Tuberculosis (TB) Facts (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Jerry R. Balentine, DO, FACEP
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
In this Article
- Tuberculosis (TB) facts
- What is tuberculosis?
- Are there different types of tuberculosis (TB)?
- What causes tuberculosis?
- What are risk factors for tuberculosis?
- What are tuberculosis symptoms and signs?
- Is TB contagious, and how long is the incubation period and contagious period?
- How do physicians diagnose tuberculosis?
- What is the treatment for tuberculosis?
- What types of doctors treat TB?
- What are complications of tuberculosis?
- What is the prognosis of tuberculosis?
- How can people prevent tuberculosis?
What are risk factors for tuberculosis?
There are many risk factors for developing tuberculosis. Certain groups of people have a high risk, such as people who work in hospitals and other areas where TB-infected people may reside (jails, nursing homes, group homes for HIV patients, homeless shelters). Close association with drug users, or people with known TB infections are also at higher risk. Other people at high risk include the following:
- Visitors and immigrants from areas known to have high incidence of TB
- Children and the elderly with weakened immune systems (especially those with a positive TB skin test, see below)
- Patients with HIV infection
- Drug abusers, especially IV drug abuse
- Head and neck cancer patients
- Transplant patients
- Kidney disease patients
- People undergoing immunosuppressive therapy
What are tuberculosis symptoms and signs?
Although there are a number of TB types, pulmonary TB is responsible for the majority (about 85%) of TB infections. Consequently, pulmonary TB symptoms and signs may occur with or even before other types of TB are diagnosed. The classical clinical symptoms and signs of pulmonary TB may include the following:
- Night sweats
- Cough (often chronic)
- Hemoptysis (coughing up bloody sputum)
- Decrease or loss of appetite
- Weight loss and/or muscle loss (unintentional)
- Fatigue and/or malaise
- Chest pain (pain while breathing)
- Shortness of breath
- Swollen lymph nodes
- Pneumonitis (may be the only symptom in the elderly).
Other types are loosely classified as extra pulmonary and often have symptoms that are nonspecific but frequently localized to the involved site. The following includes the signs and symptoms of additional types of TB:
- Skeletal TB (also termed Pott's disease): spinal pain, back stiffness, paralysis is possible
- TB meningitis: headaches (variable in length but persistent), mental changes, coma
- TB arthritis: usually pain in a single joint (hips and knees most common)
- Genitourinary TB: dysuria, flank pain, increased frequency, masses or lumps (granulomas)
- Gastrointestinal TB: difficulty swallowing, nonhealing ulcers, abdominal pain, malabsorption, diarrhea (may be bloody)
- Miliary TB: many small nodules widespread in organs that resemble millet seeds (hence its name)
- Pleural TB: empyema and pleural effusions
- MDR TB: patients infected with TB bacteria that are resistant to multiple drugs
- XDR TB: patients infected with TB bacteria that are resistant to some of the most effective anti-TB medications; XDR stands for extensively drug resistant
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