Tuberculosis “the great imitator”: False healing and subclinical activity

Tuberculosis is still being a health problem worldwide despite it being a curable disease. Although the only way to prevent its spread is treating cases of active pulmonary disease, we still do not have reliable markers that help us to evaluate the response to anti-tuberculosis drugs. Currently, a patient with negative conversion in the culture of the sputum is considered as cured; however, several studies have questioned the usefulness of this test given that some individuals persist with data of clinical activity despite their negative culture. A couple of recent studies based on sophisticated imaging techniques confirm the above and show us a broader clinical spectrum of the disease, with false healing and subclinical activity in the affected lung tissue even in the absence of symptoms, forcing us to reconsider the way in which we classify tuberculosis and led us to question the efficacy of the current schemes to treat this illness. Here, we comment the findings of these trials and analyze what is their influence in the view of physicians for future applications in diagnosis and/or therapeutics of tuberculosis.