What is pulmonary tuberculosis?
The bacterium Mycobacterium tuberculosis causes TB, a
contagious, airborne infection that destroys body tissue. Pulmonary
tuberculosis (TB) is when M. tuberculosis
primarily attacks the lungs. However, it can spread from there to other organs.
Pulmonary TB is curable with an early diagnosis and antibiotic treatment.
Pulmonary TB, also known as consumption, spread widely as an
epidemic during the 18th and 19th centuries in North America and Europe. After
streptomycin, an antibiotic, was discovered in 1944, people were able to treat
and control the spread of TB. Since then, TB has been in decline. It’s at its
lowest recorded rate since 1953.
That said, it’s still important to protect yourself against
TB. Over 9.2 million people have an active form of the bacteria, according to
Lung Association (ALS). If left untreated, the disease can cause
life-threatening complications like permanent lung damage.
What does TB in the lungs look like?
What is latent TB?
Being exposed to M.
tuberculosis doesn’t necessarily mean you’ll get sick. Among the 2.2 billion
people who carry the germ, most have latent TB. This means your immune system
protects you from getting sick. People with latent pulmonary TB aren’t
contagious and have no symptoms, but they must still be tested.
It is possible for latent TB to develop into
active TB. People with the germ have a 10 percent lifetime risk of getting sick
with TB. When you start showing symptoms, you may become contagious and have
What are the symptoms of pulmonary TB?
If you or someone you know has pulmonary TB, they will
- cough almost continuously
- cough up blood
- have a consistent fever, including low-grade
- have night sweats
- have chest pains
- have unexplained weight loss
There may also be other symptoms of pulmonary TB, such as
fatigue. Your doctor will be able to give an accurate diagnosis after reviewing
all your symptoms.
How pulmonary TB spreads
You can’t get pulmonary TB by:
- shaking hands
- sharing food or drink
- sleeping in the same bed
TB is airborne, which means you can get pulmonary TB after
breathing air exhaled by someone with tuberculosis. This can be air from:
The germs can stay in the air for several hours. It’s
possible to inhale them even when the infected person isn’t in the room. But
usually you have to be close to someone with TB for a long period of time to
Risk factors for pulmonary TB
The risk for getting pulmonary TB is highest for people who
are in close contact with those who have TB. This includes being around family
or friends with TB or working in places like medical facilities or institutions
that house people with TB.
These places are often:
- correctional facilities
- group homes
- nursing homes
People also at risk for developing pulmonary TB disease are:
- older adults
- small children
- people with an autoimmune disorder, such as Lupus or rheumatoid
- people with lifelong conditions, such as
diabetes or kidney disease
- people who use drug injections
- people who are immunocompromised, such as those
taking chemotherapy, chronic steroids, or who have HIV or AIDS
How is pulmonary TB diagnosed?
During your examination, your doctor will:
- conduct a physical exam to check for fluid in
- ask about your medical history
- schedule a chest X-ray
- order a medical test to confirm pulmonary TB
The two medical tests for pulmonary TB are a skin test and a
blood test. These tests won’t tell you if you’ve developed TB, only if you have
The skin test is the most common and it’s less expensive,
but it requires two visits to your doctor. Your doctor will ask for a blood
test if you’re unable to return for a second visit.
For the skin test, your doctor or nurse will inject a very
small amount of the protein from TB under your skin. It’s important not to
scratch the area, even if it itches. Scratching could make the test results
harder to read.
Your doctor will ask you to come back in two or three days
to see if the injection spot is swollen. Redness at the location of the
injection is normal and is not a sign of a TB infection.
A hard, swollen lump of five or more millimeters may mean
you have TB. Five millimeters is about the size of a pea.
Your doctor will take a sample of your blood, and then
expose your blood to TB in a laboratory. This test measures how your immune
system responds to bacteria that causes the disease. Blood test results are
usually available within 24 hours.
These exams can also look for pulmonary TB, which can be
hard to diagnose in children, people who have HIV, and people who have multidrug-resistant
Treatment for pulmonary TB
It’s important to get treatment even if you have no
symptoms. You can still develop pulmonary TB disease in the future. You may
only need one TB drug if you have latent TB.
If you have pulmonary TB disease, your doctor may prescribe
several medicines. You’ll need to take these drugs for six months or longer for
the best results.
The most common TB medicines are:
Your doctor might recommend an approach called directly
observed therapy (DOT) to ensure that you complete your treatment. Stopping
treatment or skipping doses can make pulmonary TB resistant to medicines,
leading to multidrug-resistant (MDR-TB).
With DOT, a healthcare professional meets with you every day
or several times a week to administer your medication so that you don’t have to
remember to take it on your own.
If you aren’t on DOT, make a schedule for taking your
medicines so that you don’t miss a dose. Here are some tips to help you
remember to take your medicines:
- Take medicines at the same time every day.
- Make a note on your calendar each day to show that
you’ve taken your medicine.
- Ask someone to remind you to take your medicine
- Keep your medicines in a pill organizer.
You won’t need to go to the hospital unless you’re unable to
take the medication at home or have a bad reaction to the treatment.
Pricing of TB medications
What is multidrug-resistant TB?
The primary cause for MDR-TB is inappropriate treatment or
incorrect use of anti-TB drugs, but sometimes the TB strain someone has can
already be resistant to an anti-TB drug.
People who develop MDR-TB also have fewer options for
treatment. The second-line treatments can be expensive and take as long as 2
years. It’s also possible for MDR-TB to develop even further into extensively
drug-resistant TB (XDR-TB). This is why it’s important to finish your
medications, even if you feel better before you finish your dosage.
Outlook for pulmonary TB
Pulmonary TB is curable with treatment, but if left
untreated or not fully treated, the disease often causes life-threatening
concerns. Untreated pulmonary TB disease can lead to long-term damage to the:
New drugs and treatments are
currently being developed to prevent latent TB and TB, especially as MDR-TB
grows. In some countries, they use a vaccine called Bacillus Calmette-Guérin
(BCG). This vaccine is useful for severe forms of TB in children, but not
reliable enough for adults.
How to prevent pulmonary TB
It can be difficult to avoid catching TB if you work in an
environment frequented by people with TB or if you’re caring for a friend or
family member with TB.
To minimize your risk for pulmonary TB, you can:
- Provide education on preventing TB like cleaning
equipment and cough etiquette.
- Avoid extended close contact with someone who
- Air out rooms regularly.
- Cover your face with a mask that is approved for
protection against TB.
Anyone exposed to tuberculosis should be tested, even if
they show no symptoms. The Centers for Disease Control
and Prevention has detailed guidelines
and precautions for people who work or visit a healthcare setting.
How to protect others
People with latent pulmonary TB aren’t contagious and can go
about their day-to-day lives as usual.
But if you have pulmonary TB disease, you need to stay home
and avoid close contact with others. Your doctor will tell you when you’re no
longer contagious and can resume a regular routine.