Tuberculosis history and symptoms: Difference between revisions
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===Pulmonary Tuberculosis=== | ===Pulmonary Tuberculosis=== | ||
When the disease becomes active, 75% of the cases are located in the lungs. Pulmonary tuberculosis should be suspected in persons who have the following symptoms:<ref name="Mandell">{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref> | When the disease becomes active, 75% of the cases are located in the lungs. Pulmonary tuberculosis should be suspected in persons who have the following symptoms:<ref name="Mandell">{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref> | ||
*[[Cough]] (most common symptom) | *[[Cough]] (most common symptom) | ||
:*Initially dry cough that progresses to productive. | :*Initially dry cough that progresses to productive. | ||
:*Persistent cough, usually for more than three weeks. | :*Persistent cough, usually for more than three weeks. | ||
*[[Fever]] | |||
*[[Fever]] | |||
*[[Night sweats]] | *[[Night sweats]] | ||
*Unexplained [[weight loss]] | *Unexplained [[weight loss]] | ||
*[[Hemoptysis]] | *[[Hemoptysis]] | ||
*[[Chest pain]] | *[[Chest pain]] | ||
| Line 25: | Line 28: | ||
*[[Fatigue]] | *[[Fatigue]] | ||
*[[Dyspnea]] | *[[Dyspnea]] | ||
*[[Lymphadenopathy]] | |||
===Extra-Pulmonary Tuberculosis=== | ===Extra-Pulmonary Tuberculosis=== | ||
In the other 25% of active cases, the infection moves from the [[lungs]], causing other kinds of TB more common in [[immunosuppressed]] persons and young children. | In the other 25% of active cases, the infection moves from the [[lungs]], causing other kinds of TB more common in [[immunosuppressed]] persons and young children. | ||
An especially serious form is disseminated TB, more commonly known as [[miliary tuberculosis]]. Although extrapulmonary TB is not contagious, it may co-exist with pulmonary TB, which is contagious.<ref name=CDCcourse>[[Centers for Disease Control and Prevention]] (CDC), Division of Tuberculosis Elimination. [http://www.cdc.gov/nchstp/tb/pubs/corecurr/default.htm Core Curriculum on Tuberculosis: What the Clinician Should Know.] 4th edition (2000). Updated Aug 2003.</ref> | An especially serious form is disseminated TB, more commonly known as [[miliary tuberculosis]]. Although extrapulmonary TB is not contagious, it may co-exist with pulmonary TB, which is contagious.<ref name="CDCcourse">[[Centers for Disease Control and Prevention]] (CDC), Division of Tuberculosis Elimination. [http://www.cdc.gov/nchstp/tb/pubs/corecurr/default.htm Core Curriculum on Tuberculosis: What the Clinician Should Know.] 4th edition (2000). Updated Aug 2003.</ref> | ||
All forms of extra-pulmonary tuberculosis can include symptoms of pulmonary tuberculosis such as [[malaise]], [[night sweats]], [[cough]], [[weight loss]], and can be associated with an active pulmonary infection. | All forms of extra-pulmonary tuberculosis can include symptoms of pulmonary tuberculosis such as [[malaise]], [[night sweats]], [[cough]], [[weight loss]], and can be associated with an active pulmonary infection. | ||
{| style="border: 0px; font-size: 90%; margin: 3px; width:600px" align=center | {| style="border: 0px; font-size: 90%; margin: 3px; width:600px" align="center" | ||
|valign=top| | | valign="top" | | ||
|+ | |+ | ||
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Extra-Pulmonary Location}} | ! style="background: #4479BA; width: 200px;" |{{fontcolor|#FFF|Extra-Pulmonary Location}} | ||
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|History and Symptoms}} | ! style="background: #4479BA; width: 400px;" |{{fontcolor|#FFF|History and Symptoms}} | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Tuberculous lymphadenitis|Tuberculous Lymphadenitis]] | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |[[Tuberculous lymphadenitis|Tuberculous Lymphadenitis]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | [[Fever]], painless lymph node swelling. | | style="padding: 5px 5px; background: #F5F5F5;" |[[Fever]], painless lymph node swelling. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Pott's disease|Skeletal Tuberculosis]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Pott's disease|Skeletal Tuberculosis]] | ||
