Tuberculosis

Tuberculosis (TB) is an illness caused by a bacterial infection. It commonly affects your lungs, but it can also affect other areas of your body like your spine, brain or kidneys.

Not everyone who’s infected with TB gets sick. If you’re infected but have no symptoms, it’s called inactive tuberculosis, or latent TB. TB is dormant (sleeping) inside your body. As many as 13 million people in the U.S. have latent TB. Some people can have a latent TB infection for a lifetime, without ever developing symptoms (active TB).

But TB can become active if your immune system becomes weakened. A weakened immune system may not be able to stop the bacteria from growing.

Symptoms of tuberculosis

Active TB symptoms include:

• Bad cough (lasting longer than two weeks)
• Chest pain
• Coughing up blood or sputum (mucus)
• Fatigue or weakness
• Loss of appetite
• Weight loss
• Chills
• Fever
• Night sweats

You won’t have symptoms if you have inactive TB. But you might have a positive TB test.

Tuberculosis causes

Mycobacterium tuberculosis bacteria cause TB. The germs spread through the air and can infect your lungs when you breathe them in. Sometimes, they also infect other parts of your body.

Types

The most common type of TB is pulmonary (lung) tuberculosis. But the bacterium can also affect other parts of your body (extrapulmonary tuberculosis). You might also hear about miliary tuberculosis, which can spread throughout your body and cause:

• Meningitis, an inflammation of the lining of your brain
• Pott’s disease, also called spinal tuberculosis or tuberculosis spondylitis
• Addison’s disease, an adrenal gland condition
• Hepatitis, liver inflammation
• Scrofula, swollen lymph nodes in your neck

How does tuberculosis spread?

TB can spread when a person with active TB coughs, sneezes, talks, sings or laughs. Only people with an active lung infection are contagious. You usually have to spend a lot of time in contact with someone who’s contagious to catch TB. Most people who breathe in TB bacteria can fight the bacteria and stop it from growing. This causes a latent TB infection.

Risk factors

You might be at a higher risk for TB exposure if you:

• Are a resident or employee in group settings where TB can spread, such as jails, hospices, skilled nursing facilities, shelters and other healthcare facilities
• Work in a mycobacteriology laboratory
• Have lived in a region where TB is common, like Latin America, the Caribbean, Africa, Asia, Eastern Europe and Russia
• Have been in contact with someone who’s known or suspected to have TB disease

You might be at a higher risk for getting active TB if you:

• Inject intravenous drugs
• Have an immature, impaired or weakened immune system (including babies and children)
• Have kidney disease, diabetes or other chronic (long-term) illness
• Have received an organ transplant
• Are on chemotherapy treatment for cancer

How doctors diagnose tuberculosis

Healthcare providers use a skin or blood test to diagnose TB. You might also need:

• Lab tests on sputum and lung fluid
• Chest X-ray
• Computed tomography (CT) scans

How is tuberculosis treated?

Healthcare providers treat both active and inactive tuberculosis with specific kinds of antibiotics. You’ll likely need to take a combination of medications to get rid of the infection.

You’ll have to take these medications for a long time — several months. You must take them exactly as your provider prescribes to get rid of all the bacteria. It’s very important to finish your entire prescription.

TB medications

Specific medications your provider might prescribe include:

• Isoniazid (Hyzyd®)
• Rifampin (Rifadin®)
• Ethambutol (Myambutol®)
• Pyrazinamide (Zinamide®)
• Rifapentine (Priftin®)

Recovery time

You might start having more energy and fewer symptoms within a few weeks of starting treatment. But it’ll take longer than that to complete it. You’ll need to take your medications for at least six to nine months.

When should I see my healthcare provider?

If you’ve been exposed to TB, you should talk to your healthcare provider right away. They can talk to you about options for getting tested. It’s important to get tested if you’ve developed any symptoms — you could pass TB on to others.

If you’re taking medications to treat TB, talk to your provider about any side effects. Some side effects can be serious.

Can tuberculosis be prevented?

You can reduce your risk of contracting and spreading TB by:

• Washing your hands thoroughly and often
• Coughing into your elbow or covering your mouth when you cough
• Avoiding close contact with other people
• Making sure you take all your medications as prescribed
• Not returning to work or school until you’ve been cleared by your healthcare provider

In the hospital, the most important measures to stop the spread of TB are having proper ventilation and using personal protective equipment.

Is there a vaccine for tuberculosis?

Some countries (but not the U.S.) use a TB vaccine called Bacillus Calmette-Guerin (BCG). It’s mostly given to children in countries with high rates of TB.

How common is tuberculosis?

In 2020, about 10 million people became ill with TB throughout the world, and about 1.5 million people died from it. TB was once the leading cause of death in the U.S., but with new treatments, the number of cases fell rapidly in the 1940s and 1950s. There were 7,860 tuberculosis cases reported in the U.S. in 2021.