Diagnostic standards and classification of tuberculosis in adults and children

Abstract

A joint statement of the American Thoracic Society and the CDC, this article provides a framework for and an understanding of the diagnostic approaches to tuberculosis (TB) infection/disease and to present a classification scheme that facilitates management of all persons to whom diagnostic tests have been applied. The specific objectives of this revision of the Diagnostic Standards are to define diagnostic strategies for high- and low-risk patient populations based on current knowledge of TB epidemiology and information on newer technology and to provide a classification scheme for TB that is based on pathogenesis. Definitions of TB disease and latent infection have been selected that (1) aid in an accurate diagnosis; (2) coincide with the appropriate response of the health care team, whether it be no response, treatment of latent infection, or treatment of disease; (3) provide the most useful information that correlates with the prognosis; (4) provide the necessary information of appropriate public health action; and (5) provide a uniform, functional, and practical means of reporting. Because TB, even after it has been treated adequately, remains a pertinent and lifelong part of a person's medical history, previous as well as current disease is included in the classification. This edition of the Diagnostic Standards has been prepared as a practical guide and statement of principles for all persons involved in the care of patients with TB. References have been included to guide the reader to texts and journal articles for more detailed information on each topic. Section headings are (I) Epidemiology, (II) Transmission of Mycobacterium Tuberculosis, (III) Pathogenesis of Tuberculosis, (IV) Clinical Manifestations of Tuberculosis, (V) Diagnostic Microbiology, (VI) Tuberculin Skin Test, (VII) Classification of Persons Exposed to and/or Infected with Mycobacterium Tuberculosis, and (VIII) Reporting of Tuberculosis.I. Epidemiology -- II. Transmission of Mycobacterium Tuberculosis -- III. Pathogenesis of Tuberculosis -- IV. Clinical Manifestations of Tuberculosis -- V. Diagnostic Microbiology -- VI. Tuberculin Skin Test -- VII. Classification of Persons Exposed to and/or Infected with Mycobacterium Tuberculosis -- VIII. Reporting of Tuberculosis.This official statement of the American Thoracic Society and the Centers for Disease Control and Prevention was adopted by the ATS Board of Directors, July 1999. This statement was endorsed by the Council of the Infectious Disease Society of America, September 1999.Reprinted from American journal of respiratory and critical care medicine, Vol. 161, 2000.Also available on the World Wide Web (accessed 06/18/2010),Includes bibliographic references (p. 1392-1395)