Are there clinical scenarios in which you would start empiric treatment for pulmonary TB without microbiologic confirmation?   

Yes, there are a few situations. One of them being pauci-bacillary TB in which you catch TB very early on its course hence your micro/cultures will be negative. CT will demonstrate micronodules. This is a diagnosis of exclusion and requires the right clinical setting (high-risk patient, from an ende...

In my opinion, the question could be divided into 2 separate questions. First, what is the sensitivity/specificity of diagnostic tests for pulmonary disease? Second, is there a clinical scenario where empiric treatment would be warranted while awaiting respiratory cultures? For diagnostics for pulmo...