In the early stages, you may have very mild, coldlike symptoms—a cough or a general feeling of malaise—or no symptoms at all. At this stage, you may not even know that you have TB unless a skin test or chest x-ray are performed.
If TB persists beyond the initial stages, you may experience mild cough, fever, night sweats, poor appetite, and problems gaining weight Table 01. In many cases, your immune system will fight off TB in its preliminary stages, and you will have no further symptoms. If, however, your body is unable to fight the infection efficiently (as often happens with immune-compromised or elderly individuals), further symptoms will appear. These additional symptoms include difficulty breathing, chest pain, and a cough that may produce discolored mucus (which may be bloody or blood-streaked).
TB can affect many different areas in the body, such as the bones, skin, and heart, causing an array of symptoms Table 01.
Table 1. Common Symptoms of TB
GENERAL SYMPTOMS Fever Night sweats Loss of appetite Malaise Fatigue Weight loss Lung-specific symptoms Chronic cough Spitting up blood or blood-streaked sputum Chest pain Shortness of breath OTHER SYMPTOMS Lymph nodes Swollen glands at the sides and base of the neck. Bones and joints Pain and swelling of a joint, such as the knee or hip; hunchback-type of curvature of the spine; damage to bones of the spine. Genitals and urinary tract Pain in the lower back and side; frequent urination; pain on urination or bloody urine; a slowly enlarging mass in the testes or prostate for men, or in the fallopian tubes or uterus for women. Skin A red, hardened rash, usually on the arms or legs. Nervous system Headache or stiffness of the neck (may indicate tuberculous meningitis); a tumor-like mass in the brain. Heart Prominent neck veins; shortness of breath, dizziness, headache. Adrenal glands Dizziness and symptoms of Addison's disease (weakness, darkening of the skin).
Patients with AIDS and others with a weakened immune system have an increased risk of contracting TB Table 02. AIDS prevents the immune system from fighting off such infections as TB. Alcoholism and homelessness (due to malnutrition, overcrowding, and close contact with others with active TB) are also associated with weakened immune response, and thus create an additional risk for contracting TB.
TB is more common in the elderly. Aging diminishes the efficacy of the immune system, making elderly individuals more susceptible to TB infection. In addition, since older adults are more likely to have contracted TB during their lifetimes, when the disease was more common, they are more likely to have the dormant bacteria in their bodies. These bacteria may reactivate, for example, as a consequence of ill health when the immune system is weakened. Older adults who live in chronic care facilities in close contact with other individuals with TB are at additional risk of contracting the disease.
Crowding and poor ventilation increase the likelihood of TB infection. Persons who live or work in nursing homes, hospitals, prisons, or other crowded, poorly ventilated institutions are at higher risk for exposure to TB. This is because the close proximity makes it more likely for these individuals to come in contact with air contaminated with the bacteria that cause the disease.
Impoverished population groups and people living in developing countries have an increased risk for contracting TB. The combination of crowding, poor medical care, and consumption of unpasteurized milk (which may contain M. bovis, another causative agent) places individuals living in such situations at an increased risk for TB.
Table 2. TB Risk Factors
AIDS Alcoholism Homelessness Old age Living or working in crowded conditions: (i.e., nursing homes, prison, hospitals, dormitories) Living in a developing country Drinking unpasturized milk
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