Tuberculosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]: Associate Editor(s)-in-Chief: Mashal Awais, M.D.[2]; Alejandro Lemor, M.D. [3]


Physical examination can give us important information regarding the patient’s general condition and other factors that may affect tuberculosis management, particularly HIV infection or other illnesses. Physical examination findings depend on the site of the tuberculosis infection and the most common physical examination findings are fever, decreased breath sounds, tachypnea and tachycardia.

Physical Examination

Pulmonary Tuberculosis

Physical examination findings of pulmonary tuberculosis include:[1]

Appearance of the Patient

Some patients with active tuberculosis may have a normal physical examination, so further testing should be performed to confirm the diagnosis.

Extra-Pulmonary Tuberculosis

Extra-pulmonary tuberculosis may also include some of the physical findings of pulmonary tuberculosis such as fever, cachexia, tachypnea, tachycardia, and may be associated with an active pulmonary infection.

Extra-Pulmonary Location Additional Physical Examination Findings
Tuberculous Lymphadenitis Cervical lymph node enlargement
Skeletal Tuberculosis Low back pain, stiffness, tenderness, joint swelling and erythema, limited range of motion.
Central Nervous System Tuberculosis Altered mental status, CN palsy (specially CN VI), papilledema, hemiparesis, hemiplegia, and nuchal rigidity.
Tuberculosis Peritonitis Diffuse abdominal tenderness, ascites, fever.
Tuberculous Pericarditis Tachycardia, pulsus paradoxus and hypotension (in cardiac tamponade), jugular venous distension with a prominent Y descent, Kussmaul's sign, pleural dullness, pericardial knock, pericardial rub,distant heart sounds, hepatomegaly, ascites, and ankle edema.
Renal Tuberculosis Costo-vertebral angle tenderness (in UTI), lower abdominal tenderness (in obstructive uropathy), findings of renal insufficiency.
Adapted from Asian Spine J. Feb 2014; 8(1): 97–111[2]; Handbook of Clinical Neurology[3]; Circulation Dec 2005 vol.112 no.23 3608-3616[4]; Am J Trop Med Hyg 2013 vol. 88 no. 1 54-64[5] Clin Infect Dis.(2011)53(6):555-562.[6]


  1. Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
  2. Moon, Myung-Sang (2014). "Tuberculosis of Spine: Current Views in Diagnosis and Management". Asian Spine Journal. 8 (1): 97. doi:10.4184/asj.2014.8.1.97. ISSN 1976-1902.
  3. Garcia-Monco, Juan Carlos (2014). "Tuberculosis". 121: 1485–1499. doi:10.1016/B978-0-7020-4088-7.00100-0. ISSN 0072-9752.
  4. Mayosi, B. M. (2005). "Tuberculous Pericarditis". Circulation. 112 (23): 3608–3616. doi:10.1161/CIRCULATIONAHA.105.543066. ISSN 0009-7322.
  5. Daher, E. D. F.; da Silva Junior, G. B.; Barros, E. J. G. (2013). "Renal Tuberculosis in the Modern Era". American Journal of Tropical Medicine and Hygiene. 88 (1): 54–64. doi:10.4269/ajtmh.2013.12-0413. ISSN 0002-9637.
  6. Fontanilla, J.-M.; Barnes, A.; von Reyn, C. F. (2011). "Current Diagnosis and Management of Peripheral Tuberculous Lymphadenitis". Clinical Infectious Diseases. 53 (6): 555–562. doi:10.1093/cid/cir454. ISSN 1058-4838.

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