Smear microscopy to diagnose tuberculosis early and prevent further transmission in a population with a high prevalence of HIV infection.

In western Europe, Portugal has the highest incidence of tuberculosis (TB). The quickest way to diagnose TB is with a positive smear. To evaluate the usefulness of smear microscopy in a population with a high HIV seroprevalence, TB patients admitted during the year 2000 were retrospectively analyzed. Of the 74 TB patients admitted, 45 (61%) had pulmonary TB, 11 having multiresistant (MR)-TB. Considering that only half of the patients with pulmonary TB had a positive smear, a high degree of clinical suspicion is of great importance. Appropriate isolation facilities for TB are much needed, in order to prevent nosocomial TB spread.