The Role of the Laboratory in the Management of Tuberculosis Patients

Abstract

Historically, the importance of the laboratory in the diagnosis and management of tuberculosis patients dates back to 1882 when Robert Koch discovered the tubercle bacillus and confirmed the bacteriologic etiology of this disease. Soon after, specific methods for the detection of the bacilli in the sputum and other biologic fluids, mainly by the carbolfuchsin technique, developed by Ziehl-Neelsen, and the methods of cultivating the bacilli in artificial media, gave a great boost to the importance of the laboratory in this disease. The landmarks in the development of the role and importance of the laboratory are listed in Table 1. Contributions from the laboratory paralleled very closely other developments in the management of this disease. Of particular importance is the role of the laboratory in assisting the clinician in the proper use of chemotherapy. Soon after specific drugs were available, the laboratory was very prompt in assisting clinicians by advising about the suitability of any drug or combination of drugs by carrying out drug susceptibility tests. The laboratory also assisted the clinicians in measuring