Tuberculosis.

Pillay, Timesh; Kon, Onn Min; Lalvani, Ajit · Ann Intern Med · 2026

Level V

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Abstract

Tuberculosis (TB) is the leading cause of infection-related mortality in the world, and cases in the United States are increasing. Prompt diagnosis, isolation, and treatment improve patient outcomes and reduce onward transmission. Screening of contacts and high-risk persons for asymptomatic TB infection and treatment of those testing positive reduces progression to disease. TB disease should be suspected in persons with compatible symptoms, risk factors, and consistent imaging. Microbiological confirmation requires an acid-fast smear, nucleic acid amplification test, and culture. Treatment, guided by drug sensitivity testing, requires multiple antibiotics given for 4 to 9 months and monitoring for drug toxicity and clinical response.