Current concepts in the management and prevention of tuberculosis in adults.

After a steady decline in incidence during most of this century, tuberculosis case rates stabilized in the mid-1980s, and since then have steadily increased. Several factors may have been responsible for the increase, including the influx of immigrants from endemic areas and the appearance of AIDS. This review outlines the current recommendations for treatment of tuberculosis in the otherwise normal patient, then discusses special problems which may affect treatment, including primary drug failure and relapse, pregnancy and lactation, extrapulmonary disease, AIDS, renal failure, and liver disease. The appearance and significance of multiple-drug-resistant tuberculosis (MDRT) in AIDS victims is discussed, and current recommendations for screening patients for the presence of tuberculosis are reviewed.