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The resurgence of tuberculosis in the United States presents a challenge for primary care physicians. The disease remains concentrated in the growing population of socioeconomically disadvantaged persons, immigrants from areas where drug resistance is common, certain racial groups, persons in extended-care facilities, alcohol and drug abusers, and persons infected with the human immunodeficiency virus. Because people in these groups are much less likely than others to seek regular medical care, it is difficult to identify and treat active tuberculosis in these populations. Contacts of patients with tuberculosis are equally difficult to identify. Active intervention by primary care physicians--including tuberculin screening, prophylactic therapy, treatment of active disease, and follow-up--is needed to help achieve the goal of eradicating tuberculosis.
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