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Pulmonary tuberculosis must be suspected in patients with respiratory symptoms longer than 2–3 weeks. Immunosuppression may modify the clinical and radiological presentation. The chest X-ray is highly suggestive of tuberculosis (TB), but is occasionally atypical. The complex radiological tests (CT scan, MRI) are more useful in extrapulmonary TB. At least 3 consecutive representative samples from the clinical location are used for diagnosis, whenever possible. Bacilloscopy and liquid medium cultures are indicated in all cases. Genetic amplification techniques are coadjuvant in moderate or high suspicion of TB. In new cases of TB, administration of isoniazid, rifampin, ethambutol, and pyrazinamide (HREZ) for 2 months and isoniazid plus rifampin for 4 months is recommended. For meningitis cases, treatment should continue for up to 12 months, and up to 9 months in spinal TB with neurological affectation and silicosis. Appropriate adjustments with antiretroviral treatment must be made in HIV patients. Combined therapy is recommended to prevent development of resistance. An antibiogram for first line drugs should be performed in all initial extractions from new patients. Treatment control is one of the most important activities in TB management. The Tuberculin Skin Test (TST) is positive in TB infection when ≥ 5mm, and Interferon-Gamma Release Assays (IGRA) are recommended in combination with TST. The standard treatment schedule for infection is 6 months with isoniazid. In pulmonary TB, respiratory isolation is applied for 3 weeks or until 3 negative bacilloscopy samples are obtained. © 2010 SEPAR. Published by Elsevier España, S.L. All rights reserved. ☆ Document published simultaneously in Infectious diseases and microbiology. ☆ ☆ Joint consensus document from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Society of Pneumology and Thoracic Surgery (SEPAR). * Corresponding author. E-mail address: [email protected] (J. González-Martín), [email protected] (J.M. García-García). 07 DOCUMENTO CONS (255-274).indd 255 20/7/10 17:39:00 D oc um en t d ow nl oa de d fro m h ttp :// w w w .a rc hb ro nc on eu m ol .o rg , d ay 2 0/ 02 /2 01 1. T hi s co py is fo r p er so na l u se . A ny tr an sm is si on o f t hi s do cu m en t b y an y m ed ia o r f or m at is s tri ct ly p ro hi bi te d. 256 J. González-Martín et al / Arch Bronconeumol. 2010;46(5):255-274