A. Chronic cough with scant sputum production and blood streaking of sputum are the most common symptoms of pulmonary disease. Pulmonary tuberculosis should be considered in any patient with the following characteristics:
1. cough for more than 3 weeks
2. night sweats
3. bloody sputum or hemoptysis
4. weight loss
7. history of exposure to tuberculosis, institutionalization, HIV infection, or a positive PPD test.
B. Diagnosis of active pulmonary tuberculosis rests upon sputum examination for acid fast bacilli and subsequent culture and sensitivities. This process requires 4-6 weeks for identification and another 4-6 weeks for sensitivity testing. Smears and cultures should be performed on three different days in patients at high risk for infection.
C. DNA probes that use polymerase chain reactions (PCR) are available for more rapid identification of tuberculosis. They are useful for making an early diagnosis of Tb while awaiting culture results.
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