Does tuberculosis cause fever in its initial stage?

Written by Wang Chun Mei
Pulmonology
Updated on December 05, 2024
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Tuberculosis is caused by an infection of the lungs by the bacterium Mycobacterium tuberculosis, and it is a very common infectious respiratory disease clinically. Typically, the early stage of tuberculosis is accompanied by mild fever to varying degrees, usually occurring in the afternoon, along with coughing, expectoration of blood, chest tightness, shortness of breath, and even chest pain, weight loss, fatigue, and night sweats as accompanying clinical symptoms.

In the early stages, the diagnosis of tuberculosis in patients is generally made through these specific clinical symptoms, along with some sputum culture and chest X-ray examinations. Usually, most patients with early-stage tuberculosis will experience symptoms of low-grade fever, but these patients have a characteristic of fever that occurs in the afternoon and does not require antipyretics as it can return to normal by itself in the evening.

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Written by Wang Xiang Yu
Pulmonology
1min 51sec home-news-image

How to test for tuberculosis

To examine pulmonary tuberculosis, it is essential to understand that it pertains to tuberculosis changes in the lung tissue, airways, bronchi, and pleura. The pathogen causing tuberculosis is Mycobacterium tuberculosis, also known as the tubercle bacillus. There are multiple tests available for people with pulmonary tuberculosis, as the disease can vary based on location and type. Therefore, such patients generally require numerous tests. The most commonly used are imaging studies for the chest, including X-rays and CT scans. In imaging studies, most patients will show some lesions, but there are instances where tuberculosis in the airways and bronchi might not be clearly visible on CT or X-rays, necessitating more invasive tests like bronchoscopy. Additionally, bacteriological examinations, such as sputum smear and pleural fluid smear, as well as culture for Mycobacterium tuberculosis, are typically conducted for patients. Nowadays, hospitals equipped with the necessary facilities conduct molecular biological tests, namely nucleic acid testing for Mycobacterium tuberculosis DNA. Furthermore, some patients with complex conditions may require a histopathological biopsy, commonly referred to as tissue sampling, at the site of the lesion to observe under a microscope for characteristic changes indicative of tuberculosis. There are also immunological tests that assist in diagnosing tuberculosis, such as the gamma interferon release assay (commonly known as the T-SPOT), tuberculin skin test, and traditional antibody tests against Mycobacterium tuberculosis.

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Written by Wang Xiang Yu
Pulmonology
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Is tuberculosis easily contagious?

Whether tuberculosis (TB) is easily transmitted primarily depends on the source of infection, which refers to the TB patients and the amount of Mycobacterium tuberculosis in their sputum. If TB bacilli can be detected in their sputum, and the quantity is substantial, then their infectiousness is indeed higher. However, if the TB patient has undergone treatment, or if there are only a few TB bacilli in their sputum, or none at all, then their infectiousness may not be as significant. The second factor is the mode of transmission, which mainly occurs through the respiratory tract. If TB patients can be isolated timely, or if they wear masks, and their sputum is properly managed, for example by wrapping the sputum in paper and burning it, then they are less likely to transmit the disease to others. TB generally involves susceptibility issues; even if someone has been vaccinated with BCG or the TB vaccine, they can still be reinfected. Therefore, controlling these three transmission pathways is essential to minimize the risk of contracting TB.

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Written by Wang Xiang Yu
Pulmonology
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Does tuberculosis cause fever?

Does tuberculosis cause fever? Certainly, fever can occur. Fever is one of the most common clinical manifestations of tuberculosis, which can be mild or high fever. Most cases of tuberculosis mainly present as afternoon febrile flushes, or say, an evening low-grade fever. In a few cases, such as infectious pneumonia or more severe infections like tuberculous pleurisy, there can be high fever, and these fever episodes may last a long time and be recurrent, making them difficult to control.

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Written by Xiong Hong Hai
Infectious Disease
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How is tuberculosis diagnosed?

The diagnosis of tuberculosis primarily involves combining relevant clinical symptoms, such as whether there is cough, expectoration, low fever, night sweats, and blood in phlegm. It also requires considering the patient's chest imaging features, whether there is obvious infection, fresh exudation, cavities, as well as sputum tests. For example, if the sputum stain for acid-fast bacilli is positive, and the sputum culture is positive, using these comprehensive diagnostic methods, tuberculosis can be diagnosed, after which anti-tuberculosis treatment should be initiated.

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Written by Li Jiao Yan
Neonatology
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Does the BCG vaccine prevent tuberculosis?

The BCG vaccine primarily prevents infection by the tuberculosis bacillus, so it can prevent pulmonary tuberculosis. The protective effect of the BCG vaccine is mainly achieved through inducing a cell-mediated immune response. After vaccination, a primary infection is formed, which is processed by macrophages that transmit the antigen information to immune-active cells, leading to the differentiation and proliferation of T cells and the formation of sensitized lymphocytes. When the body is re-infected with the tuberculosis bacillus, the macrophages and sensitized lymphocytes are activated, causing a specific immune response in the body, thereby resisting the infection by the tuberculosis bacillus. Therefore, the BCG vaccine mainly prevents pulmonary tuberculosis.