Tuberculosis

Tuberculosis: Overview

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 and Development; Contributing 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 and 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 and 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 and 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.

Signs, symptoms & indicators of Tuberculosis:

Lab Values - Cells

Symptoms - Abdomen

Symptoms - Metabolic

Symptoms - Respiratory

Recent/chronic productive cough may be a sign or symptom of Tuberculosis 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.

Conditions that suggest Tuberculosis:

Autoimmune

Addisons Disease may suggest Tuberculosis 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.

Inflammation

Bursitis may suggest Tuberculosis Bursitis

Tuberculosis has been known to be an underlying cause of bursitis.

Lab Values

Nervous System

Respiratory

Collapsed Lung may suggest Tuberculosis Collapsed Lung

Tuberculosis increases the risk of a collapsed lung.

Skin-Hair-Nails

Night Sweats often suggests Tuberculosis 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.

Risk factors for Tuberculosis:

Family History

Lab Values - Scans

Counter-indicators

Recommendations for Tuberculosis:

Mineral

KEY

Weak or unproven link: may be a sign or symptom of; may suggest
Weak or unproven link:
may be a sign or symptom of; may suggest
Strong or generally accepted link: often suggests; often increases risk of
Strong or generally accepted link:
often suggests; often increases risk of
Strong counter-indication: often decreases risk of
Strong counter-indication:
often decreases risk of
May be useful: may help with
May be useful:
may help with