How to test for tuberculosis

Written by Wang Xiang Yu
Pulmonology
Updated on March 09, 2025
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To examine pulmonary tuberculosis, it is essential to understand that it pertains to tuberculosis changes in the lung tissue, airways, bronchi, and pleura. The pathogen causing tuberculosis is Mycobacterium tuberculosis, also known as the tubercle bacillus. There are multiple tests available for people with pulmonary tuberculosis, as the disease can vary based on location and type. Therefore, such patients generally require numerous tests.

The most commonly used are imaging studies for the chest, including X-rays and CT scans. In imaging studies, most patients will show some lesions, but there are instances where tuberculosis in the airways and bronchi might not be clearly visible on CT or X-rays, necessitating more invasive tests like bronchoscopy. Additionally, bacteriological examinations, such as sputum smear and pleural fluid smear, as well as culture for Mycobacterium tuberculosis, are typically conducted for patients.

Nowadays, hospitals equipped with the necessary facilities conduct molecular biological tests, namely nucleic acid testing for Mycobacterium tuberculosis DNA. Furthermore, some patients with complex conditions may require a histopathological biopsy, commonly referred to as tissue sampling, at the site of the lesion to observe under a microscope for characteristic changes indicative of tuberculosis. There are also immunological tests that assist in diagnosing tuberculosis, such as the gamma interferon release assay (commonly known as the T-SPOT), tuberculin skin test, and traditional antibody tests against Mycobacterium tuberculosis.

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Written by Xiong Hong Hai
Infectious Disease
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Can people with tuberculosis drink alcohol?

Patients with tuberculosis should not drink alcohol. They need to rest well, enhance their nutrition, and abstain from smoking and drinking. Systematic and standardized anti-tuberculosis treatment is necessary. With standardized anti-tuberculosis treatment, the tuberculosis bacteria can be effectively suppressed, symptoms can be controlled, and the patient’s weight can increase. It is crucial to abstain from smoking and drinking during treatment, as drinking can lead to poor treatment outcomes and even the development of drug-resistant tuberculosis. With timely and standardized medication and comprehensive treatment, most patients can generally be cured within a six-month course of anti-tuberculosis treatment.

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Written by Xiong Hong Hai
Infectious Disease
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How is tuberculosis diagnosed?

The diagnosis of tuberculosis primarily involves combining relevant clinical symptoms, such as whether there is cough, expectoration, low fever, night sweats, and blood in phlegm. It also requires considering the patient's chest imaging features, whether there is obvious infection, fresh exudation, cavities, as well as sputum tests. For example, if the sputum stain for acid-fast bacilli is positive, and the sputum culture is positive, using these comprehensive diagnostic methods, tuberculosis can be diagnosed, after which anti-tuberculosis treatment should be initiated.

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Written by Han Jian Hua
Infectious Disease
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Can tuberculosis be cured?

Early diagnosis and standard treatment can often cure tuberculosis. Tuberculosis requires anti-tuberculosis treatment. Effective anti-tuberculosis treatment must follow five principles: early intervention, proper dosage, combination therapy, regular administration, and full-course treatment to ensure thorough treatment. Consistency is crucial; one must not stop taking medication, substitute drugs, or alter dosages on their own, as doing so not only makes it difficult to cure the disease but also increases the risk of developing drug resistance and complicates treatment further. Additionally, it is important to supplement nutrition appropriately and maintain a healthy diet in daily life. Since tuberculosis is a chronic, debilitating disease, it is advisable to consume foods rich in calories, proteins, and vitamins. Ensuring adequate rest and sleep is vital. Engaging in moderate physical activities, such as outdoor exercises, while avoiding strenuous activities and factors that could exacerbate conditions, such as overexertion, exposure to cold, and catching a cold, is also important.

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Written by Han Jian Hua
Infectious Disease
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Does tuberculosis infect people?

Tuberculosis is a contagious disease, and hearing the term "tuberculosis" inevitably makes people nervous. However, not all tuberculosis patients are contagious. Research shows that among tuberculosis patients, only those who have tuberculosis bacteria found in sputum smear tests are contagious. With a source of infection, the tuberculosis bacteria must be transmitted to others through certain routes. Airborne transmission is the main route of transmission for tuberculosis bacteria. When a tuberculosis patient coughs, sneezes, or speaks loudly, they release a large number of droplet nuclei containing tuberculosis bacteria into the air, which can be inhaled by healthy individuals and cause infection. The degree of tuberculosis bacteria infection mainly depends on factors such as the amount of bacteria the patient expels, the severity of coughing symptoms, and the extent of contact. Therefore, when there is a tuberculosis patient nearby, we first need to understand whether they are in the active phase of the disease, that is, expelling bacteria, and whether they are undergoing anti-tuberculosis chemotherapy. If the patient has a negative sputum test or has undergone chemotherapy for a positive sputum test, such patients have very low contagiousness, so there is no need to worry too much about being infected.

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Written by Wang Chun Mei
Pulmonology
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Does tuberculosis cause fever in its initial stage?

Tuberculosis is caused by an infection of the lungs by the bacterium Mycobacterium tuberculosis, and it is a very common infectious respiratory disease clinically. Typically, the early stage of tuberculosis is accompanied by mild fever to varying degrees, usually occurring in the afternoon, along with coughing, expectoration of blood, chest tightness, shortness of breath, and even chest pain, weight loss, fatigue, and night sweats as accompanying clinical symptoms. In the early stages, the diagnosis of tuberculosis in patients is generally made through these specific clinical symptoms, along with some sputum culture and chest X-ray examinations. Usually, most patients with early-stage tuberculosis will experience symptoms of low-grade fever, but these patients have a characteristic of fever that occurs in the afternoon and does not require antipyretics as it can return to normal by itself in the evening.