20 years old Rajesh presence with fever and chronic cough ESR 35 mm sputum cytology is negative for AFB and tuberculin test show in durations of 19 X. 23 mm. The probable diagnosis is –

The history and tuberculin test strongly suggests the diagnosis of T.B. Do not get confused by negative sputum cytology because negative sputum cytology does not rule out pulmonary tuberculosis. “Sputum cytology is just a presumptive diagnosis" - Harrison "The definitive diagnostic of T.B. depends upon the culture of bacteria obtained from respiratory specimen" - Harrison The presence of induration > 15 mm in size strongly indicates T.B. infection.