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Pulmonary tuberculosis
Symptoms of pulmonary tuberculosis
Now let me talk about the symptoms of tuberculosis. Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis, which can invade many organs, with pulmonary tuberculosis being the most common. The main symptoms are respiratory symptoms and systemic symptoms. The respiratory symptoms are mainly manifested as coughing, expectoration for more than two weeks, or blood in the sputum, which are common suspicious symptoms of pulmonary tuberculosis. Generally, the cough is mild, either dry or with a small amount of mucus. When cavities form, the amount of sputum may increase, and if there is a secondary bacterial infection, the sputum may become purulent. If there is concomitant bronchial tuberculosis, it will manifest as an irritating cough. About one-third of patients will experience hemoptysis, and some may experience massive hemoptysis. If the tuberculosis lesions involve the pleura, it can manifest as chest pain. Dyspnea is more common in patients with caseous pneumonia or those with a large amount of pleural effusion. These are local symptoms. Systemic symptoms mainly manifest as fever, which is the most common manifestation, often as long-term afternoon fever, meaning it begins to rise in the afternoon or evening, drops in the morning, and then returns to normal. Some patients may also experience fatigue, night sweats, loss of appetite, weight loss, etc. Women of childbearing age may experience menstrual disorders, etc.
What is tuberculosis?
Tuberculosis is a disease where the bacterium Mycobacterium tuberculosis infects the lungs. It is a persistent bacterium that grows slowly. Tuberculosis is an infectious disease and quite common historically, often referred to as consumption in the past, as mentioned in the novels of Lu Xun. In modern times, tuberculosis is relatively manageable if the infection has not developed resistance to drugs. Proper anti-tuberculosis treatment can result in a cure rate exceeding 90% on the first attempt. However, if the treatment is not adhered to correctly—if the patient stops taking the medication prematurely or does not follow the prescribed regimen—the bacteria may develop resistance, reducing the effectiveness of the treatment. This is particularly problematic in elderly patients, who might also experience adverse reactions to tuberculosis medications, making treatment difficult. Thus, while tuberculosis is generally treatable, infections with drug-resistant strains can be fatal if not managed properly.
Is tuberculosis contagious?
Firstly, pulmonary tuberculosis is contagious, but it also depends on the type. Generally, pulmonary tuberculosis is most contagious during its active phase, but some patients with fibrosis and in a stable phase are not contagious. The transmission of pulmonary tuberculosis is mainly through droplets, spread by talking, sneezing, or spitting from a tuberculosis patient to a healthy person. However, this droplet transmission has a distance requirement. We believe that a distance of more than 1 meter is relatively safe, and 2 meters is absolutely safe. To prevent the transmission of tuberculosis, it is essential to maintain a distance from tuberculosis patients, wear masks, and ensure frequent ventilation by opening windows.
Does tuberculosis cause fever?
Does tuberculosis cause fever? Certainly, fever can occur. Fever is one of the most common clinical manifestations of tuberculosis, which can be mild or high fever. Most cases of tuberculosis mainly present as afternoon febrile flushes, or say, an evening low-grade fever. In a few cases, such as infectious pneumonia or more severe infections like tuberculous pleurisy, there can be high fever, and these fever episodes may last a long time and be recurrent, making them difficult to control.
How long can someone with tuberculosis live?
Early detection and appropriate anti-tuberculosis treatment of tuberculosis can lead to a normal lifespan once cured. However, it is important to exercise regularly and enhance immunity, since tuberculosis may recur if the body's resistance decreases. With the increase of drug-resistant tuberculosis, treatment difficulties have intensified. If it is detected late or not treated properly and the lung damage progresses to an advanced stage, it can be life-threatening, with survival ranging from days to years. When tuberculosis involves massive hemoptysis, death can occur at any time due to suffocation or hemorrhagic shock, depending on the specific condition.
Can tuberculosis relapse?
Tuberculosis can relapse, and the answer is definitely yes. In clinical practice, we see many patients who have had tuberculosis and, years later, experience a recurrence of the disease, even multiple recurrences. However, the probability of this is generally not high. As long as everyone follows the doctor's instructions for standard anti-tuberculosis treatment and completes the full course of treatment, most patients can be cured. However, there are a few people whose treatment process is not standard, or who stop taking their medication on their own, and these actions can increase the risk of tuberculosis recurrence.
Does tuberculosis cause coughing?
Do tuberculosis patients cough? Most tuberculosis patients can experience coughing, and the duration of the cough is generally quite long, often exceeding two to three weeks and in some cases even reaching over six months to a year. However, there is also a small number of patients who might not cough due to the different types of tuberculosis they have. Additionally, not all cases of coughing indicate tuberculosis. A tuberculosis patient might cough, but they might also not cough, and while a person who coughs could possibly have tuberculosis, not all coughs are due to tuberculosis. There is no definitive equivalence between tuberculosis and coughing. I hope this explanation helps you understand the relationship between tuberculosis and coughing. Thank you.
What department should tuberculosis patients visit?
For tuberculosis, you can visit the Department of Infectious Diseases. Infectious diseases or respiratory medicine are suitable options, and if a hospital doesn't have these specialized departments, you can consider visiting the Center for Disease Control. In smaller hospitals, below the secondary level, where such specific departments may not be available, you might also consider seeing the Department of General Internal Medicine. General Internal Medicine or typical internal medicine departments can also handle this. However, our first recommendation would still be the Respiratory Medicine Department. Some hospitals combine Infectious Diseases with other related departments, making them the preferred choice for tuberculosis patients as these departments likely have the most experience in treating such diseases.
Does tuberculosis get inherited?
Is tuberculosis hereditary? Tuberculosis is not a hereditary disease; it is an infectious disease. Infectious diseases and hereditary diseases are two completely different concepts. Tuberculosis is generally infectious, which means that in a family, if parents are infected, they can easily transmit the tuberculosis bacteria to their children or others around them. Therefore, many people might mistakenly believe that tuberculosis is hereditary. However, this is not the case; tuberculosis is transmitted through the tuberculosis bacteria.
Is tuberculosis easily contagious?
Whether tuberculosis (TB) is easily transmitted primarily depends on the source of infection, which refers to the TB patients and the amount of Mycobacterium tuberculosis in their sputum. If TB bacilli can be detected in their sputum, and the quantity is substantial, then their infectiousness is indeed higher. However, if the TB patient has undergone treatment, or if there are only a few TB bacilli in their sputum, or none at all, then their infectiousness may not be as significant. The second factor is the mode of transmission, which mainly occurs through the respiratory tract. If TB patients can be isolated timely, or if they wear masks, and their sputum is properly managed, for example by wrapping the sputum in paper and burning it, then they are less likely to transmit the disease to others. TB generally involves susceptibility issues; even if someone has been vaccinated with BCG or the TB vaccine, they can still be reinfected. Therefore, controlling these three transmission pathways is essential to minimize the risk of contracting TB.