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Children with symptoms of pulmonary tuberculosis are often diagnosed on the basis of clinical findings, sputum smear microscopy and the Mantoux test. This study was designed to compare the sensitivity of sputum microscopy, sputum culture and the Mantoux test in the diagnosis of pulmonary tuberculosis in children. We evaluated 310 patients with suspected pulmonary tuberculosis at a government referral hospital in a rural setting in central India. A Mantoux test with 2 tuberculin units of PPD RT23 was performed in all patients. Sputum was collected and examined using the Löwenstein-Jensen method. Sputum cultures were performed on Lowenstein-Jensen medium as well as on Middlebrook 7H10 (7H10) and Mycobacterium growth indicator tube (MGIT) liquid medium. Sputum for microscopy and culture was collected from 245 patients and for the Mantoux test, from 313. Of the patients, 46 (17.2%) had culture-proven tuberculosis, of whom 37 (80.4%) had smear-positive sputum. Of the 178 patients with negative sputum culture results, 65 (36.5%) had smear-positive sputum; of these, 67.7% were given a provisional diagnosis of tuberculosis. Thus, the sensitivity of a positive


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