Tuberculosis history and symptoms: Difference between revisions

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{{Tuberculosis}}
{{Tuberculosis}}
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==Overview==
==Overview==
Tuberculosis can be a difficult disease to [[diagnose]], due mainly to the difficulty in [[Cell culture|culturing]] this slow-growing organism in the laboratory. A complete medical evaluation for TB must include a [[medical history]], a [[chest x-ray]], and a [[physical examination]].
[[weakness]], [[weight loss]], [[fever]], and [[night sweats]] are common general symptoms of [[tuberculosis]]. Symptoms of pulmonary tuberculosis include pulmonary tuberculosis [[cough]], [[hemoptysis]], and [[chest pain]]. It is difficult to [[Diagnosis|diagnose]] [[tuberculosis]] in [[children]], as these may lack the classic common findings.


==History and Symptoms==
==History and Symptoms==
[[Image:Mantoux tuberculin skin test.jpg|thumb|right|350px|[[Mantoux test|Mantoux tuberculin skin test]]]]


Clinicians should ask about the patient’s history of TB exposure, [[infection]], or [[disease]]. It is also important to consider demographic factors (e.g., country of origin, age, ethnic or racial group, occupation) that may increase the patient’s risk for exposure to TB or to drug-resistant TB. Also, clinicians should determine whether the patient has medical conditions, especially [[HIV]] infection, that increase the risk of latent TB infection progressing to TB disease.  
Physicians should be mindful of the patient’s [[History and Physical examination|history]] of [[Tuberculosis|TB]] exposure, [[infection]], or [[disease]]. In addition, it is also important to consider [[demographic factors]] (e.g., country of origin, age, ethnic or racial group, occupation) that may increase the individual’s risk for TB exposure or to [[drug-resistant TB]]. Also, physicians should figure out other medical conditions that can decrease the [[immunity]], especially [[HIV]] infection, which increase the risk of latent [[TB]] infection progression to active TB disease.  


When the disease becomes active, 75% of the cases are pulmonary TB. Pulmonary TB disease should be suspected in persons who have the following symptoms:
===Pulmonary Tuberculosis===
In case of active tuberculosis, 75% of the cases present with lung involvement. Suspect [[Pulmonary tuberculosis]] in any individual who has the following symptoms:<ref name="Mandell">{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref>
 
*[[Cough]] (most common symptom)
 
:*Initially dry [[cough]] which progresses to productive.
:*Persistent [[Cough, fever, and haemoptysis|cough]], often for more than three weeks.
 
*[[Fever]]
*[[Night sweats]]
*Unexplained [[weight loss]]
*[[Hemoptysis]]
*[[Chest pain]]
*[[Chest pain]]
*[[Hemoptysis]] ([[cough]]ing up [[blood]])
*[[Anorexia]]
*Productive, prolonged [[cough]] for more than three weeks
*[[Malaise]]
*Unexplained [[weight loss]]
*[[Loss of appetite]]  
*[[Night sweats]]
*[[Chills]]
*[[Chills]]
*[[Fever]]
*[[Fatigue]]
*[[Fatigue]]
*[[Pallor]]
*[[Dyspnea]]
*[[Lymphadenopathy]]


In the other 25% of active cases, the infection moves from the [[lungs]], causing other kinds of TB more common in [[immunosuppressed]] persons and young children.  Extrapulmonary infection sites include:
===Extra-Pulmonary Tuberculosis===


*[[Pleura]]
* The rest of the active [[tuberculosis]] cases (other 25%) of active cases spread from the [[lungs]], causing other forms of TB that are more common in [[immunosuppressed]] individuals and young children.
*[[Central nervous system]] in [[meningitis]]
*[[Lymphatic system]] in [[scrofula]] of the [[neck]]
*[[Genitourinary system]] in [[urogenital]] tuberculosis
*[[Bones]] and [[joints]] in [[Pott's disease]] of the [[spine]]


