According to the U.S. Centers for Disease Control and Prevention (CDC), 12,904 cases of tuberculosis were reported in the U.S. in 2008--the lowest number on record. However, tuberculosis (TB) remains a major public health threat globally. TB infections can be latent or active. With latent TB, the bacteria are inactive and cause no symptoms; latent TB is not contagious. With active TB, the causative bacteria--Mycobacterium tuberculosis--are actively multiplying causing a symptomatic and contagious illness.
Fever, Chills and Night Sweats
Fever is a common symptom of active TB. It is typically low grade and intermittent. Chills may accompany the fever. Soaking night sweats--sweats occurring during sleep that wet the bedclothes and linens--are a classic symptom of active TB. However, this symptom may not be present and can be caused by conditions other than TB.
Loss of Appetite and Weight Loss
Most people with TB experience loss of appetite and unintentional weight loss. In severe cases, muscle mass may be lost due to extreme weight loss.
Malaise, Fatigue and Weakness
People with active TB do not feel well. Chronic fatigue--a feeling of extreme tiredness that is unrelieved by sleep--is typical. Physical weakness and a decreased tolerance for physical activity often accompany this symptom.
Productive Cough
Active pulmonary TB causes a persistent, productive cough. Productive cough lasting more than two to three weeks should raise suspicion for active TB. Early in the disease, the cough is dry. With time, it becomes productive of yellowish-green phlegm. As the infection progresses, the amount of phlegm produced typically increases. The phlegm may contain streaks of blood. Although uncommon, active TB can cause brisk lung bleeding; this results large amounts of blood being coughing up and breathing distress.
Shortness of Breath
In active TB, both lungs are typically involved in the infection. The inflammation caused by the infection and the destructive activity of the tuberculous bacteria decrease the lungs' normal functional capacity leading to shortness of breath.
Pleuritic Chest Pain
TB often causes chest pain. Although the lungs do not have the capacity to feel pain, they are covered by thin sacs called the pleura, which do have pain innervation. Active TB can cause inflammation of the pleura, which causes pain as the lungs move in the pleural sacs. Deep inhalation and coughing characteristically trigger pain, which is called pleuritic chest pain.
Hoarseness and Difficulty Swallowing
Active TB may involve the trachea, the tube that carries air from the nose and mouth to the lungs. Hoarseness and difficulty swallowing are common symptoms of tracheal involvement with active TB.
References
- "Principles and Practice of Infectious Diseases, Sixth Edition;" Gerald L. Mandell, M.D., et al, Editors; 2004
- World Health Organization: Tuberculosis treatment guidelines
- Centers for Disease Control and Prevention: Tuberculosis fact sheet
- Mayo Clinic: Tuberculosis
- American Family Physician: Management of active tuberculosis
