What are the symptoms of active tuberculosis?
Cough lasting more than three weeks is often a first symptom of active tuberculosis (TB). It can start as a dry irritating cough. It tends to continue for months and get worse. In time the cough produces a lot of phlegm (sputum), which may be bloodstained.
Other common symptoms are a high temperature (fever), sweats, feeling unwell, weight loss, pains in the chest, and poor appetite. You may become breathless if the infection progresses and damages the lungs. If left untreated, complications often develop, such as fluid collecting between the lung and the chest wall (pleural effusion). This can make you very breathless. If the TB gets close to a blood vessel in the lung then you may cough up blood.
TB infection sometimes spreads from the lungs to cause infection in other parts of the body. Depending on which part of the body is affected, various symptoms may then occur:
- Lymph glands - you may have a swollen gland or glands anywhere in the body. If the swollen glands are in the neck, armpit or groin then you may see or feel them.
- Gut and tummy (abdomen) - the TB may cause tummy pain or swelling, or poor digestion of food with diarrhoea and weight loss.
- Bones and joints - TB can get into a bone or joint, causing bone pain (for example, in the spine) or pain and swelling in a joint.
- Heart - TB sometimes causes inflammation around the heart, with chest pain or shortness of breath.
- Kidneys and bladder - if these are infected, you may have pain in the side (loin), or pain when passing urine.
- Brain - TB can cause meningitis, with symptoms such as:
- Feeling sick (nausea).
- Being sick (vomiting).
- Fits (convulsions).
- A change in behaviour.
- Skin - TB can cause certain rashes, including erythema nodosum - a red, lumpy rash on the legs - or lupus vulgaris which gives lumps or ulcers.
- Spread to many parts of the body - this is called miliary TB, and can affect many organs, including lungs, bones, liver, eyes and skin.
How infectious is active tuberculosis?
A person with active TB disease in the lungs will cough and sneeze TB germs (bacteria) into the air, which can infect others. To catch TB you normally need close and prolonged contact with a person who has active TB in the lungs. So, the people most likely to be infected will be those in the same house or same family. In the UK, if someone is diagnosed with TB then health workers will arrange TB tests for their close contacts.
Further reading and references
Tuberculosis; NICE Guideline (January 2016)
Tuberculosis (TB); World Health Organization
Tuberculosis; NICE CKS, January 2015 (UK access only)
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