tuberculosis

What is Tuberculosis?

Tuberculosis (TB) is a serious bacterial infection that primarily affects the lungs, but can also spread to other parts of the body such as the brain, spine, and kidneys [1]. It is caused by the bacterium Mycobacterium tuberculosis (M. tuberculosis), which is typically spread through the air when an infected person coughs or sneezes [5].

Symptoms and Effects

TB can be fatal if left untreated [3]. The symptoms of TB may include fever, chills, and fatigue, as well as small lesions in the lungs or other parts of the body [10]. In its acute stages, TB can affect various parts of the body, including the lungs, brain, spine, and kidneys.

Transmission

TB is an airborne disease that spreads through the air when people with lung TB cough, sneeze, or spit [5]. It can also be spread through contact with contaminated food, water, or surfaces. However, this mode of transmission is less common.

Types of Tuberculosis

There are two main types of tuberculosis: latent and active. Latent TB occurs when the bacteria are present in the body but do not cause symptoms. Active TB, on the other hand, occurs when the bacteria multiply and cause symptoms [9].

References

[1] Mar 22, 2023 — Overview. [2] Oct 30, 2024 — Overview. [3] Tuberculosis is a bacterial infection that is also known as TB. It can be fatal if not treated. [5] Overview. TB is caused by bacteria (Mycobacterium tuberculosis) and it most often affects the lungs. [9] Tuberculosis is a chronic, progressive mycobacterial infection, often with an asymptomatic latent period following initial infection. [10] Result: noun | infection transmitted by inhalation or ingestion of tubercle bacilli and manifested in fever and small lesions (usually in the lungs but in various other parts of the body in acute stages)

Common Signs and Symptoms of Tuberculosis (TB)

Tuberculosis, also known as TB, is a bacterial infection that can affect various parts of the body, including the lungs, kidneys, spine, and brain. The symptoms of TB can vary depending on the location and severity of the infection.

General Symptoms:

• Cough: A persistent cough is one of the most common symptoms of TB, often accompanied by coughing up blood or mucus.
• Weight Loss: Unintentional weight loss is a common symptom of TB, especially in cases where the infection has spread to other parts of the body.
• Fever: Fever is another common symptom of TB, which can be accompanied by chills and night sweats.
• Night Sweats: Heavy sweating during sleep is a characteristic symptom of TB.

Other Symptoms:

• Chest Pain: Pain in the chest or back can occur due to the infection affecting the lungs or other parts of the respiratory system.
• Pain with Breathing or Coughing: Some people may experience pain when breathing or coughing, which can be a sign of TB.
• Loss of Appetite: A decrease in appetite is another symptom that can occur in some cases of TB.

Symptoms by Location:

• Lung TB: Symptoms of lung TB include a persistent cough, chest pain, and coughing up blood or mucus.
• Pulmonary TB: Symptoms of pulmonary TB are similar to those of lung TB, but may also include fever, chills, and night sweats.

Important Note:

TB symptoms can be mild for many months, making it easy to overlook the infection. If you suspect that you have TB or know someone who does, it's essential to seek medical attention promptly.

References:

• [1] Mar 6, 2024 — Common symptoms of active tuberculosis disease include cough, chest pain, and coughing up blood.
• [2] Mar 22, 2023 — Symptoms · Cough. · Coughing up blood or mucus. · Chest pain. · Pain with breathing or coughing. · Fever. · Chills. · Night sweats. · Weight loss.
• [4] What Are the Symptoms of TB? · A cough that lasts more than three weeks · Loss of appetite and unintentional weight loss · Fever · Chills · Night sweats.
• [7] Jul 29, 2024 — Signs and symptoms of active TB disease · A bad cough, lasting three weeks or longer · Pain in the chest · Coughing up blood or phlegm from deep ...
• [9] Jun 23, 2023 — Symptoms of TB · a persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody · weight loss · night sweats ...

Diagnosing Tuberculosis (TB): A Comprehensive Overview

Tuberculosis, a bacterial infection caused by Mycobacterium tuberculosis, can be challenging to diagnose due to its varied symptoms and manifestations. Fortunately, several diagnostic tests are available to confirm the presence of TB.

