Diagnosis is made primarily based on sputum smear examination.

If there is any question of active TB, sputum smears must be obtained.

Even if sputum smear is negative, tuberculosis must be considered and is only excluded after negative cultures.

Sputum smears and cultures should be done for acid-fast bacilli if the patient is producing sputum.

Sputum smear microscopy, using the Ziehl-Neelsen staining technique, is employed as the standard case-finding tool.

Sputum smear (KOH test) is a test for the presence of fungal microorganisms in sputum.

Study subjects who were acid-fast bacilli sputum smear and culture negative at the one-year follow-up sputum examination were considered cured.

HIV serostatus does not affect the yield from sputum smear and culture examinations; positive smear results are more common in cavitary pulmonary disease (309).

In particular, the sputum smear microscopy test does not work well in HIV-positive patients and children and relies on the expertise of the microscopist.

Clinical evaluation and additional tests (such as a chest radiograph, sputum smear, and culture) are needed to differentiate between a diagnosis of latent TB or active TB.

Even with normal chest radiographs, patients with HIV infection and pulmonary TB might have acid fast bacilli (AFB)-positive sputum smear and culture results.

Although acid-fast stained sputum smears are positive in 50%--70% of adults with pulmonary TB, young children with TB rarely produce sputum voluntarily and typically have a low bacterial load (178).