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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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 Wang Xiang Yu
Pulmonology
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Does tuberculosis cause a runny nose?

Do patients with tuberculosis have a runny nose? First, we need to understand what tuberculosis is. The pathogen of tuberculosis is Mycobacterium tuberculosis, commonly referred to as TB bacillus. Its primary site of infection is the lungs, but now we also classify and manage tracheobronchial and tuberculous pleurisy under pulmonary tuberculosis. However, these sites do not include the nasal part. Generally, patients with pulmonary tuberculosis show symptoms of the respiratory system and systemic symptoms. The most common respiratory symptoms include coughing and phlegm production for more than two weeks. Some patients may also experience hemoptysis, with varying amounts from mild to severe. A few patients may also experience chest pain. Additionally, patients with caseous pneumonia or significant pleural effusion may experience difficulty in breathing. Systemic symptoms of tuberculosis include fever, mainly characterized by afternoon tidal fever, with some patients exhibiting high fevers, and other general symptoms such as loss of appetite, weight loss, night sweats, and fatigue. However, the majority of patients with pulmonary tuberculosis do not exhibit nasal symptoms, meaning a runny nose is generally not a manifestation of tuberculosis. It could be possible that a tuberculosis patient might also have other infections or causative diseases, such as allergic rhinitis.

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Written by Wang Xiang Yu
Pulmonology
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How is tuberculosis transmitted?

How is pulmonary tuberculosis transmitted? First, we need to know the pathogen of pulmonary tuberculosis, which is the tuberculosis bacillus. Tuberculosis bacillus is a type of bacterium that can live in our surrounding environment. Pulmonary tuberculosis also needs a source of infection, that is, a patient carrying the tuberculosis bacillus. The most common source of tuberculosis infection is usually patients with secondary pulmonary tuberculosis. Then, its mode of transmission mainly includes coughing, sneezing, laughing, and talking loudly, which can release the tuberculosis bacilli from the patient into the air, spreading them through droplets. Droplet transmission is the most important route for the spread of pulmonary tuberculosis. Additionally, pulmonary tuberculosis can also be transmitted through other routes such as the gastrointestinal tract or the skin, although these methods of transmission are less common.

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Written by Xiong Hong Hai
Infectious Disease
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Can tuberculosis be cured?

Tuberculosis can actually be completely cured, primarily through anti-tuberculosis treatment. If it is confirmed to be active tuberculosis, systematic and standardized anti-tuberculosis treatment is required. Through scientific and reasonable anti-tuberculosis treatment and taking medication on time and according to guidelines, most tuberculosis patients can be cured, with a cure rate reaching 85%. The treatment includes an intensive phase of anti-tuberculosis treatment and a consolidation phase, with the total course of treatment being about six months. After being cured, it is not easy to relapse, but it is essential to take medications on time, adjust nutrition, modify work and rest schedules, and rest well.