Quick overview of the tuberculosis symptoms
Symptoms of active TB in the lungs usually develop gradually and tend to worsen over a period of weeks. They may include:
- Persistent cough lasting over two weeks
- Chest pain
- Coughing up blood or mucus (sputum)
- Fatigue or weakness
- Loss of appetite
- Sudden, unexplained weight loss
- Chills
- Fever
- Night sweats
Active TB outside the lungs occurs when the infection spreads from the lungs to other parts of the body, known as extrapulmonary tuberculosis. Symptoms vary depending on the affected area, but some common signs may include:
- Fever.
- Chills.
- Night sweats.
- Weight loss.
- Unwilling to eat.
- Fatigue.
- Persistent feeling of being unwell.
- Pain near the infection site.
Active TB in the voice box occurs outside the lungs but can present with symptoms similar to those of lung disease.
What exactly is tuberculosis?
Tuberculosis, commonly known as TB, is a severe disease that primarily affects the lungs. The bacteria Mycobacterium tuberculosis cause it. TB primarily affects the lungs but can also impact other areas of the body, such as the spine, brain, or kidneys.
Tuberculosis spreads when an infected individual coughs, sneezes, or sings, releasing tiny droplets containing germs into the air. Another person may then breathe in these droplets, allowing the germs to enter their lungs.
Not everyone infected with TB becomes ill. If you’re infected but show no symptoms, it’s called inactive tuberculosis or latent TB. In this state, TB remains dormant inside your body. In the U.S., up to 13 million people have latent TB. Some can carry this dormant infection for their entire lives without ever developing active TB symptoms. But TB can become active if your immune system weakens. A weakened immune system may not be able to stop the bacteria from growing.
Tuberculosis spreads rapidly in crowded environments, such as gatherings or densely populated living spaces. It usually occurs with prolonged indoor exposure over hours, days, or weeks, such as in shelters, prisons, or when a large number of family members live in a tight space.
People with HIV/AIDS or weakened immune systems face a higher risk of infection compared to those with healthy immune systems. Although antibiotics can treat tuberculosis, specific bacterial strains have developed resistance, making some treatments less effective.
What are the causes of TB?
Mycobacterium tuberculosis bacteria cause TB. These germs spread through the air and can infect your lungs when you inhale them. Occasionally, they also affect other parts of your body.
People with active tuberculosis in their lungs or voice box can spread the disease by releasing small droplets containing bacteria into the air. This happens when they talk, sing, laugh, cough, or sneeze. Others can become infected by breathing in these droplets.
The disease is more prone to spreading when individuals spend extended periods together indoors. As a result, it transmits quickly in environments where people live or work in proximity. Moreover, crowded events facilitate easier disease transmission.
Drug-resistant TB
Some strains of TB bacteria have developed resistance to drugs, meaning medicines that previously cured the disease are no longer effective. This resistance arises partly due to naturally occurring genetic mutations in bacteria. A random mutation can grant a bacterium a trait that helps it survive antibiotic treatment. If it survives, it can reproduce and pass on this trait.
What are the risk factors associated with tuberculosis?
A weakened immune system increases the risk that a TB infection will progress to active TB disease. Conditions or treatments that impair the immune system include:
- HIV/AIDS.
- Diabetes.
- Severe kidney disease.
- Cancers affecting the head, neck, and blood.
- Malnutrition or underweight.
- Cancer treatment, such as chemotherapy.
- Medication to prevent organ rejection.
- Long-term use of prescribed steroids.
- Use of illegally injected drugs.
- Alcohol abuse.
- Using tobacco products, including smoking
What methods are used to diagnose tuberculosis?
To diagnose a tuberculosis (TB) infection, your doctor will perform an exam that includes listening to your breathing with a stethoscope, checking for swollen lymph nodes, and asking about your symptoms.
Your doctor will then determine which test to carry out:
Skin test
This test measures a delayed hypersensitivity reaction in which T cells of your immune system recognize TB proteins. A positive result indicates that you may have a latent TB infection or active TB disease. Individuals vaccinated against TB may also test positive even if they are not infected. A negative result means your body didn’t react to the test, but it doesn’t necessarily rule out an infection.
Blood tests
A blood sample is sent to a lab for testing whether immune system cells can “recognize” tuberculosis. A positive result indicates you may have either a latent TB infection or active TB disease. Further tests can help determine if you have active TB. Typically, a negative result means you do not have a TB infection.
X-ray
A chest X-ray can show irregular lung patches typical of active tuberculosis.