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|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Central Nervous System Tuberculosis | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Central Nervous System Tuberculosis | ||
| style="padding: 5px 5px; background: #F5F5F5;" | [[Headache]], [[seizures]], [[weakness]], [[vomiting]]. | | style="padding: 5px 5px; background: #F5F5F5;" |[[Headache]], [[seizures]], [[weakness]], [[vomiting]]. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Tuberculous Peritonitis | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Tuberculous Peritonitis | ||
| style="padding: 5px 5px; background: #F5F5F5;" | [[Abdominal pain]], [[fever]], [[ascites]] | | style="padding: 5px 5px; background: #F5F5F5;" |[[Abdominal pain]], [[fever]], [[ascites]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Tuberculous pericarditis|Tuberculous Pericarditis]] | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |[[Tuberculous pericarditis|Tuberculous Pericarditis]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | [[Shortness of breath]], [[chest pain]], [[cough]], [[pedal edema]]. | | style="padding: 5px 5px; background: #F5F5F5;" |[[Shortness of breath]], [[chest pain]], [[cough]], [[pedal edema]]. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Renal Tuberculosis | | style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Renal Tuberculosis | ||
| style="padding: 5px 5px; background: #F5F5F5;" | Symptoms of [[UTI]], such as [[polyuria]], [[dysuria]], [[hematuria]], [[flank pain]]<br> Symptoms of [[obstructive uropathy]], such as [[oliguria]] or [[anuria]], pelvic pain. | | style="padding: 5px 5px; background: #F5F5F5;" |Symptoms of [[UTI]], such as [[polyuria]], [[dysuria]], [[hematuria]], [[flank pain]]<br> Symptoms of [[obstructive uropathy]], such as [[oliguria]] or [[anuria]], pelvic pain. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #F5F5F5; | | colspan="2" style="padding: 5px 5px; background: #F5F5F5;" |<small>Adapted from Asian Spine J. Feb 2014; 8(1): 97–111<ref name="Moon2014">{{cite journal|last1=Moon|first1=Myung-Sang|title=Tuberculosis of Spine: Current Views in Diagnosis and Management|journal=Asian Spine Journal|volume=8|issue=1|year=2014|pages=97|issn=1976-1902|doi=10.4184/asj.2014.8.1.97}}</ref>; Handbook of Clinical Neurology<ref name="Garcia-Monco2014">{{cite journal|last1=Garcia-Monco|first1=Juan Carlos|title=Tuberculosis|volume=121|year=2014|pages=1485–1499|issn=00729752|doi=10.1016/B978-0-7020-4088-7.00100-0}}</ref>Circulation Dec 2005 vol.112 no.23 3608-3616<ref name="Mayosi2005">{{cite journal|last1=Mayosi|first1=B. M.|title=Tuberculous Pericarditis|journal=Circulation|volume=112|issue=23|year=2005|pages=3608–3616|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.105.543066}}</ref>; Am J Trop Med Hyg 2013 vol. 88 no. 1 54-64<ref name="Daherda Silva Junior2013">{{cite journal|last1=Daher|first1=E. D. F.|last2=da Silva Junior|first2=G. B.|last3=Barros|first3=E. J. G.|title=Renal Tuberculosis in the Modern Era|journal=American Journal of Tropical Medicine and Hygiene|volume=88|issue=1|year=2013|pages=54–64|issn=0002-9637|doi=10.4269/ajtmh.2013.12-0413}}</ref>; Clin Infect Dis.(2011)53(6):555-562.<ref name="FontanillaBarnes2011">{{cite journal|last1=Fontanilla|first1=J.-M.|last2=Barnes|first2=A.|last3=von Reyn|first3=C. F.|title=Current Diagnosis and Management of Peripheral Tuberculous Lymphadenitis|journal=Clinical Infectious Diseases|volume=53|issue=6|year=2011|pages=555–562|issn=1058-4838|doi=10.1093/cid/cir454}}</ref></small> | ||
|} | |} | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Overview
The general symptoms of tuberculosis include weakness, weight loss, fever, and night sweats. Symptoms of pulmonary tuberculosis include cough, chest pain, and hemoptysis. Tuberculosis is particularly difficult to diagnose in children, as these may not present with common findings.
