Too many times I have seen doctors miss the diagnosis of tuberculosis (TB) despite seeing an apical cavitary lesion on the patient’s radiograph. Delayed diagnosis in this case is not only unfortunate for the patient. It is also a public health issue as more people are unnecessarily exposed to a contagious disease that could have been prevented by earlier proper diagnosis. Health departments can only do so much if private clinicians fail to consider TB in their differentials. Having not been diagnosed properly, their patients with the airborne disease continue to spread it. It is true that unlike in many other countries, TB is not endemic in the US. However, that doesn’t mean we can forget about it. Doing so is one reason why TB continues to sneak up on us. Every doctor, even those in the private sector, has a public health responsibility to have TB in their differentials as appropriate.