Sputum tests
Your doctor may collect a sample of the mucus you cough up, known as sputum. Laboratory tests can identify the bacteria if you have active TB in your lungs or voice box. A rapid test can indicate whether TB bacteria are present in the sputum, though it might also detect bacteria with similar characteristics. A more definitive lab test can confirm the presence of TB bacteria, but results typically take several weeks. Additionally, lab testing can determine if the bacteria are drug-resistant. This information helps your healthcare provider select the most effective treatment.
Other laboratory tests
Additional lab tests that could be ordered include:
- Breath test (a currently developing test)
- Procedure for removing sputum from your lungs using a special tube.
- Urinalysis test.
- A test of the fluid surrounding the spine and brain, known as cerebrospinal fluid.
What treatment options are available?
If you have a latent TB infection, your healthcare provider might begin treatment. This is especially important for people with HIV/AIDS or other risk factors for developing active TB disease. Most latent TB infections are treated for three or four months.
Active TB disease can be treated for 4, 6, or 9 months, depending on your case. TB specialists will decide which medications are most suitable for you.
Typical medications used for tuberculosis treatment include:
- Isoniazid.
- Rifampin (Rimactane).
- Rifabutin (Mycobutin).
- Rifapentine (Priftin).
- Pyrazinamide.
- Ethambutol (Myambutol).
You might receive additional medications if you have drug-resistant tuberculosis or other related complications.
What steps can be implemented to prevent issues?
During the first two to three weeks, you can pass TB bacteria to others. Protect others with these steps:
- Stay at home. Refrain from going to work or school.
- Stay isolated at home by minimizing your time with household members and sleeping in a different room.
- Ventilate the room regularly. Tuberculosis bacteria spread more readily in small, enclosed areas. When the weather allows, open the windows to let in fresh air. Use a fan to help vent air outside. If there are multiple windows, employ one fan to exhaust indoor air and another to bring in new, fresh air.
- Wear face masks whenever you are around others. Encourage all household members to wear masks to stay protected.
- Cover your mouth by using a tissue whenever you sneeze or cough. Afterward, place the used tissue in a bag, seal it, and dispose of it properly.
Vaccinations
In countries with high tuberculosis rates, infants commonly receive the Bacillus Calmette-Guerin (BCG) vaccine. It protects young children, who are at higher risk of developing active TB disease in the fluid around the brain and spinal cord. However, the vaccine may not be effective against lung TB, which is more common in the United States. Several new TB vaccines are now in development and undergoing testing.
Living with tuberculosis
In 2020, approximately 10 million people worldwide contracted TB, resulting in about 1.5 million deaths. TB was once the leading cause of death in the U.S., but the introduction of new treatments led to a rapid decline in cases during the 1940s and 1950s. In 2021, the U.S. reported 7,860 TB cases. Although TB causes many deaths worldwide, it remains treatable when medications are taken as directed by your doctor. If you suspect exposure or experience symptoms of TB, contact your doctor promptly.
Frequently Asked Questions
When should I consult my doctor?
If you have been exposed to TB, contact your healthcare provider right away to discuss testing options. It is essential to get tested if you develop any symptoms to prevent potentially spreading TB to others. If you are taking medication for TB, consult your doctor about possible side effects, since some can be severe.
How long does it take to recover from tuberculosis?
You may experience increased energy levels and fewer symptoms within a few weeks of starting treatment. However, completing the treatment will take longer. You should continue taking your medications for at least six to nine months.
How is tuberculosis transmitted?
TB spreads through droplets released when a person with active TB coughs, sneezes, talks, sings, or laughs. Only those with an active lung infection can transmit the bacteria. Usually, prolonged exposure to a contagious individual is necessary to contract TB. Many people who inhale TB bacteria can fight off the disease, preventing it from developing into active disease and leading to a latent TB infection.
Who are the individuals most at risk of developing TB?
Anyone can contract TB, but certain groups face higher risks of infection or developing severe illness. This includes people who spend extensive time with someone who has active TB, such as household members. It also covers those born in or living in regions with higher TB rates, individuals with weakened immune systems, such as those with HIV, kidney transplants, or on treatments like chemotherapy, children under five, and those living in overcrowded or impoverished conditions, like people experiencing homelessness. Furthermore, daily smokers, alcohol consumers, drug users, and individuals with a history of TB who lack proper treatment are also more vulnerable.
What distinguishes TB infection from TB disease?
Someone infected with the TB bacilli carries the TB germ in their body, but most people’s immune systems prevent them from developing TB disease or becoming ill. They also typically do not transmit the disease to others. The risk of developing TB disease at some point in life for those infected is generally 5–15%. If a person does develop TB disease, they become sick and face the risk of death. Without proper treatment, they can also pass the disease to others.
