Pulmonary tuberculosis in non-HIV adults: an evergreen old-fashioned disease in high-income countries. A narrative review

INTRODUCTION: Tuberculosis (TB), an infective air-borne disease with worldwide non-homogeneous distribution, remains a top cause of morbidity and mortality. TB control is linked to early diagnosis and proper treatment of contagious TB cases and infected subjects at high risk of developing TB. AREAS COVERED: A narrative review of pulmonary TB in non-HIV adults with reference to high-income countries. Modern medicine offers several advancements in diagnostics and therapeutics of TB, but they often remain to be extensively implemented in real life. In high-income countries TB is now relatively uncommon, but it remains a health and socio-economic burden that should not be underestimated. EXPERT OPINION: Pulmonologists should maintain expertise toward TB for several reasons. First, the lung is the most common and the infectious moiety of TB. Second, TB remains a global issue due to common travels of western people and migrations from areas with high incidence of TB. Third, as TB has heterogenous clinics, its prompt diagnosis may be difficult. Fourth, TB is a curable disease, but its management is complex and predisposes to poor adherence with failures/relapses and selection of drug-resistant strains.