This manual describes policies, procedures and guidelines for diagnosis and treatment of tuberculosis inOrange County, California. This is the result of work by Orange County Health Care Agency DiseaseControl, Mitchel Abramsky, MD, Bisher Akil, MD, Kay Malkasian, MD, Frank Webster, MD and PennyWeismuller, DrPH. In preparing this manual, we used sample protocols from New York City, San Francisco and Los Angeles.We updated our previous manual, and expanded the section on tuberculosis in HIV infection. We wereassisted by the Centers for Disease Control and Public Health Services guidelines. Treatment for tuberculosis continues to evolve, and opinions differ regarding many issues in thetreatment. These guidelines are not meant to substitute for sound medical judgement. The treatingphysicians and clinicians are encouraged to seek consultation at all times.