A contact with a tuberculosis patient who has a negative sputum acid fast bacilli (AFB) smear can be classified using the CDC criteria.
Features of the tuberculosis patient:
(1) pulmonary or pleural tuberculosis
(2) sputum smear negative for acid fast bacilli (AFB)
(3) abnormal chest radiograph consistent with TB
(4) nucleic acid assay and/or mycobacterial culture may be positive or negative
Criteria for high priority contact:
(1) age of contact < 5 years
(2) presence of medical risk factor
(3) exposure during a medical procedure (bronchoscopy, sputum induction, autopsy)
Medical risk factors:
(1) HIV infected
(2) therapy with prednisone > 15 mg for > 4 weeks
(3) immunosuppressive agent
(4) cancer chemotherapy
(5) use of a tumor necrosis factor alpha antagonist
(6) silicosis
(7) diabetes mellitus
(8) status post gastrectomy or jejunoileal bypass surgery
(9) intravenous drug use
(10) head or neck cancer
(11) hematological or reticuloendothelial disease
(12) end-stage renal disease
(13) chronic malabsorption syndrome
(14) low body weight (underweight for age)
Criteria for medium priority:
(1) household contact
(2) contact with exposure in congregate setting
(3) exposure duration exceeds environmental limit set by local TB control program for medium-priority contact
Criteria for low priority:
(1) not medium or high priority
Specialty: Infectious Diseases
ICD-10: ,