Tuberculosis Symptoms

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By nclexnursing

Tuberculosis Symptoms is a contagious infection caused by the bacteria Mycobacterium tuberculosis, which is spread through the air. The lungs are generally affected. Tuberculosis is disseminated mostly by the inhalation of polluted air from a person with active tuberculosis.

The most common symptom is cough, although people might also have a fever and night sweats, lose weight, feel generally sick, and have a variety of additional symptoms if tuberculosis affects other organs.

A tuberculin skin test or blood test, a chest x-ray, and a sputum sample examination and culture are commonly used to make the diagnosis.

To limit the chances of bacterial resistance, two or more antibiotics are always given.

Tuberculosis can be prevented by early identification and treatment, as well as isolation of persons with the active disease until they have responded to therapy.

Tuberculosis is most commonly associated with the lungs, however, it can affect practically any organ in the body.

Mycobacterium tuberculosis is the microorganism that causes tuberculosis. Mycobacterium Bovis or Mycobacterium africanum, two related bacteria (called mycobacteria), can occasionally produce a similar condition. The mycobacterium tuberculosis complex includes these bacteria as well as Mycobacterium tuberculosis and a few others.

Other mycobacteria, particularly the mycobacterium avium complex (MAC) group, can also cause disease in humans. Tuberculosis is not one of the diseases they cause.

How Does Tuberculosis Spread?

Most infectious diseases (such as strep throat or pneumonia) cause people to become ill as soon as the microbe enters the body, and they become obviously ill within one or two weeks. Tuberculosis, on the other hand, does not follow this trend.

Few people get sick right away after tuberculosis bacteria enter their bodies, with the exception of very young children and people with a weaker immune system (this stage is called primary infection). Most tuberculosis bacteria that enter the lungs are eliminated by the body’s defenses right away. Bacteria that survive are absorbed by macrophages, which are white blood cells. The germs that have been swallowed can dwell inside these cells in a dormant state for many years (this stage is called latent infection). The bacteria never cause any more issues in 90 to 95 percent of instances, but in 5 to 10% of infected persons, the germs eventually grow and produce active disease. Infected persons grow unwell and can spread the disease at this point.

Stages of Tuberculosis

Primary infection

Some germs may migrate from the lungs to neighboring lymph nodes that drain the lungs during the first few weeks of infection. The bronchial tubes enter the lungs through these lymph nodes, which are located directly outside the lungs. Most people’s infections do not progress any further, and the germs become dormant (latent), causing no symptoms.

However, pneumonia and/or tuberculosis that affects other regions of the body can develop in extremely young children (who have fewer defenses against infection) and persons with a damaged immune system (extrapulmonary tuberculosis). In addition, the afflicted lymph nodes in young infants may become large enough to constrict the bronchial tubes and create symptoms.

During primary infection, the infection is usually not contagious.

Latent infection

Bacteria stay alive but inert inside macrophages for many years during latent infection. The bacteria inside a group of cells are protected by the body’s walls, which generate small scars. In 90 to 95 percent of cases, these bacteria are never an issue again.

During latent infection, the infection is not communicable.

Active disease

The dormant tuberculosis germs eventually grow and produce active disease in roughly 5 to 10% of affected people. Infected persons grow unwell and can spread the disease at this point.

Dormant bacteria reactivate more than half of the time within the first two years following infection, although they can take a long period, even decades, to do so.

Doctors are usually baffled as to why dormant bacteria revive, however, reactivation is more likely when a person’s immune system is compromised—for example, as a result of the following.

  • HIV infection at a very elderly age
  • Corticosteroids are drugs that are used to treat inflammation.
  • Adalimumab, etanercept, and infliximab are examples of new prescription anti-inflammatory medications.Other factors that increase the likelihood of reactivation include:
  • Diabetes
  • Cancer of the head and neck
  • stomach surgery to remove a portion or the entire stomach
  • Chronic renal disease is a serious condition that affects the kidneys.
  • Tobacco usage
  • Significant weight reduction

Transmission of infection

Only people can live with Mycobacterium tuberculosis. Animals, insects, soil, and other nonliving objects do not generally spread these bacteria. People are nearly exclusively infected with tuberculosis by breathing air contaminated by a tuberculosis patient. Because Mycobacterium tuberculosis bacteria are nearly solely disseminated through the air, touching someone who has the disease does not spread it.

