Tuberculosis due to Mycobacterium tuberculosis, Mycobacterium bovis, or Mycobacterium caprae has been reported in captive and wild elephants. Lesions most often involve the lung and associated lymph nodes. The gold-standard diagnostic assay is an organism-based test of trunk washes. Nonspecific responses are observed on tuberculin skin tests; however, immunologic assays developed specifically for elephants are used.
Multidrug regimens that include isoniazid and rifampin have been developed that eliminate the shedding of M tuberculosis and minimize the development of drug-resistant strains. Historically, elephants with multidrug-resistant infections have been euthanized, because of public health concerns.