Symptoms of tuberculosis

Written by Wang Xiang Yu
Pulmonology
Updated on September 06, 2024
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Tuberculosis of the lung presents in many forms, as there are also various types of pulmonary tuberculosis, each exhibiting different symptoms. However, the most common symptoms primarily include coughing and expectoration, which are the most typical manifestations of pulmonary tuberculosis. The cough in pulmonary tuberculosis is generally mild, either dry or producing only a small amount of phlegm. If the tuberculosis is accompanied by cavities, the amount of phlegm may be larger. If there is a bacterial infection in addition to the tuberculosis, the phlegm may become purulent. Some patients with pulmonary tuberculosis may also experience hemoptysis, which can vary in amount from light to severe. A small number of patients may suffer from chest pain and difficulty breathing. Additionally, there are systemic symptoms associated with pulmonary tuberculosis, such as fever (both low and high fever may occur), night sweats, and fatigue, among others.

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Written by Wang Xiang Yu
Pulmonology
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How is tuberculosis treated?

The primary treatment for tuberculosis is still chemotherapy, also simply called chemo, but the chemotherapy for tuberculosis is completely different from the anti-tumor chemotherapy we talk about in cancer, and the medications are also completely different. There are about more than ten anti-tuberculosis drugs, which can be divided into first-line and second-line drugs, and currently, there are third-line drugs under research. Chemotherapy for patients with pulmonary tuberculosis should be started early and administered in combination. The types of combined medication for patients with pulmonary tuberculosis generally involve three or more drugs. Some patients may exhibit drug resistance or intolerance to some drugs' side effects, and thus, second-line drugs may be used. Additionally, some patients, due to special conditions, may require four or five types of anti-tuberculosis drugs. It is crucial to strictly follow medical advice regarding how to medicate and treat. Furthermore, patients with pulmonary tuberculosis must ensure complete medication adherence, as the treatment duration for tuberculosis is quite long, typically requiring at least six months, and some patients may need one or even two years. Regular medication intake is very important because some patients might experience symptoms like coughing up blood or others, such as those with pleurisy, who might develop pleural effusion. Therefore, treatments targeted at other symptoms are necessary. Patients who cough up blood might need hemostatic drugs, while those with severe hemoptysis may even require interventional surgery. Some with tuberculous pleurisy might need to have pleural effusion drained. Additionally, some patients with pulmonary tuberculosis might experience adverse reactions to medications, such as liver or kidney failure, visual impairment, or numbness in the hands, which would require adjustments to their medication or changes based on their complications. Treatment should also be targeted toward these adverse reactions.

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Written by Wang Xiang Yu
Pulmonology
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Local symptoms of pulmonary tuberculosis

The local symptoms of tuberculosis primarily require us to understand where tuberculosis occurs. Currently, tuberculosis in the lung tissues, trachea, bronchi, and pleura are all classified as pulmonary tuberculosis. The primary local symptoms are still respiratory symptoms, with the most common being cough and expectoration. Patients with tuberculosis generally have a slow onset, with most experiencing cough and expectoration that can persist for two weeks or more. Some patients may also exhibit symptoms like blood in the sputum or hemoptysis. Additionally, some patients may experience other symptoms; for example, those with pleural involvement might have irritative cough, chest pain, and difficulty breathing, while those with tracheobronchial involvement might exhibit a prolonged irritative cough. Some patients may also develop bronchial stenosis, which can lead to difficulty breathing.

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Written by Xiong Hong Hai
Infectious Disease
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Is tuberculosis contagious?

Tuberculosis (TB) is only infectious in some patients who have a large amount of tubercle bacilli in their sputum. In fact, many patients with active pulmonary tuberculosis are not infectious. For more patients with active pulmonary tuberculosis, tubercle bacilli cannot be found in their sputum, so the actual situation must be considered. In fact, to determine if pulmonary tuberculosis is infectious, it is simple: look for acid-fast bacilli in the sputum. If the sputum acid-fast staining is positive, it indicates infectiousness. Infectious pulmonary tuberculosis requires systematic and standardized anti-tuberculosis treatment.

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Written by Wang Xiang Yu
Pulmonology
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Can tuberculosis be cured completely?

Whether tuberculosis can be completely cured varies from person to person. Most cases of tuberculosis, especially initial occurrences of pulmonary tuberculosis, can be cured in more than 80 to 90 percent of patients if they undergo standardized anti-tuberculosis treatment. However, it is essential that the treatment is standardized; it is not appropriate to simply take medication for one or two months and then stop when symptoms seem to disappear. The treatment duration for pulmonary tuberculosis is considered to be at least six months, and for some patients, it may even extend to a year. However, not all cases of pulmonary tuberculosis can be completely cured. A small percentage of patients may not achieve complete eradication due to resistance to tuberculosis bacteria or intolerance to the side effects of tuberculosis medications. In such cases, the prognosis might be poor, and some individuals may succumb to tuberculosis due to these factors.

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Written by Wang Xiang Yu
Pulmonology
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Can people with tuberculosis drink alcohol?

Whether patients with tuberculosis can drink alcohol, first of all, it is important to know that tuberculosis is a chronic infectious disease and a consumptive disease that consumes the body's calories. Drinking alcohol can affect the body's absorption of energy. Moreover, most patients with tuberculosis need to take anti-tuberculosis medication, most of which are metabolized through the liver and can cause varying degrees of liver damage. Drinking alcohol can exacerbate liver damage and reduce the effectiveness of the medication. Additionally, since there are many types of anti-tuberculosis medications for tuberculosis patients, some medications may cause adverse reactions when drinking alcohol. Therefore, all tuberculosis patients must strictly abstain from drinking alcohol during treatment.