What is the diagnostic procedure recommended for a patient with cough, night sweats, and unexplained fever who is not a contact of a confirmed TB case?

The recommended diagnostic procedure for a patient presenting with cough, night sweats, and unexplained fever—especially in a context where tuberculosis (TB) is being considered—is the Xpert MTB/Rif Test. This test is a molecular diagnostic method that detects the presence of Mycobacterium tuberculosis and simultaneously assesses resistance to rifampicin, an important first-line anti-TB medication.

The Xpert MTB/Rif Test is favored in such scenarios because it provides rapid results compared to traditional culture methods. It allows for early diagnosis and prompt initiation of appropriate treatment, significantly improving the management of suspected TB cases. The test is performed directly on respiratory specimens, which is ideal since the patient exhibits respiratory symptoms such as a persistent cough.

Using the Xpert MTB/Rif is particularly beneficial because of its high sensitivity and specificity for diagnosing TB, even in patients who may not have a known contact with a confirmed TB case. In practice, the ability to quickly identify TB and drug resistance can significantly impact public health responses and individual patient outcomes.

Other diagnostic options, such as TB culture and the TB LAMP test, have their own merits but are generally slower or less suitable for initial screening. The Direct Sputum Smear Microscopy (DSSM) can be