What is the first diagnostic option for an individual with suspected tuberculosis presenting with cough and fever?

In cases of suspected tuberculosis (TB), the first diagnostic option typically involves imaging studies, and a chest X-ray is the most commonly used initial test. The reason for choosing a chest X-ray is that it can reveal characteristic findings associated with TB, such as infiltrates, cavitary lesions, or effusions. These visual cues help in establishing a high index of suspicion for TB infection.

Once TB is suspected based on X-ray findings, further confirmatory tests, such as sputum acid-fast bacilli (AFB) smear and culture, may be conducted. Imaging is crucial early in the assessment process to rule out other conditions or complications and to guide subsequent management. The other options, while they may have their roles in the overall evaluation of respiratory symptoms, do not serve as the primary or initial diagnostic tool for TB in this context.