A 34-year-old male farmer from a rural village in Sub-Saharan Africa presents to a local clinic with a persistent cough lasting over three months. He reports significant weight loss, night sweats, and occasional episodes of hemoptysis. His family notes that he has become progressively weaker, struggling to complete daily farm work.

On examination, he appears thin and fatigued, with noticeable pallor. Auscultation of the lungs reveals crackles in the upper lobes. A chest X-ray shows cavitary lesions in the right upper lung, raising suspicion for pulmonary tuberculosis. Sputum smear microscopy confirms the presence of acid-fast bacilli, and GeneXpert testing detects Mycobacterium tuberculosis without rifampin resistance.

The patient is started on a six-month regimen of first-line anti-tuberculosis therapy, including isoniazid, rifampin, ethambutol, and pyrazinamide. Health workers engage his family for treatment support and ensure adherence through directly observed therapy (DOT). Additionally, contact tracing is initiated to prevent further spread within the community.

Despite initial challenges, including medication side effects and financial constraints, the patient shows gradual improvement. After completing treatment, his symptoms resolve, and follow-up sputum tests confirm clearance of the infection. Efforts are made to improve local awareness and screening to curb tuberculosis transmission in the region.