What symptoms may a patient with tuberculosis (TB) experience?

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Last updated: April 25, 2025View editorial policy

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From the Guidelines

Patients with tuberculosis (TB) may experience a range of symptoms including persistent cough lasting more than two weeks, which may produce blood-streaked sputum, fever, night sweats, unexplained weight loss, fatigue, and chest pain during breathing or coughing. These symptoms typically develop gradually over weeks to months. Other possible symptoms include loss of appetite, chills, and shortness of breath in advanced cases. The severity and combination of symptoms can vary depending on whether the infection is active or latent, and if the TB has spread beyond the lungs (extrapulmonary TB). Extrapulmonary TB can cause symptoms specific to the affected organ, such as back pain with spinal TB or swollen lymph nodes with lymphatic TB. These symptoms occur because the Mycobacterium tuberculosis bacteria trigger an inflammatory response in infected tissues, particularly in the lungs where the bacteria typically establish infection. The bacteria multiply slowly, which explains the gradual onset of symptoms. Individuals with weakened immune systems, such as those with HIV, are at higher risk for more severe or rapidly progressing symptoms. Some key symptoms to consider include:

  • Persistent cough lasting more than two weeks
  • Fever
  • Night sweats
  • Unexplained weight loss
  • Fatigue
  • Chest pain during breathing or coughing
  • Loss of appetite
  • Chills
  • Shortness of breath in advanced cases According to the most recent study 1, cough lasting more than two weeks warrants investigation in resource-limited countries where the prevalence of TB is high. This is because the consequences of TB are greatest in the developing world where the prevalence is greatest and resources to diagnose and treat it are most limited. The study also highlights the importance of improved case detection rather than diagnostic testing in low-income countries. It's also important to note that the clinical presentation of TB varies considerably as a result of the extent of disease and the host response, and variation in clinical symptoms and signs of TB is associated with underlying illnesses, such as HIV infection, chronic renal failure, alcoholism, drug abuse, and diabetes mellitus 1. Therefore, it is essential to consider TB in the differential diagnosis of patients with persistent cough or other compatible symptoms, especially in high-risk populations.

From the Research

Symptoms of Tuberculosis

  • Coughing that lasts for more than 2 weeks
  • Chest pain or discomfort when coughing or breathing
  • Coughing up blood or sputum
  • Fatigue or weakness
  • Weight loss
  • Loss of appetite
  • Night sweats
  • Chills or fever
  • Shortness of breath

Treatment-Related Symptoms

  • Patients with tuberculosis may experience side effects from treatment, such as:
    • Hepatotoxicity (liver damage) from isoniazid or pyrazinamide 2, 3
    • Nausea and vomiting from rifampin or ethambutol 3
    • Rash or itching from any of the first-line medications 3

Disease Progression Symptoms

  • If left untreated, tuberculosis can progress to more severe symptoms, including:
    • Severe coughing or coughing up large amounts of blood
    • Chest pain or discomfort that worsens over time
    • Shortness of breath or difficulty breathing
    • Fatigue or weakness that interferes with daily activities
    • Weight loss or loss of appetite

Note: The provided studies do not directly address the symptoms of tuberculosis, but rather focus on treatment regimens and outcomes. However, the symptoms listed above are commonly associated with tuberculosis and can be inferred from the treatment-related side effects and disease progression discussed in the studies 2, 4, 5, 3, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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