Tuberculosis (TB): Symptoms, Types, Diagnosis, and Treatment

Tuberculosis (TB) is a contagious infectious disease that usually attacks your lungs. However, it can also spread to other parts of your body, like your brain and spine. A type of bacteria called Mycobacterium tuberculosis causes it.

In the 20th century, TB was a leading cause of death. Today, Most illnesses can be treated with antibiotics. However, it takes a while. Medications for tuberculosis must be taken for at least 6 to 9 months.

According to the World Health Organization (WHO), 1.5 million people died from the disease in 2020. Tuberculosis is also the thirteenth leading cause of death worldwide. Currently, it is the second leading cause of infectious death after COVID-19.

Causes of Tuberculosis

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis, primarily targeting the lungs but capable of spreading to other parts of the body. The disease spreads through airborne droplets released when a person with active TB in their lungs or throat talks, coughs, sneezes, or sings. Inhaling these bacteria-laden droplets can lead to infection.

This disease is more likely to spread in crowded or enclosed environments where people spend extended periods together, such as households, workplaces, or healthcare settings. However, casual interactions like touching, sharing food, or kissing do not contribute to TB transmission.

Drug-Resistant TB

In some cases, the TB bacteria become resistant to medications, leading to drug-resistant TB. This occurs when bacteria develop genetic mutations that make them immune to standard antibiotic treatments. Factors contributing to drug resistance include:

• Improper or incomplete use of prescribed TB medications
• Incorrect treatment plans
• Poor-quality or unavailable medicines
• The body’s inability to absorb the medications properly

Drug-resistant TB presents a major global health challenge, necessitating more intricate and extended treatment approaches.

Symptoms of Tuberculosis

Typical symptoms of tuberculosis include:

• A persistent cough that lasts more than three weeks and usually causes phlegm, which may be bloody
• Weight loss
• Night sweats
• High fever
• Tiredness
• Loss of appetite
• Neck swelling

You should see a doctor if you have a cough that lasts longer than three weeks or if you are coughing up blood.

Types of Tuberculosis

There are two forms of the disease:

Latent TB: You have germs in your body, but your immune system prevents them from spreading. As a result, you have no symptoms and are not contagious. But the infection is still alive and could one day become active. If you’re at high risk for re-activation, For example, if you have HIV, you had an infection in the past two years, your chest X-ray is unusual, or your immune system is weakened your doctor will give you medications to prevent active TB.

Active TB: The germs multiply and make you sick. You can transmit the disease to others. 90% of active cases in adults come from latent tuberculosis infection.

Three Stages of TB

The three stages of TB are:

• Exposure. This happens when a person has been in contact with or exposed to another person with TB.
• Latent TB infection. A person with TB bacteria in their body, but no disease symptoms. The person’s immune system walls off TB organisms, and the TB remains inactive throughout life.
• TB disease. This describes the person who has signs and symptoms of an active infection. In addition, the person would have a positive skin test and a positive chest X-ray.

Risk Factors of Tuberculosis

Risk factors that increase your chance of contracting the bacteria that cause TB disease include:

• Suffering from diabetes, end-stage renal failure or certain cancers
• Malnutrition
• Tobacco or alcohol for long periods
• A diagnosis of HIV or other weakened immune system condition
• Medications that suppress the immune system can also put people at risk of developing active TB disease.

Other factors include:

• Cancer
• Rheumatoid arthritis
• Crohn’s disease
• Psoriasis
• Lupus

Diagnosis of TB

Healthcare experts can diagnose TB with a few different tests, including a skin check, a blood test, etc. A false-negative result can happen if your immune system isn’t running well or if it’s been less than eight weeks since exposure to TB.

Skin Test

Your physician can use a purified protein derivative (PPD) skin check to diagnose if you’ve TB bacteria. For this test, the doctor will inject 0.1 millilitres (mL) of PPD (a small quantity of protein) under the top layer of your skin. After, 2 and 3 days, you’ll return to your doctor’s office to have the results. A welt in your skin over 5 millimetres (mm) in size where the PPD was injected can be considered a positive result. Reactions between 5 and 15 mm in length may be positive depending on risk factors, health, and medical history.

All responses over 15 mm are considered active, irrespective of risk factors. The test isn’t perfect, though. It can inform you whether or not you’ve got a TB infection. People who’ve recently taken the TB vaccine may also test positive.

Blood Check

Your health practitioner can use a blood test to follow up on TB skin outcomes. They might also suggest a blood test first, particularly when you have an existing health condition that can affect your response to the skin check.

Chest X-ray

If you get a positive result from the skin or blood test, your physician will probably recommend a chest X-ray to look for certain small lung spots. These spots, a sign of a TB infection, indicate that your body is attempting to isolate the TB bacteria. A negative chest X-ray can suggest latent TB; however, it’s also feasible your check results were incorrect. Therefore, your physician may also recommend further testing. If the test indicates you’ve got active TB disease, you’ll have to begin treatment for active TB. Otherwise, your health practitioner may also suggest getting treated for latent TB. This can prevent the bacteria from reactivating and making you unwell in the future.

Prevention of Tuberculosis

• Manage the environment : As TB is an airborne infection, the TB bacteria are released into the air when a person with TB coughs or sneezes. Therefore, the threat of disease may be decreased by using a few correct yet easy precautions:
• Proper ventilation : TB can remain suspended in the air for numerous hours without ventilation.
• Natural light : UV light kills off TB microorganisms
• Good hygiene : Masking the mouth and nostrils when coughing or sneezing reduces the spread of TB bacteria. In healthcare settings, the spread of TB is decreased via shielding masks, airflow systems, retaining doubtlessly infectious sufferers cutting different loose sufferers, and the regular screening of healthcare employees for TB.
• A healthy immune system : A healthy immune system is the best defence against TB: 60% of adults with a healthy immune system can kill TB microorganisms.

Treatment of Tuberculosis

Tuberculosis (TB) is managed using a combination of antibiotics designed to eliminate the Mycobacterium tuberculosis bacteria. The treatment plan depends on whether the infection is latent or active.

Treatment for Latent TB

For individuals with latent TB, where the bacteria are present but inactive, treatment helps prevent the infection from becoming active in the future. Patients typically take antibiotics for several months, with common regimens lasting between 3 to 9 months.

Treatment for Active TB

For active TB disease, a standard treatment regimen lasts between 4 to 9 months and includes a combination of antibiotics such as:

• Isoniazid
• Rifampin (or Rifapentine)
• Pyrazinamide
• Ethambutol

Strictly following the prescribed medication regimen is vital to completely remove the bacteria. Stopping treatment prematurely can lead to drug-resistant TB, making the disease more difficult to cure.

Drug-Resistant TB

Some strains of TB bacteria have developed resistance to commonly used antibiotics, leading to Multidrug-Resistant TB (MDR-TB) or Extensively Drug-Resistant TB (XDR-TB). Treating drug-resistant TB requires alternative medications that are often more expensive, have more side effects, and must be taken for a longer period—sometimes over a year.

TB and HIV Co-Infection

Individuals with HIV have a greater likelihood of developing TB because of their compromised immune systems. A combination of TB treatment and antiretroviral therapy (ART) is recommended to manage both conditions effectively.

Importance of Completing Treatment

Although symptoms may subside within a few weeks, finishing the entire treatment regimen is vital to avoid relapse or the development of drug resistance. Patients undergoing treatment should also take precautions, such as wearing masks and maintaining good ventilation, to prevent spreading the disease to others.

Frequently Asked Questions