Symptoms, Diagnosis and Treatment

What are the Symptoms of TB?

A person with TB infection will have no symptoms. A person with active TB disease may have any, all or none of the following symptoms:

  • A persistent cough
  • Constant fatigue
  • Weight loss
  • Loss of appetite
  • Fever
  • Coughing up blood
  • Night sweats

These symptoms can also occur with other diseases so it is important to see a healthcare provider and to let them find out if you have TB. A person with TB disease may feel perfectly healthy or may only have a cough from time to time. If you think you have been exposed to TB, get a TB test.

How is TB Detected?

TB can be detected through a skin test or a TB blood test.

The skin test is done by injecting a small amount of fluid called tuberculin into the skin in the arm. You will be told to return within 48 to 72 hours to have a healthcare worker check the arm to see if a bump has developed. The healthcare worker will measure the bump and tell you if your reaction to the test is positive or negative. If it's positive, it usually means you have been infected with the TB germ.

The TB blood test measures how your immune system reacts to the germs that cause TB.

If you have a positive test for TB infection, it only means that you have been infected with TB germs. It does not tell whether you have developed TB disease. You will be given other tests, such as a chest x-ray and a check of your sputum (coughed up mucus), to see whether you have TB disease.

How is TB Treated?

Treatment for TB depends on whether a person has active TB disease or only TB infection.

If you have become infected with TB, but do not have active TB disease, you may get preventive therapy. This treatment kills germs that are not doing any damage right now, but could so do in the future. The most common preventive therapy is a daily dose of isoniazid (INH) for 6 to 9 months.

If you have active TB disease you will probably be treated with a combination of several drugs for 6 to 12 months. You may only have to stay a short time in the hospital, if at all, and can then continue taking medication at home. After a few weeks you can probably even return to normal activities and not have to worry about infecting others.

The most common treatment for active TB is INH plus two to three other drugs including rifampin, pyrazinamide and ethambutol. You will probably begin to feel better only a few weeks after starting to take the drugs.

It is very important that you continue to take the medicine correctly for the full length of treatment. If you take the medicine incorrectly or stop taking it, you may become sick again and will be able to infect others with TB.

If you don't take the medicine correctly and you become sick with TB a second time, the TB may be harder to treat if it has become drug resistant. This means that some drugs used to treat TB cannot fight the TB germs in the body. TB that is resistant to more than one drug, called multidrug-resistant TB (MDR TB) is very dangerous. Extensively drug-resistant TB (XDR TB) is an even more dangerous version of MDR TB because so many of the most effective TB drugs do not work against it.