ABSTRACT

Tuberculosis (TB) remains one of the leading causes of death worldwide despite being a preventable and treatable disease. In Türkiye, the fight against TB has a deep-rooted history, and the incidence of the disease has shown a consistent decline since 2005. However, the increasing population of immunosuppressed patients, human immunodeficiency virus co-infection, and advances in medical diagnostic methods lead to TB manifesting in diverse clinical forms. This article details the current clinical approach and diagnostic methods for TB. Screening asymptomatic cases with TB infection is vital, particularly in high-risk groups such as candidates for solid organ transplantation and those using biological agents. In TB disease, the clinical presentation varies depending on the affected organ. While pulmonary TB is the most common form, asymptomatic/subclinical TB cases, which have gained prominence in recent years, play a critical role in the chain of transmission. Extrapulmonary TB can affect various tissues, including the pleura, lymph nodes, central nervous system, and skeletal system, accounting for approximately 35% of all TB cases in Türkiye. Microbiological diagnosis is the gold standard of the clinical approach. Although microscopic examination is a rapid and cost-effective method, culture techniques are essential for definitive diagnosis and the detection of drug resistance due to their high sensitivity. The World Health Organization emphasizes the use of molecular tests for rapid and accurate diagnosis. Consequently, effective control of TB depends on early diagnosis achieved through the integration of radiological, clinical, and microbiological data.