Does tuberculous pleuritis belong to pulmonary tuberculosis?

Written by An Yong Peng
Pulmonology
Updated on September 25, 2024
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Tuberculous pleurisy is not classified as pulmonary tuberculosis. Tuberculous pleurisy is a common manifestation of extrapulmonary tuberculosis, often referred to as tuberculosis of the pleura, typically presenting with pleural effusion. Symptoms can sometimes include low-grade fevers in the afternoon and night sweats, which are typical of tuberculosis intoxication. However, the clinical presentation of tuberculous pleurisy can sometimes be atypical, with some patients experiencing high fevers, and there are cases of tuberculous pleurisy without any fever. Additionally, tuberculous pleurisy often coexists with pulmonary tuberculosis. Sometimes, patients with tuberculous pleurisy who undergo a chest CT scan may find lesions in the lungs, but there are also cases where tuberculous pleurisy may exist independently, without the presence of pulmonary tuberculosis.

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Symptoms of tuberculosis in children

Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. It can affect various organs throughout the body, but pulmonary tuberculosis is the most common. Initially, symptoms typically include some signs of tuberculosis toxicity, such as prolonged low-grade fever accompanied by coughing. Sometimes the coughing is not severe and may be mild, but in some cases, severe coughing can lead to hemoptysis and other conditions. Night sweats are also common, generally presenting with afternoon low-grade fever and night sweating, along with general fatigue, loss of appetite, difficulty eating, and weight loss.

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What are some common early symptoms of tuberculosis?

Patients with tuberculosis tend to exhibit symptoms such as cough, expectoration, low-grade fever, night sweats, afternoon feverishness, and blood in sputum in the early stages. Systemic symptoms of tuberculosis include afternoon feverishness, which refers to the body temperature starting to rise in the afternoon and returning to normal by early morning. Night sweats refer to sweating profusely during sleep, which stops upon waking. These tuberculosis-related symptoms are commonly seen in the early stages of the disease.

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Tuberculosis is a bacterial infection that primarily affects the lungs but can also affect other parts of the body. It is caused by the bacterium Mycobacterium tuberculosis.

Tuberculosis is mainly due to the infection of the human body by tuberculosis bacteria, which proliferate massively within the body, destroying the tissues and organs, and producing some blood syndromes related to combined toxins. Symptoms such as low-grade fever, night sweats, blood-stained sputum, and afternoon feverishness are common, and weight loss is also a common occurrence. Different forms of tuberculosis have different clinical symptoms. Tuberculosis can be cured if it is identified early and treated promptly and properly with anti-tuberculosis therapy, allowing many to recover completely.

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The difference between sarcoidosis and tuberculosis

Sarcoidosis and tuberculosis, although only differing by one character in Chinese, are completely different diseases. Sarcoidosis and tuberculosis share some similarities, such as their pathological changes often involving granulomas. However, in tuberculosis, the granulomas are typically caseating, while in sarcoidosis, they are non-caseating. Tuberculosis shows characteristic features under pathological examination, whereas the diagnosis of sarcoidosis is one of exclusion, requiring the ruling out of other various granulomatous diseases. Secondly, their causes are also different; tuberculosis has a very clear cause, being an infectious disease caused by the tuberculosis bacterium. Meanwhile, the cause of sarcoidosis has not been identified clearly and may be related to a variety of factors including genetics, environment, and chemicals, among others. Additionally, the clinical manifestations of both sarcoidosis and tuberculosis are not specific, and both diseases can present symptoms like coughing, expectoration, chest pain, hemoptysis, low or high fever, weight loss, and night sweats. Thus, it is quite difficult to differentiate between sarcoidosis and tuberculosis based on symptoms alone. Moreover, their treatments differ; sarcoidosis is mainly treated with corticosteroids, while the primary treatment for tuberculosis involves anti-tuberculosis therapy.

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Does increased lung markings indicate tuberculosis?

Increased pulmonary markings are not an exclusive indicator of tuberculosis. The increase in pulmonary markings could be a sign of acute bronchitis or chronic pulmonary congestion. Additionally, although patients with bronchiectasis often show characteristics in a chest CT, it might only appear as increased pulmonary markings in a chest X-ray. Tuberculosis can present in various forms of lesions, often coexisting in multiple forms. Such forms may include infiltrative lesions, fibrous strip-like lesions, nodular lesions, or even lesions with calcification. For diagnosing tuberculosis, relying solely on chest X-rays or CT scans is sometimes insufficient. Further confirmation often requires additional tests such as sputum acid-fast staining and bronchoscopy.