Different from Mycobacterium bovis, which can live in animals and occasionally produces a similar disease. Drinking unpasteurized milk from sick cattle infects people in underdeveloped nations with Mycobacterium bovis. Because cattle are checked for tuberculosis and milk is pasteurized in affluent nations, this kind of tuberculosis is rarely a problem. However, cheese manufactured from unpasteurized milk from diseased calves is occasionally illegally imported into the United States, and it can cause disease. When Mycobacterium bovis affects the lungs, it can be transferred to others through coughing or sneezing.

When people with active tuberculosis in their lungs or voice box (larynx) cough, sneeze, or even speak or sing, they can contaminate the air with bacteria. These germs may survive for several hours in the air. If they are inhaled by another person, that person may become infected. People who come into touch with someone who has active tuberculosis (such as family members or health care providers who treat them) are more likely to contract the disease. However, if people start receiving adequate treatment, the chance of infection spreading diminishes dramatically, usually within two weeks.

Progression and spread of infection

The time it takes for tuberculosis to proceed from latent infection to active disease varies a lot. In patients with HIV infection and other immune-suppressing disorders (such as drug use), progression to active illness is significantly more common and much faster. People who have HIV and become infected with Mycobacterium tuberculosis have a 10% probability of developing active tuberculosis each year. People with latent tuberculosis who do not have HIV infection, on the other hand, have a 5 to 10% probability of getting active tuberculosis during their lifetime.

Active tuberculosis is largely localized to the lungs in patients who have a fully functional immune system (pulmonary tuberculosis).

Extrapulmonary tuberculosis is caused by pulmonary tuberculosis that has spread from the lungs to other regions of the body through the bloodstream. The infection may not produce sickness, but the germs may remain latent in a small scar, just as it did in the lungs. Later in life, dormant germs in these scars can reactivate, causing symptoms relating to the organs implicated.

Miliary TB develops when a significant number of bacteria circulate throughout the body via circulation. This kind of TB is potentially fatal.

Symptoms and Complications of TB

Pulmonary tuberculosis

Except for not feeling well, weariness, loss of appetite, and weight loss, some persons with active pulmonary tuberculosis have no symptoms. These symptoms appear over the course of several weeks. Cough, for example, is a symptom of a lung infection in some people.

The most common symptom of TB is cough. Because the disease progresses slowly, infected individuals may initially attribute their cough to smoking, a recent bout of influenza, the common cold, or asthma. When people get up in the morning, they may cough up a little amount of green or yellow phlegm. Sputum may become streaked with blood over time, though substantial volumes of blood are uncommon.

People can wake up in the middle of the night drenched in a cold sweat, with or without a temperature. People sometimes have to change their nightclothes or even their bedsheets due to excessive sweating. However, night sweats are not necessarily caused by tuberculosis, and they can be caused by a variety of other illnesses.

Shortness of breath that develops quickly, together with chest pain, could indicate the presence of air (pneumothorax) or fluid (pleural effusion) in the space between the lungs and the chest wall. A pleural effusion is the earliest sign of tuberculosis infection in around a third of cases. As the illness spreads in the lungs, many people with untreated TB suffer shortness of breath.

Extrapulmonary tuberculosis is a type of tuberculosis

that affects the outside of the lungs, the most prevalent sites for tuberculosis are probably the intestines and the skin.

  • Nodes of the lymphatic system
  • Kidneys

Tuberculosis can also damage the bones, brain, abdominal cavity, pericardium (the two-layered membrane that surrounds the heart), joints (particularly weight-bearing joints like the hips and knees), and reproductive systems. Tuberculosis can be difficult to detect in certain regions.

Extrapulmonary tuberculosis has a wide range of symptoms, including exhaustion, a loss of appetite, intermittent fevers, sweats, and even weight loss.

Depending on the location involved, the infection might produce pain, discomfort, a collection of pus (abscess), or other symptoms:

Lymph Nodes

The germs can migrate from the lungs to the lymph nodes that drain the lungs in new tuberculosis infection. If the body’s natural defenses are able to control the infection, the germs become dormant. Young children, on the other hand, have a poorer defense system. The lymph nodes that drain the lungs may enlarge to the point that they press against the bronchial passages, resulting in a brassy cough and possibly a collapsed lung. Bacteria can move from these lymph veins to lymph nodes in the neck on rare occasions. An infection in the lymph nodes of the neck can cause pus to leak through the skin. Bacteria can migrate through the bloodstream to lymph nodes in different regions of the body.


