Tuberculosis (TB) - Types, Causes, Symptoms, Diagnosis, and Treatment

What Is Tuberculosis?

Tuberculosis (TB) is one of the common infectious diseases that majorly affects the lungs but can also affect other organs in the body. It can be prevented and treated, but sometimes it can be fatal. The bacteria causing this disease tend to be contagious through tiny droplets that are released into the air through coughs and sneezes.

Before the development of antibiotics and improvements in hygiene, TB was a major cause of death worldwide, especially in underdeveloped and developing countries. But after major improvements in these areas, the number of people infected with this bacteria has drastically reduced. The cases in developed countries began to rise in 1985, which was mainly due to the emergence of HIV infection. As HIV (Human Immuno Virus) weakens the person's immune system, it leaves the body unable to fight bacteria causing TB.

Antibiotic resistance due to indiscriminate use has made most strains of this bacteria resistant to the most effective antibiotics. Such resistant cases are difficult to treat. Tuberculosis patients are treated with a combination of different antibiotics.

What Are the Types of Tuberculosis?

They are primarily classified as latent or active.

1. Latent Tuberculosis - The bacteria stay in an inactive stage and are asymptomatic but can get reactivated at a later stage causing active symptoms.

2. Active Tuberculosis - The bacteria are active causing symptoms and at this stage, can be contagious (spread to other people).

And depending on the part of the body affected, TB is classified into:

1. Pulmonary Tuberculosis - It is an active type of TB that involves the lungs.

2. Extrapulmonary Tuberculosis - TB that affects any body part apart from the lungs. It includes:

• TB lymphadenitis - TB involves the lymph nodes, mainly the lymph nodes of the neck. The symptoms include swollen and painful lymph nodes, fever, night sweats, and tiredness.

• Bone TB - TB that spreads to the bones from the lungs. It causes back pain, bone deformities, swelling, and abscess.

• Military TB - TB that spreads to multiple organs in the body.

• Liver TB - Otherwise called hepatic TB, and is the type that affects the liver. It can result in fever, jaundice, and liver enlargement.

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• Genitourinary TB - TB that spreads to the genitourinary system, which includes the kidneys, ureter, urethra, and urinary bladder. It is the second most common type. The symptoms include pain during urination, pelvic pain, infertility, and testicular swelling.

• Gastrointestinal TB - In this type, the gastrointestinal tract is affected, which results in symptoms such as stomach pain, weight loss, nausea, vomiting, etc.

• TB peritonitis - When the bacteria infects the peritoneum, which is the tissue that lines the abdomen. It can cause nausea, loss of appetite, and vomiting.

• TB Pericarditis - When TB spreads to the tissue that surrounds the heart (pericardium).

• TB meningitis - When TB spreads to the meninges of the brain. The symptoms are persistent headache, light sensitivity, and neck stiffness.

• Cutaneous or skin TB - It is a very rare type where the skin gets affected.

What Are the Symptoms of Tuberculosis?

Symptoms may vary and the most common symptoms are mentioned below.

• Fever

• Night sweats.

• Cough.

• Blood-stained phlegm.

• Pain when coughing.

• Pain in breathing.

• Fatigue.

• Chest pain.

• Loss of appetite.

How Does It Spread?

It spreads through the air. When a person with active TB infection coughs, sneezes, talks, or spits, the infected droplets containing the bacteria enter into the air and can get into a healthy person and infect them when they breathe the same air.

However, it does not spread so easily to all, it takes some time and repeated exposure. For example, individuals living in the same house or working at the same office as an infected person are at higher risk.

Risk Factors:

The following factors increase the risk of an individual getting TB:

1. Immunocompromised Conditions - HIV/AIDS (Acquired Immunodeficiency Syndrome), diabetes, chronic kidney disease, cancer and cancer treatments, immunosuppressant drugs, malnutrition, and very young or old people.

2. Living in Certain Places - Traveling or living in underdeveloped or developing countries.

3. Poverty - People who have a fixed low income and no access to medical care.

4. Substance Use - As it weakens the immune system and makes one susceptible to infections.

5. Healthcare professionals who come in constant contact with infected patients.

6. Working or living in nursing homes, prisons, psychiatric hospitals, and homeless shelters, can make one more vulnerable due to overcrowding.

7. Living with someone who has TB.

How Does a Doctor Diagnose Tuberculosis?

Apart from the initial skin test (Mantoux test), the more accurate tests to diagnose TB are:

• Blood tests.

• Chest X-ray.

• Sputum tests.

• CT scan (computed tomography), lung biopsy, and bronchoscopy may be ordered if other tests are inconclusive.

What Are the Treatment Options for Tuberculosis?

Drugs:

Special antibiotics are needed to treat TB. The regimen includes three or more drugs in a combination depending on the age, symptoms, and general health.

• Isoniazid (INH).

• Rifampin (RIF).

• Rifapentine (RPT).

• Ethambutol.

• Pyrazinamide.

These drugs have to be taken on a long schedule of four to six months or more as these bacteria are quite resistant and not easy to eliminate from the body. It is important to complete the entire duration of the course as prescribed by the doctor. Many patients discontinue the treatment halfway when they have no more symptoms. But the bacteria would not have been completely eliminated and discontinuation can cause reactivation and relapse.

What Are the Possible Complications of Tuberculosis?

If left untreated, TB can spread and result in the following complications:

• Back pain.

• Tuberculous arthritis causes joint pain and stiffness.

• Severe headache and mental changes when the meninges of the brain get infected.

• Impaired functioning of the liver and kidneys.

• It affects the heart’s ability to pump blood efficiently.

Conclusion

When suspected of an active TB infection, be sure to wear a special mask until treatment completion to prevent the spread to near and dear ones. Keep away from school or work to minimize exposure. Open the windows of the room for better air circulation. Bacillus Calmette-Guerin (BCG) vaccine is used to vaccinate infants In countries where tuberculosis is prevalent. Individuals who notice TB symptoms are advised to consult a healthcare professional at the earliest.