CRITERIA FOR GUIDANCE IN THE DIAGNOSIS OF TUBERCULOSIS

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Abstract
In countries with a high incidence of tuberculosis and where BCG vaccination at birth is a routine procedure, the diagnosis of tuberculosis in infants and young children may be exceedingly difficult. A point system is proposed in order to evaluate all the available data when tuberculosis is suspected. This approach offers the advantages of a uniform criterion for diagnosis and treatment and a useful guide for completing diagnostic procedures. This point system carried out on each individual case gives four possible answers: (1) tuberculosis unlikely; (2) tuberculosis possible, requires further investigation; (3) tuberculosis probable, may justify therapy; (4) tuberculosis appears unquestionable. It is a great help in clarifying a dubious diagnosis of tuberculosis based on vague x-ray shadows and positive tuberculin tests of doubtful interpretation in the absence of positive sputum or gastric washings. This point system has the limitations of all rigid point systems of evaluation. However, if priority is given to clinical experience, it is an additional tool in a difficult diagnosis.
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