Fever, back pain, and blood in the urine are all symptoms of kidney infection. When an infection spreads to the bladder, patients are forced to urinate more frequently and urination becomes uncomfortable.


Tuberculosis has the potential to spread to the genitals as well. The scrotum enlarges in men with genital tuberculosis. It causes pelvic pain and menstruation irregularities in women, as well as an increased risk of a pregnancy in an unusual site (ectopic pregnancy).


Tuberculosis that infects the tissues that surround the brain (tuberculous meningitis) can be fatal. Tuberculous meningitis is particularly common in the elderly and persons with compromised immune systems in the United States and other affluent countries. Tuberculous meningitis is most common in children between the ages of one and five in underdeveloped nations. Fever, continuous headache, neck stiffness, nausea, confusion, and drowsiness are some of the symptoms, which might lead to coma. Tuberculosis can also infect the brain, resulting in a mass known as a tuberculoma. Symptoms of tuberculoma include headaches, convulsions, and muscle weakness. Tuberculomas are also more common and devastating in HIV-positive individuals.


The pericardium (the two-layered membrane that surrounds the heart) thickens and sometimes spills fluid into the gap between the pericardium and the heart in tuberculous pericarditis. Fever, chest pain, swollen neck veins, and difficulty breathing are all symptoms of these effects, which impair the heart’s ability to pump blood. Tuberculous pericarditis is a common cause of heart failure in areas where tuberculosis is prevalent.


Intestinal tuberculosis is primarily found in developing areas where cow tuberculosis is an issue. It’s spread through unpasteurized dairy products contaminated with Mycobacterium Bovis, which you can get by eating or drinking. Pain, diarrhea, bowel blockage, and the flow of bright red blood from the anus are all symptoms of this infection. The abdomen’s tissues may enlarge. This swelling could be misinterpreted as malignancy.


Tuberculosis can spread from another part of the body to the skin, such as the lymph nodes or bones (called cutaneous tuberculosis). It may result in the formation of painless, solid lumps. These lumps eventually expand and become open sores. Between the affected part of the body and the skin, channels may form, and pus may leak through them.

Tuberculosis (TB) diagnosis

  • A sputum sample is examined, cultured, and subjected to additional testing.
  • Tuberculin skin test
  • Blood tests for tuberculosis
  • Tuberculosis screening tests for those at risk
  • A positive tuberculosis screening test is sometimes the first sign of the disease.

People who are at risk of tuberculosis have tuberculosis screening tests done on a regular basis.

Fever, a cough that lasts longer than three weeks, a cough that comes up with blood, chest pain, and difficulty breathing are all signs of TB.

The first tests performed when doctors suspect TB are

  • X-ray of the chest
  • A sputum sample was examined and cultured under the microscope.
  • Rapid assays to look for Mycobacterium tuberculosis genetic material (DNA) in sputum samples

If the diagnosis is still unclear, you can try the following:

  • Skin test for tuberculosis
  • Tuberculosis blood testing

If tuberculosis is detected, blood tests to check for HIV infection (a risk factor for tuberculosis) may be performed.

Tuberculosis (TB) Screening Tests

For persons who are at risk of tuberculosis, certain tests are performed on a regular basis. The tuberculin skin test and the interferon-gamma release assay (IGRA) blood test are among the diagnostics available.

Tuberculosis is a disease that affects people of all ages.

If you live or work with people who have active tuberculosis, you should be aware of the risks (screening is done yearly)

Have recently emigrated from tuberculosis-endemic areas

Are beginning to use a medication that may impair the immune system and, if present, reactivate latent TB (for example,
corticosteroids and cancer chemotherapy)

Have a chest x-ray done for another cause that shows symptoms of potential tuberculosis

Have a compromised immune system? (for example, because of HIV infection)

Have a condition such as diabetes, kidney disease, or cancer of the head or neck

Are you over the age of 70?

Injecting illicit substances

People are reviewed by a doctor and a chest x-ray is conducted if the findings of a skin test or blood test are positive. If a chest x-ray is normal but no symptoms suggest tuberculosis, the patient most likely has latent tuberculosis. Antibiotics are used to treat people who have latent tuberculosis (see Treating tuberculosis early). People are tested for active tuberculosis if their chest x-ray is abnormal (see Diagnosis).

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