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Tuberculosis (TB) in children can be challenging to diagnose with microbiological certainty. Younger children are unable to expectorate sputum and the bacillary load is frequently low; few children with a clinical diagnosis of pulmonary TB have this confirmed microbiologically. Similarly, confirmation of extra-pulmonary TB, using other samples, can be difficult.1
Despite these challenges, 27 TB guidelines, including those produced by the National Institute for Health and Care Excellence, recommend that microbiological confirmation is attempted in all children with suspected TB, and that where pulmonary TB is suspected, three samples should be sent.2 Microbiological diagnosis is useful for a number of reasons: it confirms the diagnosis, it allows epidemiological data regarding strain …
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