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Chapter 2 : Overview of Clinical Tuberculosis

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Overview of Clinical Tuberculosis, Page 1 of 2

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Abstract:

The clinical expression of infection with is quite varied and depends on a number of identified factors. The most obvious and important factor influencing the clinical features of tuberculosis is the site of involvement. Tuberculosis occurring at any site may cause symptoms and findings that are not related specifically to the organ or tissue involved but, rather, are systemic in nature or are remote from the site of disease. Weight loss, weakness, and malaise appear to be less common but are more difficult to quantify. Tuberculosis that occurs relatively early in the course of HIV infection tends to have the typical radiographic findings described. Because of the frequency of extrapulmonary tuberculosis among HIV-infected patients, diagnostic specimens from any suspected site of disease should be examined for mycobacteria. Prior to the HIV epidemic, lymph node tuberculosis made up approximately 20% of the cases of extrapulmonary tuberculosis in the United States. The diagnosis of pleural tuberculosis is generally established by analysis of pleural fluid and/or by pleural biopsy. The incidence of tuberculosis involving the joints and bones increases with increasing age and is equally frequent in men and women, making up approximately 9% of cases of extrapulmonary tuberculosis overall. Meningitis is the most frequent form of central nervous system tuberculosis; solitary or multiple tuberculomas occur less commonly. The chest pain occasionally mimics angina but usually is described as being dull, aching, and often affected by position and by inspiration.

Citation: Hopewell P, Jasmer R. 2005. Overview of Clinical Tuberculosis, p 15-31. In Cole S, Eisenach K, McMurray D, Jacobs, Jr. W (ed), Tuberculosis and the Tubercle Bacillus. ASM Press, Washington, DC. doi: 10.1128/9781555817657.ch2

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Figures

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Figure 1

Distribution of sites of involvement in newly reported cases of tuberculosis in 1978 prior to the epidemic of infection with HIV

Citation: Hopewell P, Jasmer R. 2005. Overview of Clinical Tuberculosis, p 15-31. In Cole S, Eisenach K, McMurray D, Jacobs, Jr. W (ed), Tuberculosis and the Tubercle Bacillus. ASM Press, Washington, DC. doi: 10.1128/9781555817657.ch2
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Figure 2

Frontal view chest radiograph showing extensive tuberculosis causing respiratory failure.

Citation: Hopewell P, Jasmer R. 2005. Overview of Clinical Tuberculosis, p 15-31. In Cole S, Eisenach K, McMurray D, Jacobs, Jr. W (ed), Tuberculosis and the Tubercle Bacillus. ASM Press, Washington, DC. doi: 10.1128/9781555817657.ch2
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Figure 3

Frontal view chest radiograph showing right paratracheal adenopathy as a manifestation of recently acquired tuberculous infection.

Citation: Hopewell P, Jasmer R. 2005. Overview of Clinical Tuberculosis, p 15-31. In Cole S, Eisenach K, McMurray D, Jacobs, Jr. W (ed), Tuberculosis and the Tubercle Bacillus. ASM Press, Washington, DC. doi: 10.1128/9781555817657.ch2
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Figure 4

Frontal view chest radiograph showing the typical findings of endogenous reactivation tuberculosis in an immunocompetent patient. Note the upper lobe location and cavitation.

Citation: Hopewell P, Jasmer R. 2005. Overview of Clinical Tuberculosis, p 15-31. In Cole S, Eisenach K, McMurray D, Jacobs, Jr. W (ed), Tuberculosis and the Tubercle Bacillus. ASM Press, Washington, DC. doi: 10.1128/9781555817657.ch2
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Figure 5

Portion of chest radiograph showing nodular lesions in a patient with disseminated tuberculosis.

Citation: Hopewell P, Jasmer R. 2005. Overview of Clinical Tuberculosis, p 15-31. In Cole S, Eisenach K, McMurray D, Jacobs, Jr. W (ed), Tuberculosis and the Tubercle Bacillus. ASM Press, Washington, DC. doi: 10.1128/9781555817657.ch2
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Image of Figure 6
Figure 6

Frontal view chest radiograph showing diffuse infiltration caused by in a patient with HIV infection.

