Signs and symptoms of active pulmonary / laryngeal and extrapulmonary disease include a positive TST or IGRA result, and an abnormal chest radiograph. However, persons with advanced immunosuppression or extrapulmonary disease may not have positive IGRA or TST or abnormal chest x-ray.
Respiratory specimens are usually smear or culture positive. However, they may be negative in persons with extrapulmonary disease or minimal or early pulmonary disease. People with active TB may spread TB bacteria to others and will need treatment for TB disease.