Different Methods in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis

Abstract
Background: Tuberculosis (TB) has been a major health problem in developing countries.
Rapid diagnosis of Mycobacterium tuberculosis infection plays a critical role in controlling the spread of tuberculosis. Conventional methods may take up to several weeks or longer to produce results. This study aimed to compare different methods like culture on Bio F-M media, automated BacT/ ALERT MP bottles, and urine lipoarabinomnnan by ELISA.
Subjects and Methods: This study was done on 100 patients suspected to have tuberculosis, cases divided into two groups: (Group A): 68 clinically suspected pulmonary TB cases. (Group B): 32 clinically suspected extrapulmonary TB cases. All samples from Group A and B were subjected to direct staining by Zeihl-Neelsen stain, culture of the samples on Lowenstein Jensen media, Bio FM media and automated BacT/ALERT MP bottles and detection of urine lipoarabi-nomannan by ELISA.
Results: In suspected pulmonary tuberculosis cases the sensitivity and specificity of Bio FM were 87.2%, 100% respectively, sensitivity and specificity of BacT/ALERT MP were 74.4%, 100% respectively, sensitivity and specificity of urine lipoarabinomannan were 20.5%, 96.9% respectively and in suspected extrapulmonary tuberculosis cases were the sensitivity and specificity of Bio FM were 87.5%, 100% respectively, sensitivity and specificity of BacT/ALERT MP were 50%, 100% respectively, sensitivity and specificity of urine lipoarabinomannan were 12.5%, 100% respectively.
Conclusion: The sensitivity of both solid (Lowenstein Jensen) and liquid (Bio FM) media were the same and better than BacT/ALERT MP. Bio FM media and BacT/ALERT MP show shorter time than Lowenstein Jensen for detection of mycobacterial growth. Detection of urine lipoarabinomannan by ELISA is insensitive for the diagnosis of TB.