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Pulmonary tuberculosis

Contents of this page:

Illustrations

Tuberculosis in the kidney
Tuberculosis in the kidney
Tuberculosis in the lung
Tuberculosis in the lung
Tuberculosis, advanced - chest X-rays
Tuberculosis, advanced - chest X-rays
Pulmonary nodule - front view chest X-ray
Pulmonary nodule - front view chest X-ray
Pulmonary nodule, solitary - CT scan
Pulmonary nodule, solitary - CT scan
Miliary tuberculosis
Miliary tuberculosis
Tuberculosis of the lungs
Tuberculosis of the lungs
Erythema nodosum associated with sarcoidosis
Erythema nodosum associated with sarcoidosis
Respiratory system
Respiratory system

Alternative Names    Return to top

TB; Tuberculosis - pulmonary

Definition    Return to top

Pulmonary tuberculosis (TB) is a contagious bacterial infection that mainly involves the lungs, but may spread to other organs.

Causes    Return to top

Pulmonary tuberculosis is caused by the bacteria Mycobacterium tuberculosis (M. tuberculosis). You can get tuberculosis by breathing in air droplets from a cough or sneeze of an infected person.

In the United States, most people will recover from primary TB infection without further evidence of the disease. The infection may stay asleep or nonactive (dormant) for years and then reactivate.

Most people who develop symptoms of a TB infection first became infected in the past. However, in some cases, the disease may become active within weeks after the primary infection.

The following people are at higher risk for active TB:

Your risk of contracting TB increases if you:

The following factors may increase the rate of TB infection in a population:

In the United States, there are approximately 10 cases of TB per 100,000 people. However, rates vary dramatically by area of residence and socioeconomic class.

See also: Disseminated tuberculosis

Symptoms    Return to top

The primary stage of the disease usually doesn't have symptoms. When symptoms do occur, they may include:

Other symptoms that may occur with this disease:

Exams and Tests    Return to top

Examination may show:

Tests may include:

Treatment    Return to top

The goal of treatment is to cure the infection with drugs that fight the TB bacteria. Treatment of active pulmonary TB will always involve a combination of many drugs (usually four drugs). It is continued until lab tests show which medicines work best.

You may need to take many different pills at different times of the day. This may be difficult for some people. However, it is very important that you take the pills the way your health care provider instructed.

When people do not take their tuberculosis medications as recommended, the infection becomes much more difficult to treat. Sometimes, the drugs no longer help treat the infection.

Treatment usually lasts for 6 months, but longer courses may be needed for people with AIDS or who get better slowly.

You may need to be admitted to a hospital to avoid spreading the disease to others until you are no longer contagious.

Your doctor or nurse is required by law to report your TB illness to the local health department. Your health care team will be sure that you receive the best care for your TB.

Support Groups    Return to top

You can ease the stress of illness by joining a support group where members share common experiences and problems.

See: Lung disease - support group

Outlook (Prognosis)    Return to top

Symptoms may improve in 2 - 3 weeks. A chest x-ray will not show this improvement until later. The outlook is excellent if pulmonary TB is diagnosed early and treatment is begun quickly.

Possible Complications    Return to top

Pulmonary TB can cause permanent lung damage if not treated early.

Medicines used to treat TB may cause side effects, including liver problems. Other side effects include:

When to Contact a Medical Professional    Return to top

Call your health care provider if:

Prevention    Return to top

TB is a preventable disease, even in those who have been exposed to an infected person. Skin testing (PPD) for TB is used in high risk populations or in people who may have been exposed to TB, such as health care workers.

A positive skin test indicates TB exposure and an inactive infection. Discuss preventive therapy with your doctor. People who have been exposed to TB should be skin tested immediately and have a follow-up test at a later date, if the first test is negative.

Prompt treatment is extremely important in controlling the spread of TB from those who have active TB disease to those who have never been infected with TB.

Some countries with a high incidence of TB give people a BCG vaccination to prevent TB. However, the effectiveness of this vaccine is controversial and it is not routinely used in the United States.

People who have had BCG may still be skin tested for TB. Discuss the test results (if positive) with your doctor.

Update Date: 9/17/2008

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, PhD, MD, Instructor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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