How is tuberculosis treated?

Written by Wang Xiang Yu
Pulmonology
Updated on March 09, 2025
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The primary treatment for tuberculosis is still chemotherapy, also simply called chemo, but the chemotherapy for tuberculosis is completely different from the anti-tumor chemotherapy we talk about in cancer, and the medications are also completely different. There are about more than ten anti-tuberculosis drugs, which can be divided into first-line and second-line drugs, and currently, there are third-line drugs under research. Chemotherapy for patients with pulmonary tuberculosis should be started early and administered in combination. The types of combined medication for patients with pulmonary tuberculosis generally involve three or more drugs. Some patients may exhibit drug resistance or intolerance to some drugs' side effects, and thus, second-line drugs may be used. Additionally, some patients, due to special conditions, may require four or five types of anti-tuberculosis drugs. It is crucial to strictly follow medical advice regarding how to medicate and treat. Furthermore, patients with pulmonary tuberculosis must ensure complete medication adherence, as the treatment duration for tuberculosis is quite long, typically requiring at least six months, and some patients may need one or even two years. Regular medication intake is very important because some patients might experience symptoms like coughing up blood or others, such as those with pleurisy, who might develop pleural effusion. Therefore, treatments targeted at other symptoms are necessary. Patients who cough up blood might need hemostatic drugs, while those with severe hemoptysis may even require interventional surgery. Some with tuberculous pleurisy might need to have pleural effusion drained. Additionally, some patients with pulmonary tuberculosis might experience adverse reactions to medications, such as liver or kidney failure, visual impairment, or numbness in the hands, which would require adjustments to their medication or changes based on their complications. Treatment should also be targeted toward these adverse reactions.

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Written by Wang Xiang Yu
Pulmonology
1min 10sec home-news-image

Can tuberculosis be cured completely?

Whether tuberculosis can be completely cured varies from person to person. Most cases of tuberculosis, especially initial occurrences of pulmonary tuberculosis, can be cured in more than 80 to 90 percent of patients if they undergo standardized anti-tuberculosis treatment. However, it is essential that the treatment is standardized; it is not appropriate to simply take medication for one or two months and then stop when symptoms seem to disappear. The treatment duration for pulmonary tuberculosis is considered to be at least six months, and for some patients, it may even extend to a year. However, not all cases of pulmonary tuberculosis can be completely cured. A small percentage of patients may not achieve complete eradication due to resistance to tuberculosis bacteria or intolerance to the side effects of tuberculosis medications. In such cases, the prognosis might be poor, and some individuals may succumb to tuberculosis due to these factors.

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Written by Li Jiao Yan
Neonatology
1min 1sec home-news-image

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 Hu Xue Jun
Pulmonology
1min 36sec home-news-image

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.

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Written by Wang Xiang Yu
Pulmonology
1min 38sec home-news-image

Does tuberculosis cause a runny nose?

Do patients with tuberculosis have a runny nose? First, we need to understand what tuberculosis is. The pathogen of tuberculosis is Mycobacterium tuberculosis, commonly referred to as TB bacillus. Its primary site of infection is the lungs, but now we also classify and manage tracheobronchial and tuberculous pleurisy under pulmonary tuberculosis. However, these sites do not include the nasal part. Generally, patients with pulmonary tuberculosis show symptoms of the respiratory system and systemic symptoms. The most common respiratory symptoms include coughing and phlegm production for more than two weeks. Some patients may also experience hemoptysis, with varying amounts from mild to severe. A few patients may also experience chest pain. Additionally, patients with caseous pneumonia or significant pleural effusion may experience difficulty in breathing. Systemic symptoms of tuberculosis include fever, mainly characterized by afternoon tidal fever, with some patients exhibiting high fevers, and other general symptoms such as loss of appetite, weight loss, night sweats, and fatigue. However, the majority of patients with pulmonary tuberculosis do not exhibit nasal symptoms, meaning a runny nose is generally not a manifestation of tuberculosis. It could be possible that a tuberculosis patient might also have other infections or causative diseases, such as allergic rhinitis.

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Written by Ye Xi Yong
Infectious Diseases
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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.