Tuberculosis (TB)

What is Tuberculosis?

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs but can spread to other parts of the body, such as the kidneys, spine, and brain. TB can be latent or active, with active TB being contagious and requiring treatment.

Types of Tuberculosis

1. Latent TB

• No symptoms: The bacteria remain inactive in the body and do not cause illness.
• Not contagious
• Can become active: Without treatment, latent TB can progress to active TB.

2. Active TB

• Shows symptoms and can spread to others.
• Requires immediate treatment to prevent complications and transmission.

Symptoms of Active TB

Common symptoms include:

• Persistent cough: Lasting three weeks or longer, sometimes with blood-tinged sputum.
• Chest pain
• Unintentional weight loss
• Fatigue
• Fever and chills
• Night sweats
• Loss of appetite

Causes and Transmission

• Caused by Mycobacterium tuberculosis
• Airborne transmission: TB spreads when an infected person coughs, sneezes, or talks, releasing respiratory droplets containing the bacteria.
• Close contact with someone who has active TB increases the risk of infection.

Risk Factors

• Weakened immune system: People with HIV/AIDS, diabetes, or those undergoing immunosuppressive therapy are more susceptible.
• Close contact with someone who has active TB.
• Living or working in high-risk environments: Such as prisons, shelters, or healthcare facilities.
• Substance abuse: Drug and alcohol use can weaken the immune system.
• Poor nutrition

Diagnosis

• TB skin test (Mantoux test): A small amount of tuberculin is injected under the skin to see if a reaction occurs.
• TB blood tests: Such as the interferon-gamma release assays (IGRAs).
• Chest X-ray: Helps detect lung damage associated with active TB.
• Sputum tests: Microscopic examination and culture to identify TB bacteria.

Treatment Options

• Antibiotic regimen:
  • First-line drugs: Include isoniazid, rifampin, ethambutol, and pyrazinamide.
  • Duration: Treatment typically lasts 6 to 9 months, depending on the type and severity of TB.
• Directly observed therapy (DOT): Healthcare providers supervise patients taking their medication to ensure adherence.

Drug-Resistant TB

Drug-resistant TB occurs when the bacteria do not respond to the standard treatment due to resistance to certain medications.

1. Multidrug-Resistant TB (MDR-TB)

• Resistant to isoniazid and rifampin, the two most potent TB drugs.
• Requires alternative treatment regimens that are longer and may have more side effects.

2. Extensively Drug-Resistant TB (XDR-TB)

• Resistant to first-line drugs and some second-line drugs.
• More challenging to treat and requires specialized medications.

Prevention Strategies

• Avoid close contact with individuals known to have active TB.
• Use protective measures: Such as wearing masks in high-risk settings.
• Good ventilation: Helps reduce the concentration of TB bacteria in enclosed spaces.
• Early detection and treatment: Reduces the risk of spreading the disease.

Complications of Tuberculosis

• Lung damage: Can lead to permanent scarring and reduced lung function.
• Spread to other organs: Known as extrapulmonary TB, which can affect the kidneys, spine, brain, and other parts of the body.
• Spinal pain: TB in the spine (Pott's disease) can cause severe pain and deformities.
• Meningitis: TB affecting the membranes surrounding the brain, leading to life-threatening complications.
• Joint damage: TB arthritis can affect the hips and knees.

References & Research

Historical Background

Robert Koch identified Mycobacterium tuberculosis as the causative agent of tuberculosis on March 24, 1882, a discovery for which he received the 1905 Nobel Prize in Physiology or Medicine. The introduction of streptomycin in 1944 by Albert Schatz, Elizabeth Bugie, and Selman Waksman marked the beginning of effective antibiotic treatment for TB.

Key Research Papers

Every citation below has been re-checked against the PubMed record. An earlier version of this list attached a DOI to each entry, and those DOIs were shuffled — each one resolved to a real paper, but not the one it was labelled as. The most striking mismatch: the Conradie drug-resistant tuberculosis trial linked to a placebo-controlled trial of bezafibrate in primary biliary cholangitis. Links are now numeric PubMed IDs.

