Information From Your Health Care Provider

TUBERCULOSIS

Basic information

description

Tuberculosis (TB) is a contagious, bacterial infection that mainly involves the lungs. TB is occurring less often in the United States, but it is a major health problem in many parts of the world. It can affect all ages and both sexes equally.

FREQUENT SIGNS & SYMPTOMS

Early stages:
- No symptoms (often).
- Flu-like symptoms.
Middle and later stages:
- Cough (lasts 3 weeks or more).
- Low fever and/or chills.
- Weight loss.
- Chronic fatigue.
- Heavy sweating, especially at night.
- Cough with sputum that over time becomes bloody, yellow, thick, or gray.
- Chest pain and/or shortness of breath.
- Reddish or cloudy urine (sometimes).

causes

Infection by a bacteria, most often Mycobacterium tuberculosis. Germs are transmitted in the air from one person to another. Many persons are infected with TB that is inactive and there are no symptoms (called latent TB infection or LTBI). About 1 in 10 of these people will eventually develop active TB.

risk increases with

Adults over 60.
Newborns and infants.
Exposure to a TB-infected person.
HIV infection.
Weak immune system due to illness or drugs.
Crowded or unclean living conditions.
Alcoholism or IV drug abuse.
Cancer, other lung disorders, or diabetes.
Coming from countries where TB is common.

PREVENTIVE MEASURES

Preventive treatment for several months with isoniazid (INH) if a tuberculin skin test is positive.
Latent TB may be treated to prevent active TB.
A vaccine called BCG is used in countries where TB is very common. It is less often used in the United States.

expected outcomes

Usually curable with treatment.

possible complications

Lung abscess, chronic obstructive pulmonary disease, bronchiectasis, or respiratory failure.
Spread of infection to brain, bone, spine, and kidneys.
Without treatment, TB can be fatal.

diagnosis & treatment

general measures

Your health care provider will do a physical exam and ask about your symptoms. Medical tests may include TB skin test, blood studies, sputum study, and chest x-ray.
Treatment is with drugs. It is important to take the drugs as prescribed to be sure the infection is cured.
- If people stop the drugs once they feel better, but the infection is still active, they can spread the infection to others.
- Also, this allows the TB bacteria to become resistant to the drugs and they may no longer kill the bacteria.
Multidrug-resistant TB (MDR-TB) is resistance to at least two TB drugs. Stronger TB drugs have to be used which have serious side effects. MDR-TB is more difficult to cure, and it can be fatal. Extensively drug resistant
TB (XDR TB) is a more rare form.
If you are infectious, use tissue to cover your mouth when coughing, sleep in a separate bed, keep away from others, and don't go to work or school.
It is sometimes necessary to isolate (separate from other persons) or have hospital care for a TB patient.
Have regular follow-up visits with your health care provider to see if treatment is working.
To learn more: CDC (Centers for Disease Control & Prevention); (800) 232-4636; website: www.cdc.gov/tb.

medications

Antitubercular drugs, usually for 6 to 12 months. Several types are given at the same time to avoid bacterial resistance to the drugs. Patients are probably not infectious after 10 days to 2 weeks of treatment. Drug-resistant TB may need treatment for up to two years.

activity

Rest in bed until symptoms improve. You may need to restrict activities for 6 months.