Tuberculosis history and symptoms
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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 the 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 pulmonary TB. Pulmonary TB disease should be suspected in persons who have the following symptoms:
- Chest pain
- Hemoptysis (coughing up blood)
- Productive, prolonged cough for more than three weeks
- Unexplained weight loss
- Loss of appetite
- Night sweats
- Chills
- Fever
- Fatigue
- Pallor
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.[1]
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 | |
| 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 (polyuria, dysuria, hematuria); Symptoms of obstructive uropathy (oliguria or anuria, pelvic pain. |
| Adapted from Asian Spine J. Feb 2014; 8(1): 97–111[2]; Handbook of Clinical Neurology[3]Circulation Dec 2005 vol.112 no.23 3608-3616[4]; Am J Trop Med Hyg 2013 vol. 88 no. 1 54-64[5] | |
References
- ↑ 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.