An especially serious form is disseminated TB, more commonly known as [[miliary tuberculosis]]. Although extrapulmonary TB is not contagious, it may co-exist with pulmonary TB, which is contagious.<ref name=CDCcourse>[[Centers for Disease Control and Prevention]] (CDC), Division of Tuberculosis Elimination. [http://www.cdc.gov/nchstp/tb/pubs/corecurr/default.htm Core Curriculum on Tuberculosis: What the Clinician Should Know.] 4th edition (2000).  Updated Aug 2003.</ref>
* [[disseminated]] TB is a serious form of TB that is also known as [[miliary tuberculosis]]. Extrapulmonary TB is not contagious; however, it may co-exist with pulmonary TB, that is contagious.<ref name="CDCcourse">[[Centers for Disease Control and Prevention]] (CDC), Division of Tuberculosis Elimination. [http://www.cdc.gov/nchstp/tb/pubs/corecurr/default.htm Core Curriculum on Tuberculosis: What the Clinician Should Know.] 4th edition (2000).  Updated Aug 2003.</ref>
 
All forms of [[extra-pulmonary tuberculosis]] may present with the symptoms of [[pulmonary tuberculosis]] such as [[malaise]], [[night sweats]], [[cough]], [[weight loss]], and also may be associated with an active pulmonary infection.
 
{| style="border: 0px; font-size: 90%; margin: 3px; width:600px" align="center"
| valign="top" |
|+
! style="background: #4479BA; width: 200px;" |{{fontcolor|#FFF|Extra-Pulmonary Location}}
! style="background: #4479BA; width: 400px;" |{{fontcolor|#FFF|History and Symptoms}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |Tuberculous Lymphadenitis
| style="padding: 5px 5px; background: #F5F5F5;" |[[Fever]], painless lymph node swelling.
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Pott's disease/Skeletal Tuberculosis
| style="padding: 5px 5px; background: #F5F5F5;" |[[Low back pain]], [[stiffness]], pain in the affected joint or extremity, joint swelling, limited mobility.
 
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Central Nervous System Tuberculosis
| style="padding: 5px 5px; background: #F5F5F5;" |[[Headache]], [[seizures]], [[weakness]], [[vomiting]].
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Tuberculous Peritonitis
| style="padding: 5px 5px; background: #F5F5F5;" |[[Abdominal pain]], [[fever]], [[ascites]]
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Tuberculous Pericarditis
| style="padding: 5px 5px; background: #F5F5F5;" |[[chest pain]],[[Shortness of breath]], [[cough]], [[pedal edema]].
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |Renal Tuberculosis
| style="padding: 5px 5px; background: #F5F5F5;" |Symptoms of [[UTI]], include [[polyuria]], [[dysuria]], [[hematuria]], [[flank pain]]<br>  Symptoms of [[obstructive uropathy]], such as [[oliguria]] or [[anuria]], pelvic pain.
|-
| colspan="2" style="padding: 5px 5px; background: #F5F5F5;" |<small>Adapted from Asian Spine J. Feb 2014; 8(1): 97–111<ref name="Moon2014">{{cite journal|last1=Moon|first1=Myung-Sang|title=Tuberculosis of Spine: Current Views in Diagnosis and Management|journal=Asian Spine Journal|volume=8|issue=1|year=2014|pages=97|issn=1976-1902|doi=10.4184/asj.2014.8.1.97}}</ref>; Handbook of Clinical Neurology<ref name="Garcia-Monco2014">{{cite journal|last1=Garcia-Monco|first1=Juan Carlos|title=Tuberculosis|volume=121|year=2014|pages=1485–1499|issn=00729752|doi=10.1016/B978-0-7020-4088-7.00100-0}}</ref>Circulation  Dec 2005 vol.112 no.23 3608-3616<ref name="Mayosi2005">{{cite journal|last1=Mayosi|first1=B. M.|title=Tuberculous Pericarditis|journal=Circulation|volume=112|issue=23|year=2005|pages=3608–3616|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.105.543066}}</ref>; Am J Trop Med Hyg 2013 vol. 88 no. 1 54-64<ref name="Daherda Silva Junior2013">{{cite journal|last1=Daher|first1=E. D. F.|last2=da Silva Junior|first2=G. B.|last3=Barros|first3=E. J. G.|title=Renal Tuberculosis in the Modern Era|journal=American Journal of Tropical Medicine and Hygiene|volume=88|issue=1|year=2013|pages=54–64|issn=0002-9637|doi=10.4269/ajtmh.2013.12-0413}}</ref>;  Clin Infect Dis.(2011)53(6):555-562.<ref name="FontanillaBarnes2011">{{cite journal|last1=Fontanilla|first1=J.-M.|last2=Barnes|first2=A.|last3=von Reyn|first3=C. F.|title=Current Diagnosis and Management of Peripheral Tuberculous Lymphadenitis|journal=Clinical Infectious Diseases|volume=53|issue=6|year=2011|pages=555–562|issn=1058-4838|doi=10.1093/cid/cir454}}</ref></small>
|}


