What is tuberculosis?

Written by Wang Xiang Yu
Pulmonology
Updated on September 24, 2024
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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.

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Written by Wang Xiang Yu
Pulmonology
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How is tuberculosis transmitted?

How is pulmonary tuberculosis transmitted? First, we need to know the pathogen of pulmonary tuberculosis, which is the tuberculosis bacillus. Tuberculosis bacillus is a type of bacterium that can live in our surrounding environment. Pulmonary tuberculosis also needs a source of infection, that is, a patient carrying the tuberculosis bacillus. The most common source of tuberculosis infection is usually patients with secondary pulmonary tuberculosis. Then, its mode of transmission mainly includes coughing, sneezing, laughing, and talking loudly, which can release the tuberculosis bacilli from the patient into the air, spreading them through droplets. Droplet transmission is the most important route for the spread of pulmonary tuberculosis. Additionally, pulmonary tuberculosis can also be transmitted through other routes such as the gastrointestinal tract or the skin, although these methods of transmission are less common.

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Written by Han Jian Hua
Infectious Disease
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Does tuberculosis infect people?

Tuberculosis is a contagious disease, and hearing the term "tuberculosis" inevitably makes people nervous. However, not all tuberculosis patients are contagious. Research shows that among tuberculosis patients, only those who have tuberculosis bacteria found in sputum smear tests are contagious. With a source of infection, the tuberculosis bacteria must be transmitted to others through certain routes. Airborne transmission is the main route of transmission for tuberculosis bacteria. When a tuberculosis patient coughs, sneezes, or speaks loudly, they release a large number of droplet nuclei containing tuberculosis bacteria into the air, which can be inhaled by healthy individuals and cause infection. The degree of tuberculosis bacteria infection mainly depends on factors such as the amount of bacteria the patient expels, the severity of coughing symptoms, and the extent of contact. Therefore, when there is a tuberculosis patient nearby, we first need to understand whether they are in the active phase of the disease, that is, expelling bacteria, and whether they are undergoing anti-tuberculosis chemotherapy. If the patient has a negative sputum test or has undergone chemotherapy for a positive sputum test, such patients have very low contagiousness, so there is no need to worry too much about being infected.

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Written by Wang Xiang Yu
Pulmonology
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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.

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Written by Li Jiao Yan
Neonatology
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Does the BCG vaccine prevent tuberculosis?

The BCG vaccine primarily prevents infection by the tuberculosis bacillus, so it can prevent pulmonary tuberculosis. The protective effect of the BCG vaccine is mainly achieved through inducing a cell-mediated immune response. After vaccination, a primary infection is formed, which is processed by macrophages that transmit the antigen information to immune-active cells, leading to the differentiation and proliferation of T cells and the formation of sensitized lymphocytes. When the body is re-infected with the tuberculosis bacillus, the macrophages and sensitized lymphocytes are activated, causing a specific immune response in the body, thereby resisting the infection by the tuberculosis bacillus. Therefore, the BCG vaccine mainly prevents pulmonary tuberculosis.

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Written by Wang Xiang Yu
Pulmonology
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Symptoms of tuberculosis

Tuberculosis of the lung presents in many forms, as there are also various types of pulmonary tuberculosis, each exhibiting different symptoms. However, the most common symptoms primarily include coughing and expectoration, which are the most typical manifestations of pulmonary tuberculosis. The cough in pulmonary tuberculosis is generally mild, either dry or producing only a small amount of phlegm. If the tuberculosis is accompanied by cavities, the amount of phlegm may be larger. If there is a bacterial infection in addition to the tuberculosis, the phlegm may become purulent. Some patients with pulmonary tuberculosis may also experience hemoptysis, which can vary in amount from light to severe. A small number of patients may suffer from chest pain and difficulty breathing. Additionally, there are systemic symptoms associated with pulmonary tuberculosis, such as fever (both low and high fever may occur), night sweats, and fatigue, among others.