Chapter 7: Extra-pulmonary tuberculosis

• Samples (fluid and tissue) for extra-pulmonary tuberculosis (TB) should be sent for acid-fast bacilli smear, mycobacterial culture and nucleic acid amplification test. Tissue biopsy should be sent in sterile saline for these mycobacterial tests as well as in formalin for histopathologic assessment. Drug susceptibility testing should be requested for positive culture samples. • If the specimen is insufficient for all testing, mycobacterial culture should be prioritized given it has the highest diagnostic yield and allows for gold-standard phenotypic drug testing. • Every person with presumed extra-pulmonary TB should also be assessed for pulmonary TB to assess infectiousness and potentially assist with diagnosis.