Types of Diagnostic Tests:

There are two primary types of screening tests for TB:

• Mantoux tuberculin skin test (TST): This is the most common method used to diagnose TB. It involves injecting a tiny amount of purified protein derivative (PPD) into the skin, usually on the forearm. A positive reaction indicates that you have been infected with TB.
• Interferon gamma release assay (IGRA): This blood test measures the immune system's response to TB bacteria. It is often used in conjunction with the TST or as an alternative for people who cannot undergo a skin test.

Additional Diagnostic Tests:

If the initial tests indicate the need for further analysis, your doctor may order:

• Chest X-ray or CT scan: These imaging tests can help identify visible signs of TB in the lungs.
• Rapid molecular tests: These tests are recommended by the World Health Organization (WHO) and can provide quick results.

Understanding Diagnostic Results:

A positive test result indicates that you have either a latent TB infection or active TB disease. Additional tests, such as blood samples, can help determine if you have an active infection.

References:

• [1] The WHO recommends rapid molecular tests for diagnosing TB.
• [2] The Mantoux tuberculin skin test is the most common method used to diagnose TB.
• [3] Molecular tests look for traces of the genetic material of Mycobacterium tuberculosis in a sample.

Overview of Drug Treatment for Tuberculosis

The treatment of tuberculosis (TB) involves the use of multiple antibiotics to kill the bacteria that cause the disease. The goal of TB treatment is to cure the infection and prevent its spread.

Commonly Used Drugs

Several drugs are commonly used in the treatment of TB, including:

• Isoniazid (INH): This is the most common therapy for latent TB and is often used as a first-line treatment for active TB.
• Rifampin (Rifadin, Rimactane): This antibiotic is taken daily for 4 months and is often used in combination with INH to treat active TB.
• Rifapentine (Priftin): This drug is similar to rifampin but is taken once a week for 12 weeks. It is often used as an alternative to rifampin in certain situations.
• Pyrazinamide: This drug is often used in combination with INH and rifampin to treat active TB.
• Ethambutol (Myambutol): This antibiotic is sometimes used in combination with other drugs to treat active TB.

Treatment Regimens

Several treatment regimens are available for TB, including:

• The 4-month rifapentine-moxifloxacin TB treatment regimen: This regimen has been shown to be as effective as the standard daily 6-month regimen in curing drug-susceptible TB [1].
• Three months of once-weekly isoniazid plus rifapentine (3HP): This regimen is an alternative to the standard daily regimen and involves taking INH and rifapentine once a week for 12 weeks.
• Four months of daily rifampin (4R): This regimen involves taking rifampin daily for 4 months.

Newer Drugs

Several newer drugs are being developed to treat TB, including:

• Bedaquiline: This drug has been shown to be effective in treating multi-drug resistant TB [5].
• Pretomanid: This drug is being studied as a potential treatment for TB and has shown promise in early trials.
• Linezolid: This antibiotic is sometimes used to treat TB that is resistant to other drugs.

References

[1] The 4-month rifapentine-moxifloxacin TB treatment regimen is as effective as the standard daily 6-month regimen in curing drug-susceptible TB (search result 1). [2] Isoniazid, rifampin, pyrazinamide, and ethambutol are commonly used to treat active TB (search result 2). [3] Three months of once-weekly isoniazid plus rifapentine (3HP), four months of daily rifampin (4R), and three months of daily isoniazid plus rifampin (3HR) are alternative treatment regimens for TB (search result 3). [4] Isoniazid, pyrazinamide, rifampicin, and streptomycin are important drugs used to treat TB (search result 4). [5] Bedaquiline has been shown to be effective in treating multi-drug resistant TB (search result 5).

The differential diagnosis of tuberculosis (TB) involves identifying other conditions that may present similarly to TB, making it challenging to diagnose accurately. According to various medical sources [1][2], the differential diagnoses for pulmonary TB include:

• Bacterial pneumonia, particularly anaerobic infection
• Fungal infections such as histoplasmosis and fungal pneumonia
• Actinomycosis
• Bronchiectasis, which is often secondary to other respiratory infections or chronic conditions like tuberculosis itself [3]
• Constrictive pericarditis
• Lung abscesses

Additionally, there are constitutional diseases that may be confused with TB, such as undulant fever, characterized by leukopenia and an enlarged spleen [4].

It's worth noting that the differential diagnosis of latent TB infection (LTBI) can also promote an understanding of the pathogenesis of TB and reduce the risk of progression to active disease [5].