History and Symptoms
Clinicians should ask about the patient’s history of TB exposure, infection, or disease. It is also important to consider demographic factors (e.g., country of origin, age, ethnic or racial group, occupation) that may increase the patient’s risk for exposure to TB or to drug-resistant TB. Also, clinicians should determine whether the patient has medical conditions, especially HIV infection, that increase the risk of latent TB infection progressing to TB disease.
Pulmonary Tuberculosis
When the disease becomes active, 75% of the cases are located in the lungs. Pulmonary tuberculosis should be suspected in persons who have the following symptoms:[1]
- Cough (most common symptom)
- Initially dry cough that progresses to productive.
- Persistent cough, usually for more than three weeks.
- Fever
- Night sweats
- Unexplained weight loss
- Hemoptysis
- Chest pain
- Anorexia
- Malaise
- Chills
- Fatigue
- Dyspnea
- Lymphadenopathy
Extra-Pulmonary Tuberculosis
In the other 25% of active cases, the infection moves from the lungs, causing other kinds of TB more common in immunosuppressed persons and young children.
An especially serious form is disseminated TB, more commonly known as miliary tuberculosis. Although extrapulmonary TB is not contagious, it may co-exist with pulmonary TB, which is contagious.[2]
All forms of extra-pulmonary tuberculosis can include symptoms of pulmonary tuberculosis such as malaise, night sweats, cough, weight loss, and can be associated with an active pulmonary infection.
| Extra-Pulmonary Location | History and Symptoms |
|---|---|
| Tuberculous Lymphadenitis | Fever, painless lymph node swelling. |
| Skeletal Tuberculosis | Low back pain, stiffness, joint swelling, limited mobility, pain in the affected joint or extremity. |
| Central Nervous System Tuberculosis | Headache, seizures, weakness, vomiting. |
| Tuberculous Peritonitis | Abdominal pain, fever, ascites |
| Tuberculous Pericarditis | Shortness of breath, chest pain, cough, pedal edema. |
| Renal Tuberculosis | Symptoms of UTI, such as polyuria, dysuria, hematuria, flank pain Symptoms of obstructive uropathy, such as oliguria or anuria, pelvic pain. |
| Adapted from Asian Spine J. Feb 2014; 8(1): 97–111[3]; Handbook of Clinical Neurology[4]Circulation Dec 2005 vol.112 no.23 3608-3616[5]; Am J Trop Med Hyg 2013 vol. 88 no. 1 54-64[6]; Clin Infect Dis.(2011)53(6):555-562.[7] | |
References
- ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
- ↑ Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination. Core Curriculum on Tuberculosis: What the Clinician Should Know. 4th edition (2000). Updated Aug 2003.
- ↑ Moon, Myung-Sang (2014). "Tuberculosis of Spine: Current Views in Diagnosis and Management". Asian Spine Journal. 8 (1): 97. doi:10.4184/asj.2014.8.1.97. ISSN 1976-1902.
- ↑ Garcia-Monco, Juan Carlos (2014). "Tuberculosis". 121: 1485–1499. doi:10.1016/B978-0-7020-4088-7.00100-0. ISSN 0072-9752.
- ↑ Mayosi, B. M. (2005). "Tuberculous Pericarditis". Circulation. 112 (23): 3608–3616. doi:10.1161/CIRCULATIONAHA.105.543066. ISSN 0009-7322.
- ↑ Daher, E. D. F.; da Silva Junior, G. B.; Barros, E. J. G. (2013). "Renal Tuberculosis in the Modern Era". American Journal of Tropical Medicine and Hygiene. 88 (1): 54–64. doi:10.4269/ajtmh.2013.12-0413. ISSN 0002-9637.
- ↑ Fontanilla, J.-M.; Barnes, A.; von Reyn, C. F. (2011). "Current Diagnosis and Management of Peripheral Tuberculous Lymphadenitis". Clinical Infectious Diseases. 53 (6): 555–562. doi:10.1093/cid/cir454. ISSN 1058-4838.