Isolation of M. tuberculosis from culture of a clinical specimen confirms TB disease. In most children, microbiologic confirmation is difficult because they may be too young to spontaneously produce sputum or have paucibacillary disease. In Canada, diagnosis of TB disease in children is often based on a clinical case definition, which usually relies on the triad of (1) a positive TST or IGRA; (2) an abnormal chest x-ray and/or physical examination; and (3) discovery of a link to a known or suspected case of infectious TB. Some of these cases are also symptomatic.
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