Tuberculosis (TB)

Table of Contents

What is Tuberculosis? 

Tuberculosis or TB is an infectious disease caused by the bacteria Mycobacterium tuberculosis. The spread of bacterial infection can be through inhalation of saliva droplets when a person with TB coughs or sneezes.

In general, tuberculosis attacks the lungs. However, this does not rule out the possibility that TB can affect other body parts such as the spine, stomach glands, and the nervous system. TB affecting the lungs is the most contagious type.

TB is a serious disease, but it can be treated with the right antibiotics. A patient diagnosed with TB will usually have to consume antibiotics for six to nine months.

Causes of Tuberculosis (TB)

TB is caused by a bacteria called Mycobacterium tuberculosis.

Transmission of TB is almost similar to the flu or cough, but it requires close contact and long interaction. For example, people who live under the same roof with TB sufferers have a high risk of contracting TB disease.

However, it is difficult for someone to get TB if they are sitting next to each other on the bus or train.

Latent TB and Active TB

When a healthy person is infected with TB, the immune system will kill the bacteria and stop the spread throughout the body. This condition is known as latent tuberculosis.

A person who has latent TB cannot pass it to other people. Children and people with tuberculosis outside the lungs also do not transmit the infection.

A weakened immune system causes the bacteria to become active and spread throughout the body – followed by symptoms that develop within weeks and months. This usually occurs in people with AIDS.

High Risk Factors for Tuberculosis (TB)

Tuberculosis can affect anyone, but there are several groups at high risk of for TB infection, namely:

  • People who live in areas with large cases of TB ​
  • People who have direct and frequent contact with TB-infected people
  • People who live in slums and densely populated areas
  • People who have a weak immune system. For example, people with HIV,
  • People who undergo chemotherapy treatments, which may weaken the immune system.
  • Children and the elderly.
  • People who have unhealthy lifestyles — such as active smokers, drug users, heavy drinkers
  • Homeless people.

When to See a Doctor for Tuberculosis (TB)?

Prior to the test, the doctor will ask about the patient’s complaints and medical history. Test types performed to diagnose TB will depend on the type of TB experienced by the patient. A general practitioner will usually refer the patient to an internal medicine specialist or a pulmonologist (respiratory medicine specialist) for further tests and treatment.

Pulmonary TB

To diagnose pulmonary TB, several tests will be conducted. First, the doctor will recommend a chest x-ray to locate parts of the lungs that indicate TB infection. A sputum sample will be taken and analysed to show the presence or absence of bacteria that cause TB infection.

Extrapulmonary TB

Extra-pulmonary TB disease attacks organs outside the lungs – such as tuberculosis in the glands, spine, and intestines. Several tests can be done to diagnose this disease, including:

  • CT scan or MRI scan of organs suspected of having TB infection,
  • Endoscopic test
  • Urine tests and blood tests,
  • Biopsy.

You may also be advised to undergo a lumbar puncture – a medical procedure performed to collect a small sample of fluid in the spinal area. This fluid is known as cerebrospinal fluid (CSF) that serves to maintain pressure in the brain. The sample will then be examined to see if tuberculosis has infected the brain and spinal cord.

Tests for TB Laten Patients 

A TB test is required when you have had close and direct contact with a patient with pulmonary TB. In addition, you also have to get a TB test if you recently got back from an area with a high TB rate.

Mantoux Test

The Mantoux test is used to diagnose latent TB. This test is performed by injecting the patient’s arm with a small amount of substance called PPD Tuberculin, or also known as the tuberculin test (TST).

After the injection, a small bump will appear on the skin. If the patient is infected with latent TB, the bump will increase in size and develop around the injected area. The doctor will monitor the size of the bump within 48 to 72 hours after the test. If the bump remains the same, then the test result is negative.


Interferon Gamma Release Assay (IGRA) is a blood test performed to help diagnose latent TB. IGRA test can be done, if:

  • Your Mantoux test result comes back positive  
  • You have recently undergone the BCG vaccine. This makes the Mantoux test results unreliable,
  • You recently visited an area with high TB ​​rates,
  • You are currently undergoing immune system treatment,
  • You are a health worker who treats people with active tuberculosis.

Symptoms of Tuberculosis

Common symptoms experienced by TB patients include:

  • Loss of appetite followed by weight loss,
  • High fever,
  • Sweating at night,
  • Extreme fatigue,

These symptoms can occur for several reasons. They do not always indicate tuberculosis.

In some cases, TB infection does not cause any symptoms — this condition is called latent tuberculosis. TB bacteria can hide themselves until they turn into active TB and then be passed on to other people.

Pulmonary TB

Pulmonary tuberculosis is considered as the most contagious disease with the following symptoms:

  • Persistent cough that lasts more than three weeks. Usually, you experience coughing up blood and phlegm 
  • Shortness of breath gets worse day by day.

Extrapulmonary TB

TB infection that develops outside the lungs can attack other organs such as the bones, joints, brain, and glands. Symptoms can include:

  • Continuing swelling in the glands (in cases of glandular tuberculosis) 
  • Abdominal pain in cases of tuberculosis of the digestive system,
  • Pain in the joint area in cases of joint tuberculosis,
  • Persistent headache with seizures in cases of brain tuberculosis.

Seek immediate care from your doctor to get a more appropriate examination and treatment.

Treatment for Tuberculosis

Tuberculosis is a treatable disease and is rarely fatal. The main treatment for tuberculosis is to consume antibiotics for several months – at least six months. If you stop consuming the antibiotics early, then the TB disease may potentially become resistant to the antibiotics. During treatment, patients are also expected to always prevent transmission by wearing a mask or using tissues when sneezing or coughing.

TB patients will be given antibiotics that are a combination of isoniazid, rifampicin, pyrazinamide, and ethambutol. The side effects of isoniazid might include neurological dysfunction. To reduce the side effects, patients will be given vitamin B6.

It is crucial to ensure that your house has good air circulation – thus, bringing fresh air and natural light into the house. During treatment, you must regularly undergo a sputum test to monitor the progress of treatment until you completely recover.

Treatment Cost for Tuberculosis

The treatment cost for TB patients depends on the results of the diagnosis provided by the doctor. Smarter Health can help you find the right specialist doctor with the best comparison of estimated medical costs.

Prevention of Tuberculosis

TB disease can be prevented with BCG vaccine (Bacillus Calmette-Guerin). You are at a higher risk of having TB disease if you live in an area with a high TB ​​rate. To reduce this risk, you can undertake these simple precautions: 

  • Wear a mask when in a crowded place,
  • Always wash your hands after making direct contact with TB patients.

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