Tuberculosis (TB) symptoms vary depending on whether the disease is active or latent. Symptoms typically affect the lungs and may include a persistent, productive cough, fatigue, and fever.

TB is a bacterial disease that typically affects the lungs. TB symptoms vary depending on what type a person has and where in the body the TB bacteria are growing.

In this article, we will explore the symptoms of TB, including different kinds of TB, its causes, and treatment. We will also examine how to prevent TB transmission and who is most at risk of contracting the disease.

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How TB symptoms present will depend on each individual, their overall health, and where in their body the infection occurs.

According to the United Kingdom’s National Health Service (NHS), a person may not begin to experience symptoms until months or years after the initial infection.

Pulmonary tuberculosis

Usually, TB bacteria grow in the lungs. Doctors call this pulmonary TB. Symptoms of this form of TB may include:

Extrapulmonary tuberculosis

TB infections can sometimes occur outside the lungs. Health professionals call this extrapulmonary TB.

Areas where TB bacteria can grow include the:

General TB symptoms occurring across the body may include:

Latent tuberculosis infection

TB does not necessarily make everyone sick. If their immune system is functioning well, a person can have TB bacteria living in the body without developing any of the symptoms above. Doctors refer to this as a latent TB infection.

A person with a latent TB infection:

  • will not feel sick
  • will not display any symptoms
  • cannot spread TB to others

However, they may develop TB symptoms if they do not receive treatment in some cases. Additionally, people with latent TB have a higher risk of developing symptoms if they come into contact with someone with an active TB infection.

A bacterium called Mycobacterium tuberculosis causes TB.

TB bacteria, which spread through airborne droplets, transmit when someone with an active TB infection in the lungs coughs, speaks, or sneezes and another person inhales the droplets.

According to the NHS, while TB transmits in a similar way to a common cold or flu virus, it is less contagious. Typically, a person would need to spend a lot of time in close contact with someone with an active TB infection for the TB bacteria to transmit to them. For example, they could be living together.

Because of this, the bacteria is highly unlikely to spread to someone sitting or standing near a person with TB, such as on public transport.

Additionally, the bacteria does not usually transmit from children or those with extrapulmonary TB to other individuals.

People living with HIV are most at risk from TB. According to the World Health Organization (WHO), a person living with HIV is between 14 and 18 times more likely to develop TB disease than someone without HIV.

Around the world, TB is the number one cause of death among people with HIV. In 2022, around 167,000 people died of HIV-related TB, according to the WHO. The reason for this outlook is that HIV and TB each speed up the other’s progress.

The best treatment for TB will depend on what type a person has and where the bacteria is in their body.

Active tuberculosis treatment

If someone has an active TB disease, they will most likely receive treatment using a combination of antibiotic medications for 6–12 months.

The most common medication for active TB is isoniazid (INH) alongside:

  • ethambutol
  • rifampin
  • pyrazinamide

A person may start to feel better after just a few weeks on medication. However, TB typically takes much longer to treat than other bacterial infections.

People should continue to take their full course of antibacterial medication as their doctor instructs, even if they start to feel better before they have finished the full course.

If an individual stops taking the medication sooner than their doctor advises, their immune system may have more difficulty fighting the infection. They may then:

  • experience symptoms again
  • risk the transmission of TB to others
  • have difficulty fighting the disease in the future
  • contribute to the development of drug-resistant TB

Latent tuberculosis treatment

If a person has a TB infection but does not have active TB symptoms, they should still seek preventive therapy. This form of treatment eliminates germs that may cause problems should the disease become active.

The most common type of preventive therapy is a dose of INH. A person typically consumes this as a single tablet daily for 6–9 months. A latent TB infection cannot spread to other individuals.

Drug-resistant tuberculosis treatment

Drug-resistant TB occurs when medications that doctors initially prescribe to treat TB are no longer capable of beating the TB bacteria in a person’s body.

When TB develops a resistance to multiple medications, doctors call it multidrug-resistant TB (MDR TB). This form of TB is severe and dangerous. Treatment for MDR TB takes longer than any other type of TB, typically around 20–30 months. A person may experience more side effects from this type of treatment.

The risk of developing drug-resistant TB can depend on multiple factors. For example, a person may be more likely to experience drug-resistant TB if they live in a part of the world where this form of the condition is more common. They may also experience it if they have come into contact with someone else experiencing drug-resistant TB.

To prevent the spread of TB, a person can try the following:

  • They can seek medical attention if symptoms such as persistent cough, fever, or unplanned weight loss occur. Early TB treatment can prevent the spread of the disease and improve the likelihood of recovery.
  • If someone has TB, they should take the entire course of antibiotics to prevent symptoms from returning and TB bacteria becoming drug-resistant.
  • If someone is at higher risk for TB, such as if they are living with HIV or living with a