Pulmonary TB refers to any bacteriologically-confirmed or clinically-diagnosed case of TB that involves the lung parenchyma or the tracheobronchial tree based on the revised previous standard case definitions for TB by the World Health Organization (WHO) in 2013 8. The diagnosis of TB is suspected from a combination of context, symptoms, clinical signs and investigations. Recently, non-molecular and molecular assays have been developed for early detection of active TB with or without drug resistance detection. Although sputum smear microscopy is a rapid, simple, and inexpensive tool for diagnosing pulmonary TB, it has low and variable sensitivity 3. However, mycobacterial culture, which has the highest sensitivity for diagnosing and confirming active TB, requires 2 to 6 weeks for interpretation 3. Therefore, an acid-fast bacilli (AFB) smear and bacteriological culture tests should be performed for patients with symptoms that are compatible with or suggestive of TB. As a result, it is not unusual for clinicians to prescribe a number of courses of antibiotics for pneumonia before the pulmonary TB is correctly diagnosed 6, 7. Moreover, TB can present with symptoms and atypical radiologic findings that are indistinguishable from those of community-acquired pneumonia 4, 5. Chest X-ray is useful but is not specific for diagnosing pulmonary TB. Prompt diagnosis of active pulmonary TB is a priority for TB control, both for treating the individual and for public health intervention to reduce further spread in the community 3. In clinical practice, rapid TB diagnosis can be difficult, and early pulmonary TB detection continues to be challenging for clinicians. Tuberculosis (TB) is a global health concern for both developing and developed countries and has recently become more complex due to persistence in aging populations and the rise of drug-resistant strains, even in Korea 1, 2.
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