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Latest revision as of 18:55, 3 July 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Tuberculosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Children

HIV Coinfection

Diagnosis

History and Symptoms

Physical Examination

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Electrocardiogram

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Mashal Awais, M.D.[3]; Alejandro Lemor, M.D. [4]

Overview

weakness, weight loss, fever, and night sweats are common general symptoms of tuberculosis. Symptoms of pulmonary tuberculosis include pulmonary tuberculosis cough, hemoptysis, and chest pain. It is difficult to diagnose tuberculosis in children, as these may lack the classic common findings.

History and Symptoms

Physicians should be mindful of the patient’s history of TB exposure, infection, or disease. In addition, it is also important to consider demographic factors (e.g., country of origin, age, ethnic or racial group, occupation) that may increase the individual’s risk for TB exposure or to drug-resistant TB. Also, physicians should figure out other medical conditions that can decrease the immunity, especially HIV infection, which increase the risk of latent TB infection progression to active TB disease.

Pulmonary Tuberculosis

In case of active tuberculosis, 75% of the cases present with lung involvement. Suspect Pulmonary tuberculosis in any individual who has the following symptoms:[1]

  • Cough (most common symptom)
  • Initially dry cough which progresses to productive.
  • Persistent cough, often for more than three weeks.

Extra-Pulmonary Tuberculosis

  • The rest of the active tuberculosis cases (other 25%) of active cases spread from the lungs, causing other forms of TB that are more common in immunosuppressed individuals and young children.
  • disseminated TB is a serious form of TB that is also known as miliary tuberculosis. Extrapulmonary TB is not contagious; however, it may co-exist with pulmonary TB, that is contagious.[2]

All forms of extra-pulmonary tuberculosis may present with the symptoms of pulmonary tuberculosis such as malaise, night sweats, cough, weight loss, and also may be associated with an active pulmonary infection.

Extra-Pulmonary Location History and Symptoms
Tuberculous Lymphadenitis Fever, painless lymph node swelling.
Pott's disease/Skeletal Tuberculosis Low back pain, stiffness, pain in the affected joint or extremity, joint swelling, limited mobility.
Central Nervous System Tuberculosis Headache, seizures, weakness, vomiting.
Tuberculous Peritonitis Abdominal pain, fever, ascites
Tuberculous Pericarditis chest pain,Shortness of breath, cough, pedal edema.
Renal Tuberculosis Symptoms of UTI, include polyuria, dysuria, hematuria, flank pain
Symptoms of obstructive uropathy, such as oliguria or anuria, pelvic pain.
Adapted from Asian Spine J. Feb 2014; 8(1): 97–111[3]; Handbook of Clinical Neurology[4]Circulation Dec 2005 vol.112 no.23 3608-3616[5]; Am J Trop Med Hyg 2013 vol. 88 no. 1 54-64[6]; Clin Infect Dis.(2011)53(6):555-562.[7]

References

  1. Mandell, Gerald (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Churchill Livingstone/Elsevier. ISBN 0443068399.
  2. Centers for Disease Control and Prevention (CDC), Division of Tuberculosis Elimination. Core Curriculum on Tuberculosis: What the Clinician Should Know. 4th edition (2000). Updated Aug 2003.
  3. Moon, Myung-Sang (2014). "Tuberculosis of Spine: Current Views in Diagnosis and Management". Asian Spine Journal. 8 (1): 97. doi:10.4184/asj.2014.8.1.97. ISSN 1976-1902.
  4. Garcia-Monco, Juan Carlos (2014). "Tuberculosis". 121: 1485–1499. doi:10.1016/B978-0-7020-4088-7.00100-0. ISSN 0072-9752.
  5. Mayosi, B. M. (2005). "Tuberculous Pericarditis". Circulation. 112 (23): 3608–3616. doi:10.1161/CIRCULATIONAHA.105.543066. ISSN 0009-7322.
  6. Daher, E. D. F.; da Silva Junior, G. B.; Barros, E. J. G. (2013). "Renal Tuberculosis in the Modern Era". American Journal of Tropical Medicine and Hygiene. 88 (1): 54–64. doi:10.4269/ajtmh.2013.12-0413. ISSN 0002-9637.
  7. Fontanilla, J.-M.; Barnes, A.; von Reyn, C. F. (2011). "Current Diagnosis and Management of Peripheral Tuberculous Lymphadenitis". Clinical Infectious Diseases. 53 (6): 555–562. doi:10.1093/cid/cir454. ISSN 1058-4838.

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