Challenges in assessing transmission of Mycobacterium tuberculosis in long-term-care facilities

• We describe a case study of a TB outbreak in a long term care facility.
• TB in long term care facilities poses several diagnostic and treatment challenges.
• We highlight areas for improved TB prevention and control in this setting.
• TB must be considered in the differential diagnosis of ill LTCF residents.
• Continued strengthening of TB surveillance programs is essential.