What criteria should I use to determine whether to refer a patient with suspected tuberculosis to a specialist?

Refer a patient with suspected active tuberculosis (TB) to a specialist if they have highly suggestive symptoms of active TB that require urgent assessment, or if they are systemically unwell, or have complex social needs such as homelessness ¹.

Arrange hospital admission if the person is highly symptomatic, systemically unwell, or has complex social needs ¹.

If symptoms are highly suggestive of active TB, do not delay specialist referral by waiting for culture results ¹.

People with known active or latent TB who have not completed treatment as planned should be referred, especially if they are symptomatic or systemically unwell ¹.

Referral should also be considered if there is suspicion of TB of the central nervous system or spinal TB, particularly if there is evidence of raised intracranial pressure, spinal instability, or spinal cord compression ².

In cases where multidrug-resistant TB is suspected based on risk factors such as previous treatment, contact with MDR TB, or residence in high MDR prevalence areas, rapid diagnostic testing and specialist management are indicated ².