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Smear-Negative Pulmonary Tuberculosis in Industrialized Countries

Richard Long, MD, FCCP
Author and Funding Information

Affiliations: Edmonton, Alberta, Canada 
 ,  Dr. Long is a professor in the Pulmonary Division, Department of Medicine, University of Alberta.

Correspondence to: Richard Long, MD, FCCP, Department of Medicine, University of Alberta, Room 2E4.21, Walter C. Mackenzie Center, 8440–112 St, Edmonton, Alberta T6G 2B7, Canada; e-mail: richard.long@ualberta.ca



Chest. 2001;120(2):330-334. doi:10.1378/chest.120.2.330
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Much attention has recently been paid to the problem of smear-negative pulmonary tuberculosis. Quite appropriately, the discussion has focused on low-income countries, home to the vast majority of individuals with tuberculosis and HIV and where the ability to culture diagnostic specimens may be lacking.15 Yet, there remain legitimate questions concerning this group of patients in industrialized countries. In this issue of CHEST (see page 349), Kanaya et al address one of those questions. Is it possible to predict, among patients with suspected active, smear-negative pulmonary tuberculosis, those patients whose culture specimens will ultimately prove to be positive? The object would be to avoid the adverse consequences that might result from withholding treatment in patients with the disease (remaining ill for excessively long periods of time, and possibly infecting others in the community) or introducing treatment in patients without the disease (their actual illness goes untreated, and they are exposed unnecessarily to possible drug toxicity).

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