Citation: Hopewell P, Jasmer R. 2005. Overview of Clinical Tuberculosis, p 15-31. In Cole S, Eisenach K, McMurray D, Jacobs, Jr. W (ed), Tuberculosis and the Tubercle Bacillus. ASM Press, Washington, DC. doi: 10.1128/9781555817657.ch2
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Figure 7

Age-specific case rates for the most frequent forms of extrapulmonary tuberculosis.

Citation: Hopewell P, Jasmer R. 2005. Overview of Clinical Tuberculosis, p 15-31. In Cole S, Eisenach K, McMurray D, Jacobs, Jr. W (ed), Tuberculosis and the Tubercle Bacillus. ASM Press, Washington, DC. doi: 10.1128/9781555817657.ch2
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Figure 8

Computed tomographic scan of the chest showing a tuberculosis empyema with adjacent chest wall involvement (A) and a large chest wall abscess overlying the sternum with mediastinal involvement (B).

Citation: Hopewell P, Jasmer R. 2005. Overview of Clinical Tuberculosis, p 15-31. In Cole S, Eisenach K, McMurray D, Jacobs, Jr. W (ed), Tuberculosis and the Tubercle Bacillus. ASM Press, Washington, DC. doi: 10.1128/9781555817657.ch2
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References

/content/book/10.1128/9781555817657.chap2
1. Allen, S.,, J. Batungwanayo,, K. Kerlikowske,, A. R. Lifson,, W. Wolf,, R. Granich,, H. Taelman,, P. Van De Perre,, A. Serufilira,, J. Bogaerts,, G. Slutkin,, and P. C. Hopewell. 1992. Prevalence of tuberculosis in HIV-infected urban Rwandan women. Am. Rev. Respir. Dis. 146:14391444.
2. Alvarez, S.,, and W. R. McCabe. 1984. Extrapulmonary tuberculosis revisited: a review of experience at Boston City and other hospitals. Medicine 63:2555.
3. Arango, L.,, A. W. Brewin,, and J. F. Murray. 1978. The spectrum of tuberculosis as currently seen in a metropolitan hospital. Am. Rev. Respir. Dis. 108:805812.
4. Auerbach, O. 1951. Tuberculous meningitis: correlation of therapeutic results with the pathogenesis and pathologic changes. II. Pathologic changes in untreated and treated cases. Am. Rev. Tuberc. 64:419429.
5. Barrett-Connor, E. 1967. Tuberculous meningitis in adults. South. Med. J. 60:10611067.
6. Bergen, H. W.,, and E. Mejia. 1973. Tuberculous pleurisy. Chest 63:8892.
7. Berney, S.,, M. Goldstein,, and F. Bishko. 1972. Clinical and diagnostic features of tuberculous arthritis. Am. J. Med. 53: 3642.
8. Bhansali, S. K. 1977. Abdominal tuberculosis: experiences with 300 cases. Am. J. Gastroenterol. 67:324337.
9. Bishberg, E.,, G. Sunderam,, L. B. Reichman,, and R. Kapila. 1986. Central nervous system tuberculosis with the acquired immunodeficiency syndrome and its related complex. Ann. Intern. Med. 105:210213.
10. Borhanmanesh, F.,, K. Hekmat,, K. Vaezzadeh,, and H. R. Rezai. 1972. Tuberculous peritonitis: prospective study of 32 cases in Iran. Ann. Intern. Med. 76:567572.
11. Burack, W. R.,, and R. M. Hollister. 1960. Tuberculous peritonitis: a study of forty-seven proved cases encountered by a general medical unit in twenty-five years. Am. J. Med. 28:510523.
12. Burk, J. R.,, J. Viroslav,, and L. J. Bynum. 1978. Miliary tuberculosis diagnosed by fiberoptic bronchoscopy and transbronchial biopsy. Tubercle 59:107108.
13. Burke, H. E. 1950. The pathogenesis of certain forms of extrapulmonary tuberculosis. Am. Rev. Tuberc. 62:4867.
