Hi ceecee2012, Thanks for visiting HCM. Though cardinal symptoms of tb are usually associated with the disease like cough of any type, bloody sputum , loss of eight , evening rise of temperature etc. but many a times there may be no symptoms. A spot on chest xray may be anything ranging from simple bacterial infection, tubercular to fungal infection to cancer. I think you must go for sputum examination for at least two samples, ESR, Montoux test. If sputum is positive then it is the definitive case of TB. If other two are positive, they are suggestive of TB. Treatment can be started even on strong clinical suspicion because it is better to go for cure rather than to get a complication. Best wishes