"Whatever the form in which
the tuberculosis matter develops, it begins as a grey,
semi-transparent matter that little by little becomes yellow,
opaque, and dense. Then it softens, and slowly acquires a liquidity
like pus, and, when it is expelled through the airways, it leaves
cavities, commonly called ulcers of the lung, that we will designate
as tuberculosis excavations.
-René-Théophile-Hyacinthe Laennec, 1826"
Tuberculosis (TB) is an infectious disease caused by a bacterium,
Mycobacterium tuberculosis disease, that can damage a person's lungs or
other parts of the body and cause serious illness.
It infects several organs of the human body, including the brain, the
kidneys and the bones, but most commonly, it affects the lungs causing
Pulmonary Tuberculosis. However, this is a fully treatable condition.
What are the causes of Tuberculosis ?
The infection can develop after inhaling droplets
sprayed into the air as from a cough or sneeze by someone infected with
Mycobacterium tuberculosis. The disease is characterized by the
development of granulomas (granular tumors) in the infected tissues. The
usual site of the disease is the lungs, but other organs are also
infected. Primary infection is usually without symptoms. Disseminated
disease develops in those persons whose immune systems do not heal the
primary infection. The disease may occur within weeks after the primary
infection, or may lie dormant for years before causing illness. Infants
and the elderly are at higher risk for rapid progression of the disease.
In disseminated disease, organs and tissues affected can include the
lining of the heart (pericardium), lining of the abdominal cavity
(peritoneum), larynx, bronchus, cervical lymph nodes, bones and joints,
organs of the male or female urinary and reproductive (genitourinary)
system, eye, stomach, lining of the brain and spinal cord (meninges),
What are the risk factors?
The risk of contracting TB increases with the frequency of contact with
people who are infected, crowded or unsanitary living conditions and
poor nutrition. Factors that lead to this increase is tuberculoses
infection in people with HIV infection, and increasing number of
homeless people. Another factor is the development of drug-resistant
strains of TB. Incomplete treatment of TB infections can contribute to
the proliferation of drug-resistant strains of bacteria.
How does the disease spread?
The TB bacteria are carried as droplets in the air, and can
enter the body through the air passage. TB is spread when people who
have active untreated TB germs in their lungs or throat cough, sneeze or
speak, and send their germs into the air. People who breathe these germs
into their lungs can become infected.
The process of catching tuberculosis involves two stages:
first, a person has to become infected; second, the infection has to
progress to disease. The second stage is called the "active stage". To
become infected, a person has to be in close contact with a person
having active tuberculosis.
People who breathe in TB
germs usually have had very close, day-to-day, contact with someone who
has the disease. That's why most people get TB germs from someone they
spend a lot of time with, like a family member, friend or close
TB can develop more easily
if the immune system weakens, as happens with malnutrition, AIDS,
diabetes, cancer, or treatment with immuno-suppressant drugs.
What are the symptoms of Tuberculosis ?
The first stage of the disease may be symptom-free. In
the secondary stage or active phase of the disease, there might be a
slight fever, night sweats, weight loss, fatigue and various other
symptoms, depending on the part of the body affected. Tuberculosis of
the lung (pulmonary tuberculosis) is usually associated with a dry cough
that eventually leads to a productive cough with blood-stained sputum.
Chest pain and shortness of breath are also noticed. This secondary
stage, if affecting the lungs, is the contagious stage – whereby the
bacteria can be spread to others.
How can we diagnose Tuberculosis ?
The initial screening test for tuberculosis is the
tuberculin Mantoux skin test. A small amount of fluid is injected under
the skin of the forearm; the fluid contains a protein derived from the
bacteria causing TB, and is absolutely harmless to the body. The area is
visually examined by a health professional after 48-72 hours to
determine the result of the test. This test is known as Tuberculin Skin
Test. A positive skin test does not mean that you have active disease,
however it means that your body has been exposed to bacteria in the
past. If the result of the skin test is positive, a chest x-ray is
advised to ascertain whether there is any active disease.
Other laboratory tests conducted are:
Sputum cultures shows if TB
germs are in the thick liquid a person coughs up.
Bronchoscopy for biopsy or
Open lung biopsy
Biopsies of affected organs
Retinal lesions revealed
How can Tuberculosis be treated ?
