Tuberculosis

Tuberculosis
Other namesPhthisis, phthisis pulmonalis, consumption
Tuberculosis-x-ray-1.jpg
Chest X-ray of a person with advanced tuberculosis: Infection in both lungs is marked by white arrow-heads, and the formation of a cavity is marked by black arrows.
SpecialtyInfectious disease, pulmonology
SymptomsChronic cough, fever, cough with bloody mucus, weight loss[1]
CausesMycobacterium tuberculosis[1]
Risk factorsSmoking, HIV/AIDS[1]
Diagnostic methodCXR, culture, tuberculin skin test[1]
Differential diagnosisNecrotizing pneumonia, histoplasmosis, sarcoidosis, coccidioidomycosis[2]
PreventionScreening those at high risk, treatment of those infected, vaccination with bacillus Calmette-Guérin (BCG)[3][4][5]
TreatmentAntibiotics[1]
Frequency25% of people (latent TB)[6]
Deaths1.6 million (2017)[7]

Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria.[1] Tuberculosis generally affects the lungs, but can also affect other parts of the body.[1] Most infections do not have symptoms, in which case it is known as latent tuberculosis.[1] About 10% of latent infections progress to active disease which, if left untreated, kills about half of those affected.[1] The classic symptoms of active TB are a chronic cough with blood-containing mucus, fever, night sweats, and weight loss.[1] It was historically called "consumption" due to the weight loss.[8] Infection of other organs can cause a wide range of symptoms.[9]

Tuberculosis is spread through the air when people who have active TB in their lungs cough, spit, speak, or sneeze.[1][10] People with latent TB do not spread the disease.[1] Active infection occurs more often in people with HIV/AIDS and in those who smoke.[1] Diagnosis of active TB is based on chest X-rays, as well as microscopic examination and culture of body fluids.[11] Diagnosis of latent TB relies on the tuberculin skin test (TST) or blood tests.[11]

Prevention of TB involves screening those at high risk, early detection and treatment of cases, and vaccination with the bacillus Calmette-Guérin (BCG) vaccine.[3][4][5] Those at high risk include household, workplace, and social contacts of people with active TB.[4] Treatment requires the use of multiple antibiotics over a long period of time.[1] Antibiotic resistance is a growing problem with increasing rates of multiple drug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB).[1]

Presently,[when?] one-quarter of the world's population is thought to be infected with TB.[6] New infections occur in about 1% of the population each year.[12] In 2017, there were more than 10 million cases of active TB which resulted in 1.6 million deaths.[7] This makes it the number one cause of death from an infectious disease.[7] More than 95% of deaths occurred in developing countries, and more than 50% in India, China, Indonesia, Pakistan, and the Philippines.[7] The number of new cases each year has decreased since 2000.[1] About 80% of people in many Asian and African countries test positive while 5–10% of people in the United States population test positive by the tuberculin test.[13] Tuberculosis has been present in humans since ancient times.[14]

Video summary (script)

Signs and symptoms

The main symptoms of variants and stages of tuberculosis are given,[15] with many symptoms overlapping with other variants, while others are more (but not entirely) specific for certain variants. Multiple variants may be present simultaneously.

Tuberculosis may infect any part of the body, but most commonly occurs in the lungs (known as pulmonary tuberculosis).[9] Extrapulmonary TB occurs when tuberculosis develops outside of the lungs, although extrapulmonary TB may coexist with pulmonary TB.[9]

General signs and symptoms include fever, chills, night sweats, loss of appetite, weight loss, and fatigue.[9] Significant nail clubbing may also occur.[16]

Pulmonary

If a tuberculosis infection does become active, it most commonly involves the lungs (in about 90% of cases).[14][17] Symptoms may include chest pain and a prolonged cough producing sputum. About 25% of people may not have any symptoms (i.e. they remain "asymptomatic").[14] Occasionally, people may cough up blood in small amounts, and in very rare cases, the infection may erode into the pulmonary artery or a Rasmussen's aneurysm, resulting in massive bleeding.[9][18] Tuberculosis may become a chronic illness and cause extensive scarring in the upper lobes of the lungs. The upper lung lobes are more frequently affected by tuberculosis than the lower ones.[9] The reason for this difference is not clear.[13] It may be due to either better air flow,[13] or poor lymph drainage within the upper lungs.[9]

Extrapulmonary

In 15–20% of active cases, the infection spreads outside the lungs, causing other kinds of TB.[19] These are collectively denoted as "extrapulmonary tuberculosis".[20] Extrapulmonary TB occurs more commonly in people with a weakened immune system and young children. In those with HIV, this occurs in more than 50% of cases.[20] Notable extrapulmonary infection sites include the pleura (in tuberculous pleurisy), the central nervous system (in tuberculous meningitis), the lymphatic system (in scrofula of the neck), the genitourinary system (in urogenital tuberculosis), and the bones and joints (in Pott disease of the spine), among others. A potentially more serious, widespread form of TB is called "disseminated tuberculosis", also known as miliary tuberculosis.[9] Miliary TB currently makes up about 10% of extrapulmonary cases.[21]