1. Pai M, Behr MA, Dowdy D, et al. Tuberculosis. Nature Reviews Disease Primers. 2016;2:16076. — PMID 27784885
2. Zumla A, Raviglione M, Hafner R, von Reyn CF. Tuberculosis. New England Journal of Medicine. 2013;368(8):745-755. — PMID 23425167
3. Lawn SD, Zumla AI. Tuberculosis. The Lancet. 2011;378(9785):57-72. — PMID 21420161
4. Dorman SE, Nahid P, Kurbatova EV, et al. Four-month rifapentine regimens with or without moxifloxacin for tuberculosis. New England Journal of Medicine. 2021;384(18):1705-1718. — PMID 33951360 The trial behind the four-month regimen now offered as an alternative to six months.
5. Sterling TR, Villarino ME, Borisov AS, et al. Three months of rifapentine and isoniazid for latent tuberculosis infection. New England Journal of Medicine. 2011;365(23):2155-2166. — PMID 22150035 The basis of the 12-dose weekly regimen for latent infection.
6. Diacon AH, Pym A, Grobusch MP, et al. Multidrug-resistant tuberculosis and culture conversion with bedaquiline. New England Journal of Medicine. 2014;371(8):723-732. — PMID 25140958
7. Conradie F, Diacon AH, Ngubane N, et al. Treatment of highly drug-resistant pulmonary tuberculosis. New England Journal of Medicine. 2020;382(10):893-902. — PMID 32130813 The Nix-TB trial of bedaquiline, pretomanid and linezolid.
8. Boehme CC, Nabeta P, Hillemann D, et al. Rapid molecular detection of tuberculosis and rifampin resistance. New England Journal of Medicine. 2010;363(11):1005-1015. — PMID 20825313 The Xpert MTB/RIF validation study.
9. Gandhi NR, Moll A, Sturm AW, et al. Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa. The Lancet. 2006;368(9547):1575-1580. — PMID 17084757
10. Houben RMGJ, Dodd PJ. The global burden of latent tuberculosis infection: a re-estimation using mathematical modelling. PLoS Medicine. 2016;13(10):e1002152. — PMID 27780211 The source of the widely quoted “one quarter of the world” figure.
11. Horsburgh CR Jr, Barry CE 3rd, Lange C. Treatment of tuberculosis. New England Journal of Medicine. 2015;373(22):2149-2160. — PMID 26605929 Added: the paper whose DOI was previously attached to the Pai citation.
12. World Health Organization. WHO consolidated guidelines on tuberculosis. Module 4: treatment — drug-resistant tuberculosis treatment. Geneva: WHO. — WHO guideline An earlier version of this page cited these guidelines as an article in The Lancet Infectious Diseases 2019;19(11):e348-e364. WHO guidelines are published by WHO, not in that journal; the reference has been pointed at the source document.

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Research Papers

The following PubMed topic searches retrieve current peer-reviewed literature on Tuberculosis. Each link opens a live PubMed query so you always see the most recent publications.

1. Tuberculosis review
2. Mycobacterium tuberculosis pathogenesis
3. Multidrug resistant tuberculosis MDR-TB
4. Bedaquiline tuberculosis treatment
5. Isoniazid rifampin tuberculosis
6. Latent tuberculosis infection treatment
7. BCG vaccine tuberculosis efficacy
8. Tuberculosis HIV coinfection
9. GeneXpert tuberculosis diagnosis
10. WHO tuberculosis global report
11. Extrapulmonary tuberculosis
12. Vitamin D tuberculosis

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Connections

• Infectious Disease
• HIV/AIDS
• Immune Boosting
• Vitamin D3
• Zinc
• Garlic
• Andrographis
• Meningitis
• Hepatitis B
• Hepatitis C
• Hepatitis
• Diabetes
• Fatigue
• Chest Pain
• Loss of Appetite
• Cellulitis
• Clostridium Difficile
• Eucalyptus
• Biologics TNF IL23 Integrin Inhibitors
• Herbs covered on this site that discuss this condition: Black Turmeric (Curcuma caesia) · Neem (Azadirachta indica) · Pau d'Arco (Tabebuia impetiginosa / Handroanthus impetiginosus)

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