Diagnosis and management of severe pulmonary and extrapulmonary tuberculosis in critically ill patients: A mini review for clinicians

Table 3 Methods of collection and processing of non-sputum samples for diagnosis of tuberculosis[42]

Specimen	Amount	Preservation	Comment
Biopsy of specimen (e.g., lymph nodes, peritoneal biopsies)	2 separate portions	In 0.9% NaCl for microbiological examination	N/A
		In formalin for histopathological examination
Pleural effusion/ascites	At least 20 mL	Unprocessed	ELISPOT should be performed on the same day of sample collection
CSF	2-3 mL	Unprocessed	ELISPOT should be performed on the same day of sample collection
Urine	30 mL	Unprocessed	3x specimen. First specimen of urine in the morning with fluid restriction the evening/night before
Stool	5-10 mL	Unprocessed	3x specimen
Blood	5-10 mL	Heparin- or lithium-citrated tubes	Only in immunosuppressed patients
			Not in EDTA blood
Bone marrow	2 separate portions	In heparin- or lithium-citrated tubes	Only in immunosuppressed patients
		Air-dried smears and/or formalin preserved biopsies
			Not in EDTA blood

EDTA: Ethylenediaminetetraacetic acid, used in the prevention of blood clotting through calcium chelation; ELISPOT: Enzyme-linked immunosorbent spot assay used in detection for tuberculosis; N/A: Not applicable.