Confirmation of tuberculosis is made mainly by sputum examination and imaging, and if the sputum examination is positive, including sputum culture and sputum smear. Sputum culture is considered sputum positive if there is a positive result for Mycobacterium tuberculosis or a positive sputum smear for Mycobacterium antacidum. The diagnosis of pulmonary tuberculosis can be confirmed by the presence of specific foci on imaging. In the milder cases, the imaging mainly shows patches, nodules, and cords of images, or tuberculomas or isolated cavities. In severe cases, the images show lobar infiltrates, caseous pneumonia, multiple cavity formation, and bronchial dissemination. If sputum culture tests are positive and imaging has typical lesions, the diagnosis of active TB is confirmed and anti-tuberculosis treatment should be required.