14. Cameron, S. J. 1974. Tuberculosis and the blood. Tubercle 55:5572.
15.Centers for Disease Control and Prevention. 1998. Prevention and treatment of tuberculosis among patients infected with human immunodeficiency virus: principles of therapy and revised recommendations. Morb. Mortal. Wkly. Rep . 47(RR-20):158.
16.Centers for Disease Control and Prevention. 2000. Update. Nucleic acid amplification tests for tuberculosis. Morb. Mortal. Wkly. Rep. 49:593594.
17. Chaisson, R. E.,, G. F. Schecter,, C. P. Theuer,, G. W. Rutherford,, D. F. Echenberg,, and P. C. Hopewell. 1987. Tuberculosis in patients with the acquired immunodeficiency syndrome: clinical features, response to therapy and survival. Am. Rev. Respir. Dis. 136:570574.
18. Christensen, W. I. 1974. Genitourinary tuberculosis: review of 102 cases. Medicine 53:377390.
19. Chung, D.-K.,, and W. W. Hubbard. 1969. Hyponatremia in untreated active pulmonary tuberculosis. Am. Rev. Respir. Dis. 99:595597.
20. Comstock, G. W. 1982. Epidemiology of tuberculosis. Am. Rev. Respir. Dis. 125 (Suppl.):816.
21. Cremin, B. J.,, R. M. Fisher,, and M. W. Levinsohn. 1970. Multiple bone tuberculosis in the young. Br. J. Radiol. 43:638645.
22. Daley, C. L.,, P. M. Small,, and G. F. Schecter. 1992. An outbreak of tuberculosis with accelerated progression among persons infected with the human immunodeficiency virus. An analysis using restriction fragment length polymorphisms. N. Engl. J. Med. 326:23312335.
23. Damergis, J. A.,, E. Lefterich,, and J. A. Cumin. 1979. Tuberculoma of the brain. JAMA 239:413415.
24. Danek, S. J.,, and J. S. Bower. 1979. Diagnosis of pulmonary tuberculosis by flexible fiberoptic bronchoscopy. Am. Rev. Respir. Dis. 119:677679.
25. Ellner, J. J. 1978. Pleural fluid and peripheral blood lymphocyte function in tuberculosis. Ann. Intern. Med. 89:932933.
26. Ernst, J. D. 1998. Macrophage receptors for Mycobacterium tuberculosis. Infect. Immun. 66:12771281.
27. Ewer, K.,, J. Deeks,, L. Alvarez,, G. Bryant,, S. Waller,, P. Andersen,, P. Monk,, and A. Lalvani. 2003. Comparison of T-cell based assay with tuberculin skin test for diagnosis of Mycobacterium tuberculosis infection in a school tuberculosis outbreak. Lancet 361:11681173.
28. Farer, L. S.,, L. M. Lowell,, and M. P. Meador. 1979. Extrapulmonary tuberculosis in the United States. Am. J. Epidemiol. 109:205217.
29. Frank, B. R.,, and E. C. Raffensperger. 1965. Hepatic granulomata: report of a case with jaundice improving on antituberculous chemotherapy and review of the literature. Arch. Intern. Med. 115:223233.
30. Gooi, H. C.,, and J. M. Smith. 1978. Tuberculous pericarditis in Birmingham. Thorax 33:9496.
31. Gordin, F. M.,, G. Stutkin,, G. F. Schecter,, P. C. Goodman,, and P. C. Hopewell. 1989. Presumptive diagnosis and treatment of pulmonary tuberculosis based on radiographic findings. Am. Rev. Respir. Dis. 139:10901093.
32. Grieco, M. H.,, and H. Chmel. 1974. Acute disseminated tuberculosis as a diagnostic problem: a clinical study based on twenty-eight cases. Am. Rev. Respir. Dis. 109:554560.
33. Hageman, J. H.,, N. D. D’Esopo,, and W. W. L. Glenn. 1964. Tuberculosis of the pericardium: a long-term analysis of fortyfour proved cases. N. Engl. J. Med. 270:327332.
