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A positive IGRA result may not necessarily indicate TB infection, but can also be caused by infection with non-tuberculous mycobacteria. A negative IGRA does not rule out active TB disease; a number of studies have shown that up to a quarter of patients with active TB have negative IGRA results.
For example, in patients with cutaneous adverse drug reactions, the challenge of peripheral blood lymphocytes with the drug causing the reaction produced a positive test result for half of the drugs tested. [2] There are currently two IFN-γ release assays available for the diagnosis of tuberculosis:
The medical history includes obtaining the symptoms of pulmonary TB: productive, prolonged cough of three or more weeks, chest pain, and hemoptysis.Systemic symptoms include low grade remittent fever, chills, night sweats, appetite loss, weight loss, easy fatiguability, and production of sputum that starts out mucoid but changes to purulent. [1]
A person with symptoms listed may have active tuberculosis, and the person should immediately see a physician so that tuberculosis is not spread. If a person with the above symptoms does not see a physician, ignoring the symptoms can result in lung damage, eye damage, organ damage and eventually death. [citation needed]
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Interferon-γ release assays (IGRA) and tuberculin skin tests are of little use in most of the developing world. [101] [102] IGRA have similar limitations in those with HIV. [102] [103] A definitive diagnosis of TB is made by identifying M. tuberculosis in a clinical sample (e.g., sputum, pus, or a tissue biopsy).
If oxidase positive, Gram-negative diplococci are isolated from a culture of a cervical/vaginal swab specimen, then the diagnosis is made. Culture is especially useful for diagnosis of infections of the throat, rectum, eyes, blood, or joints—areas where PCR-based tests are not well established in all labs.
Symptoms improving: End isolation after five days (as long as fever-free for 24 hours without fever-reducing medication). Moderate illness (like breathing difficulty): Isolate for 10 days.