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What are the diagnostic procedures for TB?

Q: What are the main testing procedures for tuberculosis (TB)? Can TB be tested by igA and igM? I had multiple swellings in the neck. I got chest x-ray, haemogram, igA and igM tests done, in which everything is fine except igM, which is 1.14. Am I suffering from TB? I have been prescribed R-cinex (600 + 300), Pride 750 mg, Combutol 1 gm, Beplex forte and Liv 52. Are these medicines right? Which is the best medicine for TB?

A:The definitive diagnosis of TB depends on demonstration of the organism (stained smears &/or culture) from secretions or biopsy tissues. Appropriate specimens include sputum, gastric lavage, bronchoalveolar lavage, lung tissue, lymph node tissue, bone marrow, blood, liver, cerebrospinal fluid (CSF), overnight urine, and stool, depending on the location of the disease. Automated culture methods are increasingly being used for the rapid growth of mycobacteria. X-ray of the chest is a classic diagnostic tool when evaluating patients for pulmonary TB even though a CT scan or MRI scan may be used (though not usually). Enzyme linked immunosorbent assay (ELISA) is not hundred percent sensitive and specific with sensitivity ranging from 70% to 94%. Poor immune reactions (debilitating disease), circulating immune complexes, and suppressor T-lymphocytes are said to be the main cause of false negativity of ELISA. In primary tuberculosis, IgG levels are low at beginning and hence the test may be negative. ELISA test should always be used in conjunction with other tests to reach the final diagnosis. The aim of treatment is to achieve sterilization of the TB lesion in the shortest possible time. This is best possible by strictly adhering to TB treatment regimens for a sufficient period of time. To prevent the emergence of resistance, most drug regimens consist of multiple drugs and most patients are given 4 drugs thrice weekly for 2 months followed by 2 drugs thrice weekly for 4 months. Please comply with the doctor’s advice.


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