Pulmonary Tuberculosis: Clinical Insights, Rising Challenges, and Emerging Solutions  

Pulmonary Tuberculosis (PTB), the most common and contagious form of Mycobacterium tuberculosis infection, remains a major global health concern in 2025. It primarily affects the lungs, spreading through airborne droplets when infected individuals cough or sneeze. Recent data highlight a resurgence in PTB cases following disruptions in health services, with an estimated 10.8 million new TB cases worldwide in 2023, a significant proportion of which were pulmonary. Clinically, PTB presents with chronic cough, hemoptysis, weight loss, fever, and night sweats, but asymptomatic carriers contribute substantially to ongoing transmission. The rise in antimicrobial-resistant strains, including multidrug-resistant and extensively drug-resistant PTB, poses serious challenges to treatment, often requiring prolonged regimens with toxic second-line drugs. Advances in molecular diagnostics, such as GeneXpert and next-generation sequencing, are improving detection and drug-resistance profiling, while novel approaches including mRNA-based vaccines and host-directed therapies offer promise for enhanced prevention and shorter, more effective treatment in the coming years.