Tuberculosis (TB): an overview

Although tuberculosis (TB) is uncommon in the U.S., it’s the second most deadly infectious disease around the world and it’s life-threatening for people in the U.S. If you’re diagnosed with TB, we’ll make sure you get the treatment you need to treat TB and reduce your risk of complications from this serious disease.

What is tuberculosis?

Tuberculosis is a disease caused by the Mycobacterium tuberculosis bacteria. TB infection usually affects your lungs and throat, but it can also affect other parts of your body.

Tuberculosis germs spread through airborne droplets from an infected person who coughs, sneezes, talks, laughs or sings near you. If you breathe in these droplets, you may become infected.

You need to spend lots of time indoors with an infected person to get tuberculosis. The people you see the most – friends, coworkers and family members – are the ones you’re likely to catch it from.

You can’t contract TB from brief contact such as shaking hands, kissing, or touching surfaces that have been touched by an infected person.

Types of tuberculosis

One way tuberculosis is described is by whether it’s active in the body. If it’s active, it’s called TB disease and if it isn’t active, it’s called latent TB.

Another way tuberculosis is described is by where it occurs. Pulmonary tuberculosis affects the lungs and throat. Extrapulmonary TB affects other parts of the body such as bones, spinal cord, brain, lymph nodes or skin. Extrapulmonary TB isn’t usually infectious.

Vaccination for TB

The vaccination for tuberculosis, Bacillus Calmette-Guerin (BCG), isn’t used very often in the U.S. because TB is rare here. When it’s used in the U.S., the person getting the vaccine needs to meet specific local or state criteria, and their vaccination needs to be recommended by a TB expert.

In countries where tuberculosis is more common, infants and young children are often vaccinated for TB.

Tuberculosis symptoms

People who have latent TB don’t have symptoms, don’t feel sick and can’t spread TB to other people. If they have a chest X-ray, it won’t show signs of TB.

People who have TB disease usually feel very sick and their chest X-rays show signs of TB. Pulmonary TB symptoms may include:

• Cough that lasts longer than three weeks
• Pain in the chest
• Coughing up blood or sputum
• Severe tiredness (fatigue)
• Fever
• Chills
• Night sweats
• Swollen glands
• Weight loss
• No appetite

If you’re experiencing chest pain, call 911 because it can be a sign of other serious conditions.

Extrapulmonary tuberculosis symptoms depend on the part of the body affected.

Complications from tuberculosis

Potential complications from TB infection include:

• Joint damage
• Lung damage
• Infection or damage of your bones, spinal cord, brain, lymph nodes or skin
• Liver or kidney problems
• Inflammation of the tissues around your heart

TB risk factors

Those with compromised immune systems are more at risk of catching TB. Some of those with compromised immune systems are:

• Living with HIV or AIDS
• Malnourished or have low body weight
• People who have diabetes
• Tobacco users
• Suffering from kidney disease
• Diagnosed with head or neck cancer
• Receiving chemotherapy

Risks are also increased for people who take some medications for rheumatoid arthritis, Crohn’s disease, psoriasis or having had an organ transplant.

Tuberculosis testing & diagnosis

Diagnosis requires different kinds of tuberculosis tests. First, you’ll have either a skin test or a blood test.

A skin test is done by injecting a fluid (tuberculosis antigen) under the top layer of the skin on the inside of your forearm. You’ll return to your doctor between 48 and 72 hours later so they can evaluate any reaction on your arm.

For a blood test, we’ll take a blood sample and send it to a lab for testing.

If your skin test or blood test for tuberculosis is positive, you’ll need chest X-rays or a CT scan to see if you have TB infection in your lungs.

Your doctor may also take a sample of coughed-up mucus (sputum) to test for TB bacteria. It can take up to eight weeks to get results from sputum tests.

Tuberculosis treatment

If your tests are positive for TB infection, we’ll recommend tuberculosis treatment options according to our most current guidelines.

TB treatment is vital even if you have latent TB because you may progress to TB disease at some point in the future. Developing diabetes or just becoming older can make you more vulnerable to the TB germs you’re carrying.

The current tuberculosis treatment for people with latent TB is a single antibiotic medication taken once a day for three to nine months.

People who have TB disease are treated with a combination of antibacterial drugs for six to 12 months. It’s important to finish all the medication to be sure of killing all the bacteria.

Failure to finish the course of medication for TB disease could make some of the bacteria remaining in your body become drug-resistant, which would mean you’d need an even longer course of treatment.

People who are infected with drug-resistant TB need to take more medications for 20 to 30 months and may have more intense side effects from their medications.

The length of TB treatment can be daunting, but it’s important to finish the whole course of treatment. Finishing the prescribed treatment lets you avoid the possibility of longer treatment down the road.

Side effects from TB medications

Side effects from medication to treat tuberculosis vary depending on which medication you’re taking. Most medications have nausea, poor appetite or other digestive upsets as side effects. Fatigue is another common side effect. Other common side effects are:

• Chills
• Painful or swollen joints
• Headache
• Confusion
• Muscle or joint pain
• Numbness and tingling in your hands and feet
• Skin rash
• Jaundice (yellowing of skin or eyes)