|
 |
|
|||||||
|
|||||||||
© 2006 The American Thoracic Society
Advances in the Diagnosis and Treatment of Tuberculosis
Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California at San Francisco, San Francisco, California
Correspondence and requests for reprints should be addressed to Philip C. Hopewell, M.D., Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, University of California, San Francisco, 1001 Potrero Avenue, Room 5K1, San Francisco, CA 94110. E-mail: phopewell{at}medsfgh.ucsf.edu
ABSTRACT
Although truly major advances that would revolutionize tuberculosis (TB) diagnosis and treatment have not been realized, we are beginning to see the innovations that have been prompted by the recognition of the economic potential of the market for new diagnostic tests and treatments for TB and considerably increased public and private funding. Despite the enormous global burden of TB and the overall low rates of case detection worldwide, conventional approaches to diagnosis have, until recently, relied on tests that have major limitations. In this review of advances in diagnosis, we focus on strengths and limitations of newer tests that are available for the diagnosis of latent and active tuberculosis and rapid detection of drug resistance, specifically, tests that measure release of IFN-
in response to stimulation by Mycobacterium tuberculosis antigens, nucleic acid amplification for identification of M. tuberculosis complex, and rapid tests for detecting drug resistance. Standard regimens for treating TB have not changed for more than 30 yr and still require a minimum of 6 mo to have a high likelihood of a lasting cure. In this article, we focus on important changes in the philosophy of treatment, emphasizing the responsibility of the provider to assure successful completion of treatment, and on the roles of existing anti-TB agents and newer drugs such as rifabutin, rifapentine, and fluoroquinolones.
Key Words: diagnosis • latent tuberculosis infection • treatment • tuberculosis
This article has been cited by other articles:
|
|
 |
|
  Y. J. Jeong and K. S. Lee Pulmonary Tuberculosis: Up-to-Date Imaging and Management Am. J. Roentgenol., September 1, 2008; 191(3): 834 - 844. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. C. A. M. Buijtels, H. F. M. Willemse-Erix, P. L. C. Petit, H. P. Endtz, G. J. Puppels, H. A. Verbrugh, A. van Belkum, D. van Soolingen, and K. Maquelin Rapid Identification of Mycobacteria by Raman Spectroscopy J. Clin. Microbiol., March 1, 2008; 46(3): 961 - 965. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Mohsen, A. Abou Zeid, and S. Haj-Yahia Lobectomy or pneumonectomy for multidrug-resistant pulmonary tuberculosis can be performed with acceptable morbidity and mortality: A seven-year review of a single institution's experience J. Thorac. Cardiovasc. Surg., July 1, 2007; 134(1): 194 - 198. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. C. Boehme, P. Nabeta, G. Henostroza, R. Raqib, Z. Rahim, M. Gerhardt, E. Sanga, M. Hoelscher, T. Notomi, T. Hase, et al. Operational Feasibility of Using Loop-Mediated Isothermal Amplification for Diagnosis of Pulmonary Tuberculosis in Microscopy Centers of Developing Countries J. Clin. Microbiol., June 1, 2007; 45(6): 1936 - 1940. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. J Marais and M. Pai Recent advances in the diagnosis of childhood tuberculosis Arch. Dis. Child., May 1, 2007; 92(5): 446 - 452. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Traore, A. van Deun, I. C. Shamputa, L. Rigouts, and F. Portaels Direct Detection of Mycobacterium tuberculosis Complex DNA and Rifampin Resistance in Clinical Specimens from Tuberculosis Patients by Line Probe Assay J. Clin. Microbiol., December 1, 2006; 44(12): 4384 - 4388. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |