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Tuberculosis or TB was very common in the U.S. before antibiotics were developed. At that time, it was called Consumption and was a major cause of death. It is still a common cause of death in developing countries. It is caused by the tiny, slow growing bacteria Mycobacterium tuberculosis. The bacteria lodges in the lungs and can become active immediately or wait months or years to emerge as an active infection. It is terminal if left untreated.
Tuberculosis can attack many different parts of the body, but in developed countries, it is usually found in the lungs. For that reason only the pulmonary form of the disease will be discussed here.
Causes & Development; Risk Factors
TB is one of the few diseases that are spread in the air from the sick person coughing or breathing. The bacteria ride in the air as tiny droplets that may stay airborne for hours. It is spread by inhaling these droplets. Because of this, patients with known TB must have special isolation precautions.
Active infections of TB can come from a new exposure to the bacteria or from reactivation of the disease from an old exposure.
People with weak immune systems are more likely to have active TB. This would include the elderly, children, people with HIV/AIDS, people with diabetes, or anyone who has been "worn down" from lack of sleep or lack of proper nutrition.
The risk of Tuberculosis (TB), especially among children, increases with the following risk factors: having a family history of tuberculosis infection going back two to three generations; having traveled abroad or having been exposed to foreign visitors; having contact with HIV-infected persons; having contact with current or previous prison inmates; and living in high-risk areas.
Signs & Symptoms
Pulmonary TB is often so nearly asymptomatic (showing no signs or symptoms) that the patient may deny all symptoms except "not feeling well". However, the following symptoms are possible:- A cough that does not go away is the most common symptom. The patient often ignores it and attributes it to smoking or a cold.
- A 'productive' cough, with yellow or green sputum (the material that is coughed up). At first, this is just a small amount first thing in the morning, but becomes more productive as the disease progresses.
- Dyspnea (shortness of breath) may result from damage to the lung by the bacteria
- Hemoptysis (coughing up blood) usually does not occur until the later stage of TB
- Unexplained weight loss
- Night sweats from a fever that spikes up at night and is down during the day.
Diagnosis & Tests
Diagnosis will almost certainly require lab tests and X-rays. It shares symptoms with many other respiratory infections. Since TB is not extremely common in the United States at this time, suspect other problems before you suspect TB.- Presence of signs and symptoms
- Treatment for other respiratory infections has not cleared the problem
- The following would increase your suspicion of TB:
- History of exposure to someone with active TB
- History of previous active TB
- History of a positive TB test (also called a PPD test) in the past
- History of travel to a country where TB is common (most third world nations)
- History of working/living in a high-risk area: hospital, nursing home, prison, group home, drug treatment center, refugee camp, etc.
Treatment & Prevention
As with most things, prevention is best -- especially since TB can be (extremely) hard to treat. If you are in the close company of others suspected of being at risk for TB, everyone should be screened annually for TB. The test is cheap and easy. If someone in your group has been exposed, REQUIRE them to go through the full course of treatment, which can take up to 9 months.
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Signs, symptoms & indicators of Tuberculosis: | | | | | Symptoms - Respiratory |  Recent/chronic productive cough | Tuberculosis of the lung is usually associated with a persistent cough that does not go away. It may start as a dry cough that eventually leads to a productive cough with blood-stained sputum. |
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Conditions that suggest Tuberculosis: | | | | | Autoimmune | Addison's Disease| | When Dr. Thomas Addison first described this disease in London in 1855, the most common cause was tuberculosis. This remained the leading cause until the middle of the twentieth century when antibiotics progressively reduced TB's incidence. TB is nevertheless still a possible cause. |
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Inflammation |
Bursitis |
Lab Values |
Monocytes Elevated |
Nervous System |
Neuritis/Neuropathy |
Skin-Hair-Nails |
 Night Sweats| | Tuberculosis (TB) is the classic cause of night sweats. Early on the immune system typically controls the infection and few if any symptoms develop. Then, later in life, the infection may reactivate, causing a chronic pneumonia with fever, night sweats, weight loss and cough. Sometimes the infection involves the lungs minimally, if at all. If you have had night sweats for more than a month or two without any other symptoms, tuberculosis would be less likely but not impossible. |
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Symptoms - Respiratory |
 Tuberculosis (confirmed) |
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Risk factors for Tuberculosis:
Recommendations and treatments for Tuberculosis:
KEY | | Weak or unproven link | | | Strong or generally accepted link | | | Proven definite or direct link |  | | May do some good |
GLOSSARY
AIDS
Acquired Immune Deficiency Syndrome. An immune system deficiency disorder that suddenly alters the body's ability to defend itself. The AIDS virus invades the T4 helper/inducer lymphocytes and multiplies, causing a breakdown in the body's immune system, eventually leading to overwhelming infection and/or cancer, with ultimate death.
Asymptomatic
Not showing symptoms.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Bursitis
The bursa is a fluid-filled pad that allows your muscles to easily slide over other muscles and bones. Bursitis occurs when this pad becomes inflamed. It usually occurs when you overuse or injure a specific joint, but it can also be caused by a bacterial infection. Symptoms include pain and inflammation around joints such as the elbow, hip, shoulder, big toe, ankle or knee.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.
Diabetes Mellitus (Diabetes, Diabetic, Diabetics)
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Dyspnea
Air hunger with pained/difficult breathing. It occurs normally from physical exertion, and abnormally either from impaired respiration, emotional distress, or a breakdown in nerve responses.
Human Immunodeficiency Virus (HIV)
A retrovirus associated with onset of advanced immunodeficiency syndrome (AIDS).
Immune System (Immune Response, Immunity)
A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation. The process may involve acquired immunity (the ability to learn and remember a specific infectious agent), or innate immunity (the genetically programmed system of responses that attack, digest, remove, and initiate inflammation and tissue healing).
Lung (Lungs, Pulmonary)
Organ of the body, located in the chest cavity which is designed to bring oxygen from the air into the blood stream, while also expelling carbon dioxide and other waste gases out of the body. Pulmonary: Related to the lungs.
Pneumonia (Pneumonitis)
Inflammation, usually infectious, of the lungs. Unless the result of only moderate chemical or smoke irritation, it is a potentially life-threatening condition. There are so many defenses against an infection this deep in the body that the very presence of pneumonia signals a pathogen of great virulence or impaired or exhausted immunity, or all three. Pneumonitis: Inflammation of the lungs, from whatever cause. It may be concurrent with pneumonia or pleurisy.
Tuberculosis
Also known as TB, Consumption or "The White Plague", tuberculosis is an infectious disease caused by a bacterium called Mycobacterium tuberculosis, usually affecting the lungs but possibly also the brain, kidneys and bones. Patients may at first be symptom-free or experience a flu-like illness. In the secondary stage, there might be a slight fever, night sweats, weight loss, fatigue and various other symptoms, depending on the part of the body affected. Tuberculosis of the lung is usually associated with a dry cough that eventually leads to a productive cough with blood-stained sputum. There might also be chest pain and shortness of breath.
X-rays (X-ray)
High-energy radiation used to take pictures of areas inside the body.
Last updated: Jun 22, 2008
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