What is tuberculosis?

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Tuberculosis is a highly infectious disease. Known colloquially as “TB,” the disease primarily affects the lungs. Tuberculosis, once known as “consumption”, is known to science as Mycobacterium tuberculosis. At the time of its discovery, tuberculosis killed one out of seven people who lived in the United States and Europe. Tuberculosis killed 1.7 million people in 201, and its prevalence caused the World Health Organization (WHO) to classify it as one of the top 10 causes of death worldwide.

Tuberculosis is an airborne disease. When people with lung TB cough, sneeze, or spit, they transmit tuberculosis germs to others through the air. Once another individual inhales these germs, they can become infected and carry the infection. As a result, approximately one-quarter of the world carries the TB infection. These individuals are potentially infected by TB bacteria. However, since they are not yet ill from TB, they cannot transmit it to others. Tuberculosis is prevalent in developing countries. Even so, the Centers for Disease Control and Prevention reported over 9,000 cases in the United States in 2016. If you believe you may have contracted tuberculosis, you should visit your doctor or pulmonologist as soon as possible.

What causes tuberculosis?

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Given its airborne nature, individuals are easily susceptible to tuberculosis. The bacteria known as Mycobacterium tuberculosis causes TB. People contract different TB strains through infected droplets in the air. Once another person inhales the droplets, that individual can further spread tuberculosis in any of the following ways:

  • Sneezing
  • Coughing
  • Speaking
  • Singing

It is also possible for someone to be infected with the bacteria and to not experience TB symptoms. In these cases, the individual has latent or inactive TB infection. While latent tuberculosis is not contagious, it can make you and others around you ill once it becomes active.

What are symptoms of tuberculosis?

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Symptoms can vary for individuals who have tuberculosis. However, it is challenging for doctors to diagnose children with the condition. Nonetheless, there are several known and common symptoms for the disease. These symptoms include:

  • Coughing with sputum (phlegm) and blood
  • Chest pains
  • Loss of appetite
  • Weakness
  • Weight loss
  • Fever and night sweats

If you experience any combination of these symptoms, visit your physician as soon as possible. While these symptoms are fairly nebulous, a doctor can use diagnostic tests to confirm the condition.

How is tuberculosis diagnosed?

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Only a doctor can provide a tuberculosis diagnosis. The World Health Organization recommends using rapid molecular diagnostic tests to diagnose tuberculosis. These are best used as the first diagnostic test when an individual exhibits symptoms of the condition. The tests are highly accurate. The benefit of these tests is that they often lead to early detection of tuberculosis, as well as drug-resistant tuberculosis.

What are types of tuberculosis?

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The two main types of tuberculosis are active TB and latent TB. Active TB – also referred to as TB disease – is contagious and causes symptoms. Alternatively, latent TB causes no symptoms and is not contagious while dormant. While tuberculosis generally manifests in and affects the lungs, it can also affect other body parts. In these cases, this is what helps physicians determine the difference between pulmonary TB and extrapulmonary TB diagnoses.

