A&E department: a missed opportunity for diagnosis of TB?

Patient Ethnic group Age (years) Risk factor for TB Admitted to hospital Site of TB Microbiologically confirmed diagnosis Time from A&E attendance to diagnosis of TB (days) Reason for presentation to A&E 1a White 65 HIV+ Yes Pleural No 178 Dyspnoea, ankle oedema 1b Yes 155 Dyspnoea, ankle oedema 2 Asian 53 Dialysis Yes Pleural No 122 Sepsis, MRSA bacteraemia 3 Black African 25 HIV+* Yes Meningitis No 45 Headache, malaise, right iliac fossa pain, 4a Asian 59 No Yes Pulmonary Smear positive, sensitive 126 Dyspnoea, bronchiectasis 4b No Pulmonary Smear positive, sensitive 134 Power failure at home 5 Asian 3 No No Pulmonary No 166 Mouth ulcers 6 Asian 24 No No Pulmonary Smear positive, sensitive 100 Malaise, weight loss 7 Asian 16 No No Pulmonary Smear positive, MDR 2 Haemoptysis 8 Black African 30 No No Pulmonary Smear negative, sensitive 184 Cough, diagnosed as LRTI 9 Black African 22 No No Pulmonary No 12 Foreign body in ear 10 Asian 40 No No Pulmonary and psoas abscess No 82 Cough *HIV infection only diagnosed after admission to hospital.