ABSTRACT
This chapter outlines key principles of diagnostic evaluation for tuberculosis (TB), then provide an overview of the role of the clinical history and physical examination in screening patients for active pulmonary TB. It discusses the sample collection for diagnostic testing, and conclude with a review of current and emerging diagnostic tests for TB, focusing on the principles underlying these new technologies and drawing examples from the tests most commonly implemented in routine clinical and public health practice. The history and physical examination provide an important starting point in the diagnostic evaluation of active TB disease. In individuals who cannot expectorate on initial request and with coaching, it is worth making a second request for sputum at a later time, before moving on to sputum induction or bronchoscopy. A thorough and accurate diagnostic evaluation for TB requires that clinicians integrate information from the clinical assessment with knowledge of the performance of different testing strategies using a formal or informal likelihood-based approach.
