Lung Condition: Tuberculosis

Tuberculosis (TB) is an infectious disease that mainly affects your lungs. TB also has the ability to spread to other parts of your body, such as your brain, spine, or kidneys. Tuberculosis used to be a widespread cause of death in the United States, but now it is easily curable.

Latent TB is the noncontagious form of tuberculosis. Having this form means although the germs are present in your body, your immune system is able to stop them from spreading. Due to this, you do not suffer from any symptoms and cannot pass the disease on to others, although the infection can one day become active.

With active TB, the germs in your body are multiplying and cause not only you, but those you come into consistent contact with to be sick. In fact, 90 percent of active tuberculosis cases begin with a latent tuberculosis infection.

Tuberculosis is an airborne disease, meaning it spreads through microparticles released when someone infected with TB coughs, sneezes, laughs or speaks. Similar to the flu or a cold, people can only spread TB if they are contagious. Tuberculosis is not an easy disease to catch, as people usually have to spend extended periods of time around someone suffering from active TB.

You may have an increased risk of catching tuberculosis if someone you know has active TB, if you’ve traveled to an area where there is a higher risk of tuberculosis infection, such as Russia, Africa, Eastern Europe, Asia, Latin America, or the Caribbean. You may also have an increased risk if you work or live in a hospital or nursing home or you are a smoker.

A weakened immune system also can lead to tuberculosis, as it makes it harder for your body to fight the bacteria. If you have certain diseases, such as HIV, diabetes, kidney disease, or cancer, it may be easier for you to catch tuberculosis. Treatments for diseases can also weaken your immune system, such as chemotherapy, medicine for organ transplants, or drugs that treat rheumatoid arthritis, Chrohn’s disease, and psoriasis.

Latent TB does not present any symptoms until it becomes active. Active TB disease symptoms include chest pain, a cough that lasts more than 3 weeks, coughing up blood, excessive fatigue, night sweats, chills, fever, loss of appetite, and weight loss.

TB bacteria can cause complications after infection, such as joint damage, lung damage, liver or kidney problems, and inflammation of the tissues around your heart. Tuberculosis may also lead to infection or damage of your bones, spinal cord, brain, or lymph nodes.

There are two common tests to diagnose tuberculosis. The TB skin test, also known as the Mantoux tuberculin skin test, is where a technician injects a small amount of fluid into the skin of your lower arm. Once 2 to 3 days have passed by, your doctors will check your arm for swelling to determine if you are experiencing tuberculosis.

If your results are positive, that means you likely have TB bacteria in your body. However, both false positives and false negatives exist. Due to this, you may have to receive the test more than once.

The other tuberculosis test is a blood test, also known as interferon-gamma release assays (IGRAs), which measure the response when TB proteins interact with a small amount of your blood. While these tests can determine if you have tuberculosis, doctors have to conduct other tests to see whether you are experiencing latent or active TB.

Your doctor may order a chest X-ray or CT scan to look for changes in your lungs. An acid-fast bacillus (AFB) may also be ordered, as this tests for TB bacteria in your sputum, which is the mucus that comes up during a cough.

Treatment for latent TB and active TB differ, so what your doctor recommends will depend upon which type of infection you have. For latent TB, your doctor will give you antibiotics to kill the infection before it becomes active. These medications include isoniazid, rifapentine, and rifampin, which you must take for up to 9 months.

For active TB, treatment also calls for a combination of medications. The most common medicines for this treatment include ethambutol, isoniazid, pyrazinamide, and rifampin, which you must take for 6 to 12 months. If you have drug-resistant TB, you may have to take multiple medications at a time for an extended period of time of up to 30 months.

Each medication used to treat tuberculosis can have adverse effects. Common isoniazid side effects include numbness and tingling in your hands and feet, weakness, loss of appetite, and an upset stomach, nausea, or vomiting. For ethambutol, side effects may include loss of appetite, headache, confusion, painful or swollen joints, chills, abdomen pain, nausea, and vomiting.

Side effects of pyrazinamide include lack of energy, loss of appetite, nausea, vomiting, and muscle or joint pain. For rifampin, side effects may be a skin rash, inflamed pancreas, diarrhea, loss of appetite, nausea, vomiting, or an upset stomach.

In the first few weeks of active TB infection, you have a high chance of passing the disease onto others. During the contagious period, there are preventative measures you can take to lower the risk of spreading tuberculosis. The safest thing to do is to stay home and isolate yourself from others. It will also help to ventilate your room as TB bacteria spreads more easily in enclosed spaces with little to no airflow.

Other methods include covering your mouth with a tissue when coughing or sneezing and placing the tissue in a sealed bag before disposing of it, along with wearing a face mask when exposed to other people to reduce the risk of transmission.