Does Your Patient Have Latent TB Infection? Test Your Knowledge

Jonathan M. Wortham, MD; Annie Rossetti, MPH


February 12, 2021

Editorial Collaboration

Medscape &

More than 80% of tuberculosis (TB) cases in the United States are a result of untreated latent TB infection that progresses to TB disease. The Centers for Disease Control and Prevention (CDC) estimates that up to 13 million people in the United States have latent TB infection. These people are infected with Mycobacterium tuberculosis but do not have TB disease, have neither signs nor symptoms of TB disease, and cannot spread M tuberculosis to others. However, about 5%-10% of infected people will develop TB disease over their lifetime if not treated for latent TB infection.

Healthcare providers can accelerate progress toward TB elimination by identifying and treating people with latent infection, thereby preventing TB disease.Challenge yourself with the following hypothetical case that illustrates key latent TB infection testing and treatment scenarios. Would you know what to do?

Identifying Patients at Risk for TB Disease

A 45-year-old woman presents to her primary care provider for her annual visit. She has type 2 diabetes, which is well controlled by diet, exercise, and daily metformin. Her most recent A1c was 6.5%. She was born in the Philippines and immigrated to the United States 11 years ago.