34. Handwerger, S.,, D. Mildvan,, R. Sennie,, and F. W. McKinley. 1987. Tuberculosis and the acquired immunodeficiency syndrome at a New York City hospital: 1978-1985. Chest 91:176180.
35. Harvey, A. M.,, and M. R. Whitehill. 1937. Tuberculous pericarditis. Medicine 16:4594.
36. Havlir, D.V.,, and P. F. Barnes. 1999. Tuberculosis in patients with human immunodeficiency virus infection. N. Engl. J. Med. 340:367373.
37. Holden, M.,, M. R. Dubin,, and P. H. Diamond. 1971. Frequency of negative intermediate-strength tuberculin sensitivity in patients with active tuberculosis. N. Engl. J. Med. 285: 15061509.
38. Huhti, E.,, E. Brander,, and S. Plohumo. 1975. Tuberculosis of the cervical lymph nodes: a clinical, pathological and bacteriological study. Tubercle 56:2736.
39. Huseby, J. S.,, and L. D. Hudson. 1976. Miliary tuberculosis and the adult respiratory distress syndrome. Ann. Intern. Med. 85:609611.
40. Jasmer, R. M.,, P. Nahid,, and P. C. Hopewell. 2002. Latent tuberculosis infection. N. Engl. J. Med. 347:18601866.
41. Jay, S. J. 1985. Diagnostic procedures for pleural disease. Clin. Chest. Med. 6:3348.
42. Johnson, T. M.,, W. McCann,, and W. H. Davey. 1973. Tuberculous bronchopleural fistula. Am. Rev. Respir. Dis. 107: 3041.
43. Kent, D. C. 1967. Tuberculous lymphadenitis: not a localized disease process. Am. J. Med. Sci. 254:866874.
44. Kiblawi, S. S. O.,, S. J. Jay,, R. B. Stonehill,, and J. Norton. 1981. Fever response of patients on therapy for pulmonary tuberculosis. Am. Rev. Respir. Dis. 123:2024.
45. Kim, J. H.,, A. A. Langston,, and H. A. Gallis. 1990. Miliary tuberculosis: epidemiology, clinical manifestations, diagnosis, and outcome. Rev. Infect. Dis. 12:583590.
46. Kirsch, C M.,, M. Kroe,, R. Azzi,, W. A. Jensen,, F. T. Kagawa,, and J. H. Wehner. 1997. The optimal number of pleural biopsy specimens for a diagnosis of tuberculous pleurisy. Chest 112:702706.
47. Kramer, F.,, T. Modelewsky,, A. R. Walinay,, J. M. Leedom,, and P. F. Barnes. 1990. Delayed diagnosis of tuberculosis in patients with human immunodeficiency virus infection. Am. J. Med. 89:451456.
48. Kubica, G. P.,, W. M. Gross,, J. E. Hawkins,, H. M. Sommers,, A. L. Vestal,, and L. G. Wayne. 1975. Laboratory services for mycobacterial diseases. Am. Rev. Respir. Dis. 112:773787.
49. Lattimer, J. K. 1965. Renal tuberculosis. N. Engl. J. Med. 273:208211.
50. Levine, H.,, W. Metzger,, and D. Lacera. 1970. Diagnosis of tuberculous pleurisy by culture of pleural biopsy specimen. Arch. Intern. Med. 126:268271.
51. Maartens, G.,, P. A. Wilcox,, and S. R. Benatar. 1990. Miliary tuberculosis: rapid diagnosis, hematologic abnormalities, and outcome in 109 treated adults. Am. J. Med. 89:291296.
52. Marchevsky, A.,, M. J. Rosen,, G. Chrystal,, and J. Kleinerman. 1985. Pulmonary complications of the acquired immunodeficiency syndrome: a clinicopathologic study of 70 cases. Hum. Pathol. 16:659670.
53. Markowitz, N.,, N. I. Hansen,, P. C. Hopewell,, J. Glassroth,, P. A. Kvale,, B. T. Mangura,, T. C. Wilcosky,, J. M. Wallace,, M. J. Rosen,, L. B. Reichman, and The Pulmonary Complications of HIV Infection Study Group. 1997. Incidence of tuberculosis in the United States among HIV-infected persons. Ann. Intern. Med. 126:123132.
