Touching the lesions will show that they are not warm.  This should raise the index of suspicion for tuberculosis.

The probably most simple approach would be to aspirate the most caudal lesion and request a Gram stain.  When no organisms are found on this examination, technicians can be asked to carefully examine a Ziehl-Neelsen stained smear (acid-fast bacilli are exceedingly difficult to identify in such lesions).

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