Recognizing the Symptoms of Pulmonary Tuberculosis

Recognizing the Symptoms of Pulmonary Tuberculosis

If you or someone you know has pulmonary TB, common symptoms to watch for include:

• Persistent coughing, sometimes producing phlegm or blood
• Consistent fever, often including low-grade fevers
• Night sweats
• Chest pain
• Unexplained weight loss
• Fatigue may also be present

If you exhibit these symptoms, consult a healthcare professional to determine whether TB testing is necessary.

How Pulmonary TB Spreads

Pulmonary TB is not spread through casual contact like shaking hands, sharing food or drink, sleeping in the same bed, or kissing. Instead, TB is an airborne disease, meaning you can become infected by inhaling air exhaled by someone with TB. This air can come from:

• Coughing
• Sneezing
• Laughing
• Singing

TB germs can linger in the air for several hours, making it possible to inhale them even if the infected person has left the room. However, transmission usually requires prolonged close contact with an infected individual.

Risk Factors for Pulmonary TB

Certain groups are at higher risk of contracting pulmonary TB, including:

• Those in close contact with individuals who have TB, such as family members or coworkers in high-risk environments like correctional facilities, group homes, nursing homes, hospitals, and shelters
• Older adults and small children
• People who smoke
• Individuals with autoimmune disorders like lupus or rheumatoid arthritis
• Those with chronic conditions such as diabetes or kidney disease
• People who inject drugs
• Immunocompromised individuals, including those with HIV, undergoing chemotherapy, or taking chronic steroids

Diagnosing Pulmonary TB

To diagnose pulmonary TB, your doctor will likely:

• Conduct a physical exam to check for fluid in the lungs
• Review your medical history
• Order a chest X-ray
• Request a sputum sample for testing

You may be asked to provide up to three sputum samples for laboratory analysis, where a technician will look for TB bacteria under a microscope. If TB bacteria are present, a positive culture can be confirmed. Additional tests like a polymerase chain reaction (PCR) assay might be ordered to detect TB genes.

Additional Diagnostic Exams

In cases where pulmonary TB is difficult to diagnose, especially in children, people with HIV, or those with multidrug-resistant TB (MDR-TB), further exams may include:

• CT Scan: To image the lungs for signs of infection
• Bronchoscopy: Involves inserting a scope through the mouth or nose to view the lungs and airways
• Thoracentesis: Removes fluid from the space between the lungs and chest wall
• Lung Biopsy: Collects a sample of lung tissue for analysis

Treatment for Latent and Pulmonary TB

Treating latent TB is essential, even in the absence of symptoms, to prevent the future development of pulmonary TB. Treatment may involve a single TB drug. For active pulmonary TB, multiple medications are typically prescribed for six months or longer, including:

• Isoniazid
• Pyrazinamide
• Ethambutol (Myambutol)
• Rifampin (Rifadin)

To ensure adherence to the treatment regimen, your doctor may recommend directly observed therapy (DOT), where a healthcare professional supervises your medication intake. This approach helps prevent the development of MDR-TB, which arises when TB bacteria become resistant to standard treatments due to incorrect drug administration, early cessation of treatment, or use of poor-quality medications.

If DOT is not an option, create a consistent medication schedule, use a pill organizer, and set reminders to ensure you don’t miss doses. Hospitalization is only necessary if you’re unable to manage the medication at home or experience severe side effects.

Multidrug-Resistant TB (MDR-TB)

MDR-TB is resistant to the typical antibiotics used to treat TB, such as isoniazid and rifampin. Contributing factors include improper prescription practices, premature discontinuation of treatment, and the use of substandard medications. MDR-TB requires more complex and lengthy treatment, which can extend up to two years and may evolve into extensively drug-resistant TB (XDR-TB) if not properly managed.

Outlook for Pulmonary TB

Pulmonary TB is curable with proper treatment, but if left untreated or not fully treated, it can lead to life-threatening complications, including long-term damage to the lungs, brain, liver, heart, and spine. New drugs and treatments are being developed to combat TB, especially MDR-TB, with some countries employing the Bacillus Calmette-Guérin (BCG) vaccine to prevent severe TB in children, although it is less effective against pulmonary TB.

Preventing Pulmonary TB

Preventing TB can be challenging, especially in environments where TB is common or when caring for someone with the disease. To minimize your risk:

• Educate yourself and others about TB prevention, including proper cough etiquette
• Avoid prolonged close contact with someone who has active TB
• Ensure good ventilation in living spaces
• Wear a mask approved for TB protection when necessary

If you have been exposed to TB, it is crucial to get tested, even if you are asymptomatic. The Centers for Disease Control and Prevention (CDC) provides guidelines for those who work or visit healthcare settings where TB exposure is possible.

Protecting Others from TB

Individuals with latent TB are not contagious and can continue with their normal activities. However, if you have active pulmonary TB, it’s vital to stay home and avoid close contact with others until your doctor confirms that you are no longer contagious.