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Diagnostik der pulmonalen Tuberkulose beim Erwachsenen

Diagnostics for pulmonary tuberculosis in adults

  • Schwerpunkt: Lunge und Infektion
  • Published:
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Zusammenfassung

Die Inzidenz der pulmonalen Tuberkulose (TB) in Westeuropa nimmt ab. Dennoch ist sie vor allem bei Migranten und Immunsupprimierten (z. B. HIV) keine seltene Erkrankung. Bei Immunsupprimierten ist die Präsentation oft atypisch; generell unterschätzt die Klinik das Ausmaß der Erkrankung. Eine radiologische Abklärung und eine Untersuchung von 3 sequenziell gewonnenen Sputa inklusive Mikroskopie, Kultur und Resistenztestung auf die Erstlinienmedikamente sind nötig zur Diagnosestellung. Der Tuberkulintest kommt vor allem bei der Diagnose der latenten TB und bei Umgebungsabklärungen zum Einsatz. Neuere Bluttests, basierend auf einem Nachweis von Interferon-g, welches durch antigenspezifische T-Zellen gebildet wird, haben gewisse Vorteile gegenüber dem Tuberkulintest.

Abstract

The incidence of pulmonary tuberculosis (TB) is decreasing in Western Europe. However, TB should not be considered to be a rare disease, particularly in immigrants and in immunocompromised persons (i.e. HIV infection). The clinical presentation is often atypical in immunocompromised persons. In general, the extent of the disease is underestimated by the clinical presentation. X-ray and a sequential investigation of three samples of sputum including microscopy, culture and susceptibility testing for the first-line drugs should be obtained. Tuberculin testing is useful in the diagnosis of latent TB and in screening persons with close contact to patients with active disease. New blood tests based on the detection of interferon-g released by antigen specific T-cells have some advantages compared to tuberculin testing.

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Authors and Affiliations

  1. Klinik für Infektiologie, Universitätsspital Basel, Petersgraben 4, CH-4031, Basel, Schweiz

    G. Laifer

  2. Medizinische Klinik, Kantonsspital Olten, Olten, Schweiz

    S. Bassetti

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  1. G. Laifer
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  2. S. Bassetti
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Correspondence to G. Laifer.

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Laifer, G., Bassetti, S. Diagnostik der pulmonalen Tuberkulose beim Erwachsenen. Internist 48, 489–496 (2007). https://doi.org/10.1007/s00108-007-1814-0

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  • DOI: https://doi.org/10.1007/s00108-007-1814-0

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