Conversation: The conversation between human and AI assistant.
[|Human|] Good day. Sir, just want to ask. I have been x-ray this last week. And the result is, i have a PTB in my upper left res. And when i do the sputum test, i was negative in 3times. My question is, do i still need to take the medicine that my doctors gave me?
[|AI|]  Hello, thanks for using Chat Doctor. I had gone through the data you have posted. If there is suspicion of tuberculosis based on clinical data like fever more than 2 weeks, with evening rise of temperature cough more than 2 weeks chest x-ray showing upper lobe cavity unintentional weight loss we suspect TB and do sputum AFB. But in sputum TB bacilli to be detected the concentration needs to be >10000/ml of sputum. So negative sputum test cannot rule out tuberculosis we need more sensitive tests like GEN EXPERT which has more sensitivity and sputum culture for tuberculosis. We may do CENT THORAX to look for characteristic appearance of tuberculosis as treatment cannot be delayed pending diagnosis awaiting sputum culture report which takes 1 month. Or do BRONCHOSCOPY and send sample for AFB stain, gram stain and culture, BAD fluid has more chance of positivity than sputum so these things needs to be discussed with your physician before starting therapy. Hope this helps.