  • Pulmonary TB – This type of tuberculosis is active TB and it involves the lungs. When most people think of tuberculosis, they are thinking about pulmonary TB. Individuals contract the disease by breathing in the air that is exhaled by another person who has active TB. These germs can linger in a room for several hours. Those infected with pulmonary TB can experience a cough that persists for three weeks or longer. Other symptoms include, but are not limited to, coughing up phlegm and shortness of breath.
  • Extrapulmonary TB – This type of tuberculosis affects the rest of the body outside of the lungs. It can infiltrate different bones and organs. For that reason, symptoms differ depending on which part of the body the tuberculosis affects. The different types of extrapulmonary TB include:
  1. TB Lymphadenitis: It is the most common type of extrapulmonary TB. It affects the body’s lymph nodes – most commonly, the cervical lymph nodes in the neck. Swollen lymph nodes make TB lymphadenitis noticeable. Other symptoms may include fever, fatigue, unexplained weight loss, and night sweats.
  2. Skeletal TB: The rare form of TB spreads to your bones from your lungs or lymph nodes. Also known as bone TB, it can affect your spine and joints. Skeletal TB cases are prevalent in countries with higher rates of HIV transmission and AIDS. Both these conditions weaken the immune system, which causes an increased risk of skeletal TB. Symptoms are not immediately present in the early stages. Eventually, though, skeletal TB can cause general active TB symptoms, as well as severe back pain, stiffness, swelling, abscesses, and bone deformities.
  3. Miliary TB: This form of tuberculosis can spread throughout the body and affect any number of organs. It commonly affects the lungs, bone marrow, and liver. It also can spread to the spinal cord, brain, and heart. Symptoms can include a low red blood cell count or rash if the TB affects your bone marrow.
  4. Genitourinary TB: This is the second most common type of extrapulmonary TB. Genitourinary TB most commonly affects the kidneys. It can also affect any genital region or any part of the urinary tract. The particular form of TB can spread through intercourse. More commonly, those with this type of TB will develop a tuberculous ulcer. Symptoms can include testicular swelling, pelvic pain, painful urination, and infertility.
  5. Liver TB: Also known as hepatic TB, liver TB makes up less than 1% of all TB infections. This form of TB can spread to the liver in multiple ways. It can travel from the lungs, the lymph nodes, the portal vein, or the gastrointestinal tract. A high-grade fever or liver enlargement can be symptoms of liver TB.
  6. Gastrointestinal TB: This type of TB can involve any part of the gastrointestinal tract. The tract spans from the mouth to the anus. The symptoms are not unlike those for individuals with Crohn’s disease. The symptoms depend on the region affected and can include abdominal pain and loss of appetite. Other symptoms are weight loss, change in bowel habits, nausea, vomiting, or an abdominal mass that you can feel.

If your doctor suspects you have tuberculosis, they will take care to find the specific form of the condition. Then, they will alter your treatment course to suit your diagnosis.

Can you prevent tuberculosis?

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There are different ways to prevent tuberculosis. Early vaccination is the best and easiest form of tuberculosis prevention. The vaccine, called Bacillus Calmette-Guerin (BCG), is not often given in the United States. The vaccine also only protects against some tuberculosis strains.

If you have or suspect you have tuberculosis, avoiding crowds until you are no longer contagious can help stop the spread. Without taking any precautions, people with active TB can spread the disease to 10 to 15 close-contact people per year. Health care professionals also advise wearing surgical masks to prevent spreading the airborne disease.

Are there any risk factors or groups for tuberculosis?

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Anyone can contract tuberculosis, but there are groups at higher risk for TB infection. Ultimately, there may be a number of reasons why you should get tested for tuberculosis.

  • Exposure: If you have spent time around someone with TB disease, you should get tested for TB infection.
  • Geography: Tuberculosis has varying degrees of prevalence around the world. If you spent time in Latin America, the Caribbean, Africa, Asia, Eastern Europe, or Russia, it could be prudent to get tested.
  • High-risk setting: There are several environments that can become high-risk settings for transmission. These include correctional facilities, nursing homes or long-term care facilities, and homeless shelters. Health care workers who care for high-risk patients are also potentially at risk.

How is tuberculosis treated?

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Unlike other bacterial infections, tuberculosis is not treated with antibiotics for a week or two. Once diagnosed with active TB disease, most people often need to take a combination of medications. These medications will last for anywhere from six to nine months. So, if you are wondering, “Should you see a doctor for tuberculosis?”, the answer is: Yes.

It is crucial to undergo the full treatment if prescribed medications. If you do not complete the full medication regimen, a TB infection could return. Recurring tuberculosis can become resistant to medications, making it more difficult to treat.

Some tuberculosis strains that are resistant to certain drugs. This means your doctor will likely prescribe a combination of medications and antibiotics. The most common of these combinations are:

  • Isoniazid
  • Ethambutol (Myambutol)
  • Pyrazinamide
  • Rifampin (Rifadin, Rimactane)
  • Rifapentine (Priftin)

What is the outlook for people living with tuberculosis?

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Curing tuberculosis is possible, but the outlook differs by case. A person’s medical history and willingness to undergo treatment affect successfully curing active TB. For instance, if the infected individual has other diseases, it may be more challenging to treat active TB. HIV is just one of the diseases that weakens the immune system. Ultimately, it hinders the body’s ability to fight off tuberculosis, along with other infections.

Lack of access to medical care is another issue when treating tuberculosis. Along with early diagnosis and treatment, antibiotic combinations are instrumental in potentially curing TB.