 Longo, Dan L. A2 Loscalzo, Joseph SR Print(0) ID 1178426711 T1 Diagnosis of Tuberculosis T2 Harrison's Principles of Internal Medicine, 20e YR 2018 FD 2018 PB McGraw-Hill Education PP New York, NY SN 9781259644016 LK accesspharmacy.mhmedical.com/content.aspx?aid=1178426711 RD 2024/03/28 AB The key to the early diagnosis of TB is a high index of suspicion. Diagnosis is not difficult in persons belonging to high-risk populations who present with typical symptoms and a classic chest radiograph showing upper-lobe infiltrates with cavities (Fig. 173-6). On the other hand, the diagnosis can easily be missed in an elderly nursing-home resident or a teenager with a focal infiltrate. Often, the diagnosis is first entertained when the chest radiograph of a patient being evaluated for respiratory symptoms is abnormal. If the patient has no complicating medical conditions that cause immunosuppression, the chest radiograph may show typical upper-lobe infiltrates with cavitation (Fig. 173-6). The longer the delay between the onset of symptoms and the diagnosis, the more likely is the finding of cavitary disease. In contrast, immunosuppressed patients, including those with HIV infection, may have “atypical” findings on CXR—e.g., lower-zone infiltrates without cavity formation.