Tuberculosis (TB) is one opportunistic infection often seen in HIV individuals. In 2013,
there were an estimated 31,800 HIV-TB co-infection cases and 6,100 HIV-related deaths due to
TB in the Americas. Due to the non-specific nature of its clinical symptoms, TB can be
confused with various diseases such as histoplasmosis, sarcoidosis, lymphoma, and pneumonia.
In Panama, where Histoplasma capsulatum is endemic, diagnosing TB versus histoplasmosis based
on clinical symptoms can be difficult. In Panama, approximately 7.65% of HIV patients are
co-infected with histoplasmosis, and there is a 30% mortality rate in HIV-histoplasmosis
patients in Latin America. Due to similar clinical features, misdiagnosis of active TB and
disseminated histoplasmosis in endemic regions may lead to incorrect antibiotic management,
which in turn results in unnecessary toxicity, antibiotic resistance, and monetary
expenditures. The investigators interests lie in increasing TB diagnostic accuracy using a
simple urine dipstick test and evaluating physician response to new diagnostic testing, in
order to reduce misdiagnosis and improve health outcomes in the HIV population.