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.
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What Exactly Is Tuberculosis?
Tuberculosis, which most people know simply as ‘TB’, is a serious infectious disease caused by a bacterium called ‘Mycobacterium tuberculosis’. While it primarily attacks the lungs, it doesn’t always stop there. In some cases, TB bacteria travel through the bloodstream and target other parts of the body, including the spine, kidneys, and even the brain.
Here’s something that surprises many people: not everyone who has TB actually feels sick. There are two distinct forms of the infection, latent TB and active TB, and they behave very differently from one another.
Latent TB vs. Active TB
When you’re exposed to TB bacteria but your immune system manages to keep them in check, the bacteria become dormant inside your body. This is called latent TB. In this state, you won’t experience any symptoms, and you can’t spread the disease to others. However, that doesn’t mean you’re in the clear. In the United States alone, up to 13 million people are currently living with latent TB. If the immune system weakens at any point due to illness, stress, or medication, the dormant bacteria can wake up and turn into active TB disease.
Active TB,
on the other hand, is a different story. The bacteria are multiplying, the body is struggling to fight them, and symptoms are very much present. More importantly, active TB in the lungs or throat can spread from person to person through the air.
How Does Tuberculosis Spread?
TB is an airborne disease. When someone with active TB in their lungs or voice box coughs, sneezes, laughs, sings, or even just talks, they release tiny droplets into the air that carry the bacteria. Anyone nearby who inhales those droplets can become infected.
That said, TB doesn’t spread as easily as the common cold. It usually requires prolonged close contact, typically hours or days of shared indoor space, rather than a brief encounter. This is why TB spreads more quickly in environments like shelters, prisons, crowded family homes, and other enclosed spaces where people spend a lot of time together.
It’s also worth noting TB is not spread through shaking hands, sharing food or drinks, touching surfaces, or kissing. The bacteria need to travel through the air and be inhaled to cause infection.
What Causes Tuberculosis?
The root cause of TB is always the same bacterium, Mycobacterium tuberculosis. However, there’s a growing problem that makes TB harder to treat: drug resistance.
Over time, some strains of TB bacteria have developed the ability to survive antibiotic treatment. This happens through natural genetic mutations; a random change in the bacteria’s DNA can give it a trait that helps it withstand drugs. If that resistant bacterium survives and reproduces, it passes on that resistance to future generations of bacteria. The result is drug resistant TB, which requires longer, more complex, and more expensive treatment than regular TB.
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Who Is Most at Risk?
Anyone can get TB, but certain factors significantly raise the risk. The biggest one is a weakened immune system. When your body’s defences are compromised, it struggles to keep the TB bacteria under control, whether you have a latent infection or are newly exposed.
Conditions and factors that increase the risk of TB include:
- HIV/AIDS: People living with HIV are at very high risk because the virus directly weakens the immune system
- Diabetes, which can impair the body's ability to fight infections
- Severe kidney disease: If you want to understand more about how kidney problems affect overall health, reading about kidney disease symptoms can be helpful
- Cancers affecting the head, neck, or blood
- Malnutrition or being significantly underweight
- Chemotherapy or other cancer treatments
- Medications used to prevent organ rejection after a transplant
- Long term use of steroids prescribed by a doctor
- Injecting illegal drugs
- Injecting illegal drugs
- Heavy alcohol consumption
- Smoking or using other tobacco products
Beyond health conditions, living or working in crowded environments, particularly in areas with high TB rates, also increases exposure risk.
Recognizing the Symptoms of Tuberculosis
- A persistent cough that lasts three weeks or longer
- Coughing up blood or mucus (sputum)
- Chest pain, especially when breathing or coughing
- Unexplained weight loss
- Fatigue and general weakness
- Fever, particularly in the evenings
- Night sweats
- Loss of appetite
When TB affects other parts of the body, the symptoms vary depending on the organ involved. Back pain may suggest TB in the spine, while blood in the urine could indicate kidney involvement. These overlapping symptoms can sometimes be confused with other conditions; for example, persistent fatigue and night sweats can also be early signs seen in conditions like early diabetes, making an accurate diagnosis especially important.
How Is Tuberculosis Diagnosed?
Diagnosing TB usually starts with a physical examination. Your doctor will listen to your breathing, check for swollen lymph nodes, and ask about your symptoms and any possible exposure. From there, several tests may be used:
Skin Test (TST)
A small amount of a protein from TB bacteria is injected just under the skin of the forearm. After 48 to 72 hours, the doctor checks for a raised, firm bump at the injection site. A positive result suggests TB exposure, but it isn’t conclusive on its own; people vaccinated against TB may also show a positive result.
Blood Tests (IGRAs)
Interferon Gamma Release Assays (IGRAs) are blood tests that measure how your immune system responds to TB proteins. A positive result indicates exposure to TB bacteria. These tests are particularly useful for people who have received the BCG vaccine, as they are less likely to give false positives than the skin test.
Chest X Ray
If the skin or blood test is positive, a chest X ray is typically ordered. In people with active lung TB, the X ray may show characteristic patches or shadows in the lung tissue.
Sputum Tests
If active TB is suspected, your doctor will collect a sample of the mucus you cough up (sputum) and send it to a laboratory. This is one of the most reliable ways to confirm TB and to check whether the bacteria are drug resistant information that’s critical for choosing the right treatment.
