BACKGROUND:Methods for detection and drug susceptibility of tuberculosis (TB) with solid media are inexpensive but slow and laborious. Rapid methods to diagnose TB and multidrug-resistant TB (MDR-TB) are a global priority for TB control.OBJECTIVES:A study was performed to compare the sensitivity of detection of mycobacterial growth and time of culture positivity by microscopic observation of drug susceptibility (MODS) assay with that of Lowenstein–Jensen (LJ) culture in pulmonary and extrapulmonary TB and to evaluate the concordance of the susceptibilities to isoniazid (INH) and rifampicin (RIF) by MODS and proportion method on LJ.MATERIALS AND METHODS:A prospective, laboratory-based study was conducted on a total of 300 samples from suspected cases of pulmonary and extrapulmonary TB. Samples were inoculated on LJ medium as per the standard guidelines and MODS assay was performed.RESULTS:Sensitivity of MODS assay was 80% and 83.3% and specificity was 92.9% and 83.3% for pulmonary and extrapulmonary samples, respectively. Difference between mean time to detection of Mycobacterium TB (MTB) by LJ medium and MODS was statistically significant, with MODS being faster. drug susceptibility testing (DST) by MODS when compared to economic variant of proportion method was 87.87% for RIF, 90.9% for INH, and 96.96% for MDR-TB detection.CONCLUSION:MODS assay provides rapid, safe, and sensitive detection of TB faster than the existing gold standard. It is extremely promising in effectively diagnosing MDR-TB.

Tuberculosis is considered as a 're emerging disease', because of its resurgence and increased incidence in the 21 st century particularly in immuno-compromised patients. About one fifth of diagnosed new cases of tuberculosis have an extrapulmonary lesion, of which about one-tenth involve the musculoskeletal system. Tuberculosis involving the soft tissue from adjacent bone or joint is well recognized but cutaneous tuberculous infection is rare, accounting for 0.1% of all cases seen in a dermatology service. We report a case of primary cutaneous tuberculosis of forearm following a vehicular accident in a young immunocompetent female.