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All patients who are TB suspects MUST be placed into Airborne isolation in a negative pressure room. Notify Infection Prevention of any TB suspects.
Send three AFB sputum at least 8 hours apart, one of which should be a morning specimen. Send one sample for MTB PCR
Patients with characteristic syndromes and radiographic findings should have expectorated sputum obtained for AFB smear and culture.
Sensitivity of AFB smear on expectorated sputum is 50-70%
Sensitivity is lower in HIV+ patients.
Morning expectorated sputum, induced sputum, bronchoscopy have higher sensitivity.
AFB culture of lower respiratory tract specimens is considered the gold standard.
AFB smear and culture should be obtained regardless of chest x-ray findings in patients with high clinical suspicion, HIV infection, or other immunocompromised states.
CXR is normal in approximately 10% of HIV+ patients with pulmonary TB.