Other Languages
Afrikaans: Tuberkulose
Alemannisch: Tuberkulose
العربية: سل
aragonés: Tuberculosi
অসমীয়া: যক্ষ্মা
asturianu: Tuberculosis
Avañe'ẽ: Mba'asy po'i
Aymar aru: Tisiku
azərbaycanca: Vərəm
bamanankan: Sɔgɔsɔgɔnicɛ
বাংলা: যক্ষ্মা
Bahasa Banjar: Téréng
Bân-lâm-gú: Hì-lô-pēⁿ
башҡортса: Туберкулёз
беларуская: Туберкулёз
беларуская (тарашкевіца)‎: Сухоты
български: Туберкулоза
bosanski: Tuberkuloza
brezhoneg: Torzhellegezh
català: Tuberculosi
Чӑвашла: Туберкулёз
čeština: Tuberkulóza
Cymraeg: Diciâu
Deutsch: Tuberkulose
Diné bizaad: Jéíʼádįįh
डोटेली: क्षयरोग
Ελληνικά: Φυματίωση
español: Tuberculosis
Esperanto: Tuberkulozo
euskara: Tuberkulosi
فارسی: سل
føroyskt: Tuberklar
français: Tuberculose
Gaeilge: Eitinn
Gàidhlig: A' Chaitheamh
galego: Tuberculose
ગુજરાતી: ક્ષય રોગ
客家語/Hak-kâ-ngî: Pot-thâm-fó
한국어: 결핵
Hausa: Tibi
հայերեն: Տուբերկուլոզ
हिन्दी: यक्ष्मा
hrvatski: Sušica
Ilokano: Daig
Bahasa Indonesia: Tuberkulosis
interlingua: Tuberculosis
isiXhosa: Isifo sephepha
íslenska: Berklar
italiano: Tubercolosi
עברית: שחפת
ಕನ್ನಡ: ಕ್ಷಯ
ქართული: ტუბერკულოზი
қазақша: Туберкулез
Kiswahili: Kifua kikuu
Kreyòl ayisyen: Tibèkiloz
kurdî: Tuberkuloz
Кыргызча: Кургак учук
Latina: Phthisis
latviešu: Tuberkuloze
Lëtzebuergesch: Tuberkulos
лезги: Верем
lietuvių: Tuberkuliozė
Limburgs: Taering
lingála: Tibélekilosi
Lingua Franca Nova: Tuberculose
magyar: Gümőkór
македонски: Туберкулоза
മലയാളം: ക്ഷയം
मराठी: क्षय रोग
مصرى: سل
Bahasa Melayu: Batuk kering
монгол: Сүрьеэ
မြန်မာဘာသာ: တီဘီရောဂါ
Nederlands: Tuberculose
नेपाली: क्षयरोग
नेपाल भाषा: गंल्वय्
日本語: 結核
norsk nynorsk: Tuberkulose
occitan: Tuberculòsi
ଓଡ଼ିଆ: ଯକ୍ଷ୍ମା
oʻzbekcha/ўзбекча: Sil
ਪੰਜਾਬੀ: ਟੀਬੀ
پنجابی: ٹی بی
پښتو: نری رنځ
português: Tuberculose
română: Tuberculoză
Runa Simi: Qhaqya unquy
русиньскый: Туберкулоза
русский: Туберкулёз
саха тыла: Сэллик
ᱥᱟᱱᱛᱟᱲᱤ: ᱥᱟᱦᱟᱸᱥ
संस्कृतम्: क्षयरोगः
sicilianu: Tubbirculosi
Simple English: Tuberculosis
slovenčina: Tuberkulóza
slovenščina: Tuberkuloza
ślůnski: Tubera
српски / srpski: Туберкулоза
srpskohrvatski / српскохрватски: Tuberkuloza
Basa Sunda: Tuberkulosis
svenska: Tuberkulos
Tagalog: Tuberkulosis
தமிழ்: காச நோய்
татарча/tatarça: Туберкулёз
తెలుగు: క్షయ
тоҷикӣ: Бемории сил
Türkçe: Verem
Türkmençe: Inçekesel
українська: Туберкульоз
اردو: سل
Tiếng Việt: Lao
Võro: Tiisikus
Winaray: Tuberculosis
吴语: 结核病
ייִדיש: טובערקולאז
粵語: 肺癆
žemaitėška: Džiuova
中文: 结核病