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The diagnosis of TB depends on a careful history, chest X-ray and microbiological smear and culture. Microbiological specimens include: sputum, pharyngeal swabs, samples obtained during bronchoscopy, gastric contents (via naso-gastric tube), pleural fluid, urine, CSF. For sputum, pharyngeal swabs, gastric contents and urine, samples should ideally be obtained in the early morning. Biopsy specimens such as lymph nodes and pleura should be sent for histological and bacteriological examination. The hallmarks of diagnosis are the detection of acid-fast bacilli by direct microscopy and the identification of cultured mycobacteria by biochemical tests.
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Diagnosis