Diagnosing TB
While not wishing to diminish Professor Partridge's argument that respiratory medicine needs a higher profile, there are some notable disparities between disease profiles within respiratory medicine.1 The year 2001 saw a remarkable number of outbreaks of tuberculosis including the largest since chemotherapy became available.2 In at least two of these outbreaks the doctor attending the index patient diagnosed asthma not tuberculosis for several months.3 Part of the reason is that “Doctors don't think of tuberculosis because there isn't a (pharmaceutical) company producing goods saying `think of TB'”.4
There is a point of view which would wish to move tuberculosis into the province of infectious disease. Yet chest physicians manage 85% of cases and, as the most common symptom of tuberculosis is a cough, it is likely that this will remain so.5
As chest physicians we have a duty to all respiratory patients, not just those who happen to have a pharmaceutically fashionable disease.
