“…Most, but not all 28,29 , of the studies that investigate Ultra for the diagnosis of EPTB suggest increased sensitivity of Ultra compared to Xpert in different extrapulmonary specimens 11,14,15,17,[19][20][21][22][23]25 . When culture is used as reference standard, the reported sensitivity of Ultra varies, but is generally high in lymph node specimens (90-94%) 18,24 , FNAs and tissue samples (87-95%) 18,22 , cerebrospinal fluid (80-100%) 17,18,21,25,29 and pus specimens (65-95%) 18,19 , and lower in pleural fluid samples (48-84%) 18,20,22,23 , which is in line with our findings. Several of the studies also show that Ultra can detect MTC in culture negative specimens from clinically diagnosed TB cases 17,[19][20][21][22][23][24][25]28,29 , thus, contributing to improved diagnosis of TB in samples with a very low bacillary load.…”