The suspected diagnosis of tuberculosis is often difficult to prove. The following are used clinically to diagnose tuberculosis in children:
- There is often a history of an adult in the home with infectious pulmonary tuberculosis in the last 6 months (a history of contact).
- The child often comes from a poor, overcrowded environment and has a weak immune system (young, undernourished or infected with HIV or measles).
- There are clinical signs and symptoms of tuberculosis.
- The tuberculin skin test is usually positive (but often negative in children with malnutrition or HIV infection).
- The chest X-ray is usually abnormal.
- TB bacilli (Mycobacterium tuberculosis) may be found in the sputum, gastric aspirate or other body fluids
- A high index of suspicion is very important in the early diagnosis of tuberculosis, as tuberculosis may present in many different ways.
- Identifying the person who is the source of tuberculosis is also important.
The diagnosis of tuberculosis in children usually depends on a history of contact, clinical signs, tuberculin skin test and chest X-ray.
A number of new methods, such as PCR for Mycobacterium, promise quick, sensitive and accurate methods of diagnosing tuberculosis.