title: Tuberculosis: a missed opportunity for early diagnosis at the front line?
abstract: BACKGROUND
  The incidence of tuberculosis (TB) has increased over the last two decades. Many patients with TB preferentially access healthcare via the emergency department (ED) prediagnosis, presenting an early opportunity for diagnosis.
  
  
  METHODS
  We looked at the number of patients who presented to ED in the 3 months prior to TB notification, and their outcomes.
  
  
  RESULTS
  42% of all notifications had accessed ED prior to notification. The majority were hospitalised, with a proportion of these patients previously attending ED only to be discharged. 37% of patients were discharged from ED with many having TB symptoms, and only a minority referred onto TB clinic.
  
  
  CONCLUSIONS
  The ED is often the first contact that urban TB patients have with healthcare. Healthcare professionals should ensure this diagnosis is not missed in high incidence areas as it has significant clinical and infection control consequences.
authors.affiliation: Newham University Hospital, Bart's NHS Trust, London, UK.
authors.forename: Tanuj S
authors.initials: TS
authors.lastname: Lad
authors.affiliation: Newham University Hospital, Bart's NHS Trust, London, UK.
authors.forename: Geoffrey E
authors.initials: GE
authors.lastname: Packe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D042241:Early Diagnosis; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D015994:Incidence; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology
keywords: emergency department; infectious diseases, bacterial; respiratory