A patient has TB and lives with six others. What should be the next step?

The most appropriate next step in managing a patient with tuberculosis (TB) who lives with others is to test the individuals who have been exposed to the patient. This approach is essential for identifying any latent or active TB infections among the household members. Since TB is a contagious disease that can be transmitted through the air, testing those who have been in close contact with the infected individual enables early detection and treatment if necessary.

By conducting tests such as the tuberculin skin test or interferon-gamma release assays, healthcare providers can assess the exposure and determine the need for further interventions. It is a critical step in controlling the spread of TB within the household and protecting the public health.

In contexts where the other options may lead to unnecessary measures or delays, testing first allows for a targeted and effective response based on the results. Isolating the patient or treating everyone without assessment may not be warranted at this stage and could complicate the situation unnecessarily. Additionally, chest X-rays are more appropriately performed if there is evidence of active disease from the tests. Therefore, initiating testing provides a more systematic approach to managing potential TB transmission within the household.