==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{WH}}
{{WS}}


[[Category:Bacterial diseases]]
[[Category:Bacterial diseases]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Pulmonology]]
[[Category: Pulmonology]]
[[Category:Infectious disease]]
[[Category:Primary care]]
 
{{WH}}
{{WS}}

Latest revision as of 06:29, 26 March 2021

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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]

Overview

weakness, weight loss, fever, and night sweats are common general symptoms of tuberculosis. Symptoms of pulmonary tuberculosis include pulmonary tuberculosis cough, hemoptysis, and chest pain. It is difficult to diagnose tuberculosis in children, as these may lack the classic common findings.

History and Symptoms

Physicians should be mindful of the patient’s history of TB exposure, infection, or disease. In addition, it is also important to consider demographic factors (e.g., country of origin, age, ethnic or racial group, occupation) that may increase the individual’s risk for TB exposure or to drug-resistant TB. Also, physicians should figure out other medical conditions that can decrease the immunity, especially HIV infection, which increase the risk of latent TB infection progression to active TB disease.

Pulmonary Tuberculosis

In case of active tuberculosis, 75% of the cases present with lung involvement. Suspect Pulmonary tuberculosis in any individual who has the following symptoms:[1]

  • Cough (most common symptom)
  • Initially dry cough which progresses to productive.
  • Persistent cough, often for more than three weeks.

Extra-Pulmonary Tuberculosis

  • The rest of the active tuberculosis cases (other 25%) of active cases spread from the lungs, causing other forms of TB that are more common in immunosuppressed individuals and young children.
  • disseminated TB is a serious form of TB that is also known as miliary tuberculosis. Extrapulmonary TB is not contagious; however, it may co-exist with pulmonary TB, that is contagious.[2]

All forms of extra-pulmonary tuberculosis may present with the symptoms of pulmonary tuberculosis such as malaise, night sweats, cough, weight loss, and also may be associated with an active pulmonary infection.

Extra-Pulmonary Location History and Symptoms
Tuberculous Lymphadenitis Fever, painless lymph node swelling.
Pott's disease/Skeletal Tuberculosis Low back pain, stiffness, pain in the affected joint or extremity, joint swelling, limited mobility.
Central Nervous System Tuberculosis Headache, seizures, weakness, vomiting.
Tuberculous Peritonitis Abdominal pain, fever, ascites
Tuberculous Pericarditis chest pain,Shortness of breath, cough, pedal edema.
Renal Tuberculosis Symptoms of UTI, include polyuria, dysuria, hematuria, flank pain
Symptoms of obstructive uropathy, such as oliguria or anuria, pelvic pain.
Adapted from Asian Spine J. Feb 2014; 8(1): 97–111[3]; Handbook of Clinical Neurology[4]Circulation Dec 2005 vol.112 no.23 3608-3616[5]; Am J Trop Med Hyg 2013 vol. 88 no. 1 54-64[6]; Clin Infect Dis.(2011)53(6):555-562.[7]

References

  1. ↑ Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
  2. ↑ Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination. Core Curriculum on Tuberculosis: What the Clinician Should Know. 4th edition (2000). Updated Aug 2003.
  3. ↑ 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.
  4. ↑ Garcia-Monco, Juan Carlos (2014). "Tuberculosis". 121: 1485–1499. doi:10.1016/B978-0-7020-4088-7.00100-0. ISSN 0072-9752.
  5. ↑ Mayosi, B. M. (2005). "Tuberculous Pericarditis". Circulation. 112 (23): 3608–3616. doi:10.1161/CIRCULATIONAHA.105.543066. ISSN 0009-7322.
  6. ↑ 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.
  7. ↑ 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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