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 involved with TB testing?
- 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?
Are there different types of tuberculosis (TB)?
There are many types of tuberculosis, but the main two types are termed either active or latent tuberculosis infection. Active TB is when the disease is actively producing symptoms and can be transmitted to other people; latent disease is when the person is infected with Mycobacterium tuberculosis bacteria, but the bacteria are not producing symptoms (usually due to the body's immune system suppressing the bacterial growth and spread) and have no TB bacteria in the sputum. People with latent TB usually cannot transfer Mycobacterium tuberculosis bacteria to others unless the immune system fails; the failure causes reactivation (bacterial growth is no longer suppressed) that results in active TB so the person becomes contagious. Latent TB resembles chickenpox infection that goes dormant and may reactivate years later.
Many other types of TB exist in either the active or latent form. These types are named for the signs and for the body systems Mycobacterium tuberculosis preferentially infect, and these infection types vary from person to person. Consequently, pulmonary tuberculosis mainly infects the pulmonary system, cutaneous TB has skin symptoms, while miliary TB describes widespread small infected sites (lesions or granulomas about 1 mm-5 mm) found throughout body organs. It is not uncommon for some people to develop more than one type of active TB. More types will be listed in the symptoms and signs section below.
Atypical mycobacteria that may cause disease are the M. avium complex, M. fortuitum complex, and M. kansasii.
What causes tuberculosis?
The cause of TB is infection of human tissue(s) by the bacterium Mycobacterium tuberculosis (mycobacteria or TB). These bacteria are slow growing, aerobic, and can grow within body cells (an intracellular parasitic bacterium). Its unique cell wall helps protect it from the body's defenses and gives mycobacteria the ability to retain certain dyes like fuchsin (a reddish dye) after an acid rinse that rarely happens with other bacterial, fungal, or parasitic genera.
Mycobacteria that escape destruction by body defenses may be spread by blood or lymphatic pathways to most organs, with preference to those that oxygenate well (lungs, kidneys, and bones, for example). Typical TB lesions, termed granulomas, usually consist of a central necrotic area, then a zone with macrophages, giant Langerhans cells and lymphocytes that become surrounded by immature macrophages, plasma cells, and more lymphocytes. These granulomas also contain mycobacteria. In latent infections, a fibrous capsule usually surrounds the granulomas, and in some people, the granulomas calcify, but if the immune defenses fail initially or at a later time (reactivate), the bacteria continue to spread and disrupt organ functions.
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