In TB infection or active TB disease, antibiotic therapy
can be used. Treatment for active TB disease involves taking several
anti-tuberculosis drugs for 6 to 9 months, and initial confinement is
advised. Taking nourishing food, adequate rest, and following the
doctor’s advise is essential for speedy recovery. Removal of a severely
damaged part of the organ is also done to stop further damage. Periodic
checkups is needed to ensure the health condition. Normal activity can
be continued after the infectious period.
Vaccination BCG for
tuberculin-negative persons exposed to persons with untreated TB.
Avoid contact with infected
More Valuable information about Tuberculosis...
TB accounts for one third of AIDS deaths worldwide. It
is the biggest killer of people who are HIV positive. If you are HIV
positive then you are ten times more likely to fall sick once TB is
Tuberculosis can affect the spinal cord and destroy the vertebrae. This
is called Potts’s disease. The infection can lead to the compression of
the cord and vertebrae and make the patient hunch backed.
Complications of Tuberculosis:
Relapse of the disease
Adult respiratory distress syndrome
How can we fight TB?
The best way to fight TB is to make sure that people who need medicine
take it regularly. They include:
People who are sick with
TB. These people have active germs that can infect others. The only way
people with TB disease get well is to take medicine as directed.
People who are infected but
are not sick. These people have inactive germs that are walled off.
These people may not be sick now, but the TB germs can become active
later on in life and make them sick. Taking preventive medicine every
day, as prescribed by the doctor, is the best way to get rid of TB germs
and prevent illness. In some instances, preventive medicine may not be
prescribed to some infected people because of their age or certain
People who are close
contacts to infective tuberculosis cases, regardless of age. These
people should take medicine to prevent TB as directed by the doctor.
Frequently asked questions about Tuberculosis...
Who should get tested for TB?
People who have symptoms of
People who have had close
day-to-day contact with someone who has active TB disease (this could be
a family member, friend or co- worker.)
People who have HIV
infection, lowered immunity or certain medical conditions.
People who are required for
work in community are likely to come in daily contact with people or
children. eg. school teacher.
What is Drug Resistant TB?
Sometimes, TB germs are "resistant" to one or more of the TB medicines
most often prescribed by doctors. When this happens combinations of
other TB medicines are given to the patient. Drug resistant TB can take
longer to cure than regular TB, but most patients can be cured.
Drug resistant TB develops when a person with active TB stops taking
their medicine too soon, or if they have not been given the right TB
medicine. A person with untreated drug resistant TB of the lungs or
throat can transmit these resistant germs.
If someone gets TB, can it be treated easily?
Yes, TB can usually be treated easily. However a person with TB must
take the proper medications for many months (usually at least six
months). If a TB patient stops the medication early or misses many doses
of medicine than the TB can come back. The kind of TB that comes back
can be more difficult to treat.
How is TB treated?
TB is usually treated with four medicine taken together once a day. The
medicines are usually Isoniazid, Rifampin, Ethambutol and Pyrazinamide.
Most people are also given vitamin B-6. Depending on how the medicines
have been prescribed, the doctor treating TB may stop the ethambutol and
pyrazinamide after the first two months of treatment.
What happens if I discontinue the medicine?
The primary stage of tuberculosis infection is usually without symptoms,
ignoring the disease at this stage will allow it to progress to the
secondary stage, or allow it to flare up later. Many a times, if there
are symptoms, they start to disappear and you may start feeling better
after a few weeks/months of treatment. If treatment is discontinued at
this stage, or medications are not taken as prescribed, the bacteria
will have an opportunity to develop a resistance to the drugs, and
treatment will become ineffective later on. If you are diagnosed with
active TB disease, take the medicines as prescribed by the doctor to
avoid future complications.
How long does TB need to be treated for?
Most of the time TB is treated for six to nine months. Some types of TB
need to be treated even longer. It is very important that people with TB
not stop their treatment before this time even if they are feeling
better. TB that is not treated long enough can come back. When the TB
returns, it may be harder to treat.
If you have HIV, is it easier to get sick with TB?
It is much easier for people with HIV infection to get sick from TB.
However, if you have HIV, your doctor can help prevent you from getting
TB by performing frequent TB skin tests and treating you with INH if you
What are the common side effects of anti TB drugs and how to manage
The common side effects while on anti TB drugs are Nausea, vomiting,
headache, joint pains, vision disturbance . Many of these side effects
are mild, if so you need not worry as they are transitory as one's body
gets accustomed to the drugs. In case they are of a severe nature do
consult your doctor.