Additional Tests drug resistant information
In some cases, doctors may also test urine or cerebrospinal fluid (the fluid around the spine and brain) or use a procedure to remove sputum directly from the lungs using a special tube.
How Is Tuberculosis Treated?
The good news about TB is that it is curable. The key is completing the full course of antibiotics exactly as prescribed. Stopping early, even if you feel better, can allow the bacteria to survive and develop resistance.
Treating Latent TB
Even if you have no symptoms, treating latent TB is often recommended, especially for people with HIV/AIDS or other immune weakening conditions. Treatment typically lasts three to four months and significantly reduces the risk of the infection ever becoming active.
Treating Active TB
Active TB disease is treated for four, six, or nine months, depending on the specific case and which organs are affected. Your TB specialist will determine the most appropriate drug combination for you. Commonly used medications include:
- Isoniazid
- Rifampin (Rimactane)
- Rifabutin (Mycobutin)
- Rifapentine (Priftin)
- Pyrazinamide
- Ethambutol (Myambutol)
For drug resistant TB, additional or alternative medications are required, and the treatment course is usually longer and more complex.
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How to Prevent Tuberculosis From Spreading
If you’ve been diagnosed with active TB, taking steps to protect the people around you is absolutely essential, especially during the first two to three weeks of treatment, when you are still contagious.
- Stay home; avoid going to work, school, or public places
- Sleep in a separate room from other household members
- Ventilate your room regularly by opening windows; use fans to circulate fresh air
- Wear a face mask when you must be around other people
- Cover your mouth with a tissue every time you cough or sneeze; seal used tissues in a bag and dispose of them properly
The BCG Vaccine
In countries where TB is common, infants are routinely given the Bacillus Calmette Guérin (BCG) vaccine. This vaccine is highly effective at preventing the most severe forms of TB in young children, particularly TB meningitis (TB in the fluid around the brain and spine). However, it offers less reliable protection against lung TB, which is the most common form in adults. Several new TB vaccines are currently in development and being tested worldwide.
Living With Tuberculosis
In 2020, roughly 10 million people around the world were diagnosed with TB, and about 1.5 million deaths were recorded. It was once the leading cause of death in the United States, but the development of effective antibiotics in the 1940s and 1950s led to a rapid decline. By 2021, the U.S. reported around 7,860 TB cases, a far cry from the epidemic days of the past.
The bottom line is this: TB is serious, but it is manageable. With the right medications, taken consistently and for the full prescribed duration, the vast majority of people recover completely. If you suspect you’ve been exposed to TB, or if you’re experiencing symptoms, don’t wait; contact your doctor as soon as possible.
It’s also worth knowing that respiratory symptoms sometimes overlap with other conditions. For instance, a persistent cough or breathing difficulty might occasionally be linked to winter sinusitis or even COVID 19, which is why getting a proper diagnosis is so important rather than assuming.
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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
Can tuberculosis be completely cured?
Yes, tuberculosis can be completely cured in the vast majority of cases. The key is taking the full course of antibiotics as prescribed by your doctor, which typically lasts between four and nine months for active TB, without skipping doses or stopping early.
Is tuberculosis contagious?
Active TB in the lungs or throat is contagious and spreads through the air. Latent TB, however, cannot be spread to others. People with active TB are generally considered contagious for the first two to three weeks of treatment.
How long does it take to recover from TB?
Recovery depends on the type of TB and how early it is caught. Latent TB treatment lasts three to four months. Active TB treatment typically continues for four to nine months. Most people begin feeling better within a few weeks of starting medication.
What are the early warning signs of TB?
Early signs of active TB include a persistent cough lasting more than three weeks, unexplained fatigue, mild fever (especially in the evenings), night sweats, and gradual weight loss. These symptoms are easy to overlook at first, which is why awareness is important.
Can someone get TB more than once?
Yes, it is possible to be reinfected with TB after successfully completing treatment, especially if you are exposed again or if your immune system becomes weakened in the future.
Does the TB vaccine prevent all forms of the disease?
The BCG vaccine provides strong protection against severe forms of TB in children, including TB meningitis. However, it is less effective against lung TB in adults. Research into newer, more effective TB vaccines is ongoing.
What happens if TB is left untreated?
Untreated active TB can be life threatening. The bacteria continue to damage the lungs and may spread to other organs. It also remains contagious, meaning the infected person continues to put others at risk. In some cases, untreated TB leads to permanent organ damage or death.
How is drug resistant TB different from regular TB?
Drug resistant TB occurs when the bacteria no longer respond to the standard antibiotic drugs used to treat TB. It requires different, often stronger medications and a longer treatment period, sometimes up to 18 to 24 months. It is harder to treat and carries a higher risk of complications.
Can children get tuberculosis?
Yes, children can get TB, and they are often at higher risk of developing severe forms of the disease. Young children who contract TB are particularly vulnerable to TB meningitis. The BCG vaccine is specifically recommended for infants in high risk countries to reduce this risk.
Are there other conditions that can mimic TB symptoms?
Several conditions share symptoms with TB, including pneumonia, lung cancer, and fungal infections. Respiratory symptoms like coughing, fatigue, and chest discomfort can also overlap with viral stomach infections, dengue fever, or even sore throats during winter. Always seek a proper medical diagnosis if you’re unsure.
