Tuberculosis

Tuberculosis (TB) is a bacterial infection that most commonly affects your lungs. But it can also affect your spine, brain, kidneys or other parts of your body.

Most people with TB have inactive (latent) tuberculosis, which means they don’t get sick from the infection and aren’t contagious. In fact, some people can live their whole lives without knowing they have it.

Other people will eventually develop symptoms (active tuberculosis). This is more likely if your immune system becomes weakened. If left untreated, active TB can be fatal.

You might think tuberculosis — once called consumption — doesn’t exist anymore. But nearly 1 in 4 people around the world have been infected. In the U.S., it’s estimated that over 13 million people have a TB infection. Thousands of people in the U.S. are diagnosed with active TB every year.

Symptoms of tuberculosis

The most common TB symptoms include:

• Long-lasting cough
• Chest pain
• Coughing up blood or sputum (mucus)
• Fatigue or weakness
• Loss of appetite
• Weight loss
• Chills
• Fever
• Night sweats

Inactive TB doesn’t cause symptoms or spread to other people. Active TB causes symptoms and can spread to others.

If you have TB in parts of your body outside of your lungs, you might have:

• Swollen lymph nodes in your neck (scrofula)
• Hoarseness
• Difficulty swallowing
• Blood in your pee
• Back or side pain
• Joint pain
• Headaches
• Confusion
• Neck stiffness

Complications

Complications of tuberculosis depend on where in your body the infection is. They could include:

• Addison’s disease, a condition where your adrenal glands don’t produce enough hormones
• Infertility
• Inflammation around your heart (pericarditis)
• Inflammation in the lining of your belly (peritonitis)
• Inflammation of the lining of your brain (meningitis)
• Liver inflammation
• Spinal infection (Pott’s disease)

Many people who’ve had active TB have chronic lung symptoms or conditions, even after successful treatment. These could include:

• Cough
• Shortness of breath
• Bronchiectasis
• High blood pressure in your lungs

Tuberculosis causes

Mycobacterium tuberculosis bacteria cause TB. You get it by breathing in the bacteria when someone with an infection coughs, sneezes or talks nearby. But you usually need frequent, close contact with someone who has TB to get it. You can also get it if you’re in crowded living conditions.

Only people with active TB are contagious. Your immune system often keeps the bacteria from growing when you’re exposed to it, causing an inactive infection. Inactive TB isn’t contagious. But it can become an active infection in the future.

Risk factors

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

• Live or work in group settings where TB can spread, like prisons, long-term care facilities and hospitals
• Have lived in an area where TB is common, like parts of Asia and Africa

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

• Inject drugs
• Have a weakened immune system due to HIV, cancer treatment or immunosuppressive medications
• Have kidney disease, diabetes or other long-term illnesses

Babies and kids are also at higher risk, as their immune systems aren’t fully developed yet.

How doctors diagnose tuberculosis

If you have symptoms, your healthcare provider may get imaging, like a chest X-ray or CT scan. The best way to diagnose active TB is for your provider to collect a sputum sample (mucus coughed up from your lungs) and send it to a lab for testing. Depending on your symptoms, you may need additional tests.

If you don’t have symptoms, providers can diagnose latent TB with a blood or skin test. If you’ve received the Bacillus Calmette-Guerin (BCG) vaccine in the past, you might have a positive TB skin test. A blood test to look for prior exposure and infection is the best next step in this situation.

How is tuberculosis treated?

Healthcare providers treat both active and inactive TB with antibiotics. You’ll likely need to take a combination of medications to get rid of the infection. These most often include:

• Isoniazid
• Rifampin
• Ethambutol
• Pyrazinamide

You’ll have to take these medicines for several months. They can have side effects. This can make it hard to stick with it, especially if you start to feel better.

But stopping early can make TB come back and harder to treat. That’s why it’s important to take antibiotics exactly as your provider prescribes and for the entire course of treatment. A healthcare provider may check in with you to help make sure you’re able to take your medications as prescribed and help with any questions you have.

TB can be antibiotic-resistant, meaning some drugs don’t work on it. Your provider will run tests to see which antibiotic works best to kill the bacteria before starting treatment.

When should I see my healthcare provider?

Talk to your healthcare provider if you have any concerns about TB treatment or its side effects. If you think you’ve been exposed to TB, talk to a provider right away. They can recommend when and how to get tested. You also may need to be screened for latent TB if you grew up in an area where TB is common or if you’re at higher risk for exposure to TB.

Go to the emergency room if you have symptoms of serious illness, including:

• Confusion
• Neck stiffness
• Severe headache
• Chest pain
• Sudden or severe shortness of breath

What can I expect if I have tuberculosis?

Tuberculosis is treatable with a long course of antibiotics. If you have active TB, you’ll have to avoid other people early on in your treatment. If you have inactive TB, you’re not at risk of giving TB to anyone else.

You might start feeling better after a few weeks of treatment. But make sure you continue to take your medications as directed by your healthcare provider. They’ll also let you know when it’s OK to be around other people (usually a few weeks into antibiotic treatment).

Can you survive tuberculosis?

Yes, you can survive TB with antibiotic treatment. But it takes several months, and you need to take the full course of antibiotics as prescribed. Some people have drug-resistant TB. This is harder to treat.

Can this be prevented?

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

• Washing your hands thoroughly and often
• Coughing into your elbow or covering your mouth when you cough
• Wearing a mask around others if you have active TB
• Avoiding other people if you have active TB unless your provider tells you it’s OK
• Making sure you take all of your medications as prescribed
• Not returning to work or school until you’ve been cleared by your healthcare provider

Countries with high rates of TB recommend the BCG vaccine to prevent TB in children. It’s rarely used in the U.S.