54. Massaro, D.,, S. Katz,, and M. Sachs. 1964. Choroidal tubercles: a clue to hematogenous tuberculosis. Ann. Intern. Med. 60:231241
55. Mazurek, G. H.,, P. A. LoBue,, C. L. Daley,, J. Bernardo,, A. A. Lardizabal,, W. R. Bishai,, M. F. Iademarco,, and J. S. Rothel. 2001. Comparison of a whole-blood interferon-gamma assay with tuberculin skin testing for detecting latent Mycobacterium tuberculosis infection. JAMA 286:17401747.
56. Mazurek, G. H.,, and M. E. Villarino. 2003. Guidelines for using the QuantiFERON®-TB test for diagnosing latent tuberculosis infection. Morb. Mortal. Wkly. Rep. 51(RR02):1518.
57. McTammany, J. R.,, K. M. Moser,, and V. N. Houk. 1963. Disseminated bone tuberculosis: review of the literature and presentation of an unusual case. Am. Rev. Respir. Dis. 87:889895.
58. Mitchell, R. S.,, and L. J. Bristol. 1954. Intestinal tuberculosis: an analysis of 346 cases diagnosed by routine intestinal radiography on 5529 admissions for pulmonary tuberculosis, 1924-1949. Am. J. Med. Sci. 227:241249.
59. Munt, P. W. 1971. Miliary tuberculosis in the chemotherapy era with a clinical review in 69 American adults. Medicine 51:139155.
60. Murray, H. W.,, C. U. Tuazon,, N. Kirmani,, and J. H. Sheagren. 1978. The adult respiratory distress syndrome associated with miliary tuberculosis. Chest 73:373.
61. Nash, D.-R.,, and J. E. Douglas. 1980. Anergy in active pulmonary tuberculosis: a comparison between positive and negative reactors and an evaluation of 5 TU and 250 TU skin test doses. Chest 77:32.
62. Orme, I. M.,, and A. M. Cooper. 1999. Cytokine/chemokine cascades in immunity to tuberculosis. Immunol. Today 20:307312
63. Pitchenik, A. E.,, and H. A. Rubinson. 1985. The radiographic appearance of tuberculosis in patients with the acquired immune deficiency syndrome (AIDS) and pre-AIDS. Am. Rev. Respir. Dis. 131:393396.
64. Prout, S.,, and S. R. Benatar. 1980. Disseminated tuberculosis: a study of 62 cases. S. Afr. Med. J. 58:835842.
65. Reider, H. L.,, G. M. Cauthen,, A. B. Bloch,, C. H. Cole,, D. Holtzman,, D. E. Snider, Jr.,, W. J. Bigler,, and J. J Witte. 1989. Tuberculosis and the acquired immunodeficiency syndrome— Florida. Arch. Intern. Med. 149:12681273.
66. Rooney, J. J.,, J. A. Crocco,, and H. A. Lyons. 1970. Tuberculous pericarditis. Ann. Intern. Med. 72:7381.
67. Sahn, S. A.,, and T. A. Neff. 1974. Miliary tuberculosis. Am. J. Med. 56:495505.
68. Scharer, L.,, and J. H. McClement. 1968. Isolation of tubercle bacilli from needle biopsy specimens of parietal pleura. Am. Rev. Respir. Dis. 97:466468.
69. Schepers, G. W. H. 1962. Tuberculous pericarditis. Am. J. Cardiol. 9:248276.
70. Selwyn, P. A.,, B. M. Sckell,, P. Alcabes,, G. H. Friedland,, R. S. Klein,, and E. E. Schoenbaum. 1992. High risk of active tuberculosis in HIV-infected drug users with cutaneous anergy. JAMA 268:504509.
71. Shafer, R. W.,, R. Goldberg,, M. Sierra,, and A. E. Glatt. 1989. Frequency of Mycobacterium tuberculosis bacteremia in patients with tuberculosis in an area endemic for AIDS. Am. Rev. Respir. Dis. 140:16111613.
72. Shankar P.,, N. Manjunath,, K. K. Mohan,, K. Prasad,, M. Behari,, Shriniwas,, and G. K. Ahuja. 1991. Rapid diagnosis of tuberculous meningitis by polymerase chain reaction. Lancet 337:57.
73. Simon, H. B.,, A. J. Weinstein,, M. S. Pasternak,, M. N. Swartz,, and L. J. Lunz. 1977. Genitourinary tuberculosis: clinical features in a general hospital. Am. J. Med. 63:410420.
74. Singh, M. M.,, A. M. Bhargova,, and K. P. Jain. 1968. Tuberculous peritonitis: an evaluation of pathogenetic mechanisms, diagnostic procedures and therapeutic measures. N. Engl. J. Med. 281:10911094.
75. Slavin, R. E.,, T. J. Walsh,, and A. D. Pollack. 1980. Late generalized tuberculosis: a clinical pathologic analysis of 100 cases in the preantibiotic and antibiotic eras. Medicine 59: 352366.
76. Small, P. M.,, G. F. Schecter,, P. C. Goodman,, M. A. Sande,, R. E. Chaisson,, and P. C. Hopewell. 1991. Treatment of tuberculosis in patients with advanced human immunodeficiency virus infection. N. Engl. J. Med. 324:289294.
77. So, S. Y.,, W. K. Lam,, and D. Y. C. Yu. 1982. Rapid diagnosis of suspected pulmonary tuberculosis by fiberoptic bronchoscopy. Tubercle 63:195200.
78. Stead, W. W.,, A. Eichenholtz,, and H. K. Strauss. 1955. Operative and pathologic findings in 24 patients with the syndrome of idiopathic pleurisy with effusion presumably tuberculous. Am. Rev. Respir. Dis. 71:473502.
79. Takashima, T.,, C. Ueta,, I. Tsuyuguchi,, and S. Kishimoto. 1990. Production of tumor necrosis factor alpha by monocytes from patients with pulmonary tuberculosis. Infect. Immun. 58:32863292.
80. Valone, S. E.,, E. Rich,, R. S. Wallis,, and J. J. Ellner. 1988. Expression of tumor necrosis factor in vitro by human mononuclear phagocytes stimulated with whole Mycobacterium tuberculosis, BCG, and mycobacterial antigens. Infect. Immun. 56:33133315.
81. Valway, S. E.,, M. P. C. Sanchez,, T. F. Shinnick,, I. Orme,, T. Agerton,, D. Hoy,, J. S. Jones,, H. Westmoreland,, and I. M. Onorato. 1998. An outbreak involving extensive transmission of a virulent strain of Mycobacterium tuberculosis. N. Engl. J. Med. 338:633639.
82. Vorken, H.,, S. G. Massy,, R. Fallat,, L. Kaplan,, and C. R. Kleeman. 1970. Antidiuretic principle in tuberculous lung tissue of a patient with pulmonary tuberculosis and hyponatremia. Ann. Intern. Med. 72:383387.
83. Weir, M. R.,, and G. F. Thornton. 1985. Extrapulmonary tuberculosis: experience of a community hospital and review of the literature. Am. J. Med. 79:467478.
84. Weiss, W.,, and H. F. Flippin. 1961. The prognosis of tuberculous meningitis in the isoniazid era. Am. J. Med. 242:423430.

Tables

Generic image for table
Table 1

Factors influencing the clinical features of tuberculosis

Citation: Hopewell P, Jasmer R. 2005. Overview of Clinical Tuberculosis, p 15-31. In Cole S, Eisenach K, McMurray D, Jacobs, Jr. W (ed), Tuberculosis and the Tubercle Bacillus. ASM Press, Washington, DC. doi: 10.1128/9781555817657.ch2
Generic image for table
Table 2

Recovery of from various sites in patients with tuberculosis and HIV infection

Citation: Hopewell P, Jasmer R. 2005. Overview of Clinical Tuberculosis, p 15-31. In Cole S, Eisenach K, McMurray D, Jacobs, Jr. W (ed), Tuberculosis and the Tubercle Bacillus. ASM Press, Washington, DC. doi: 10.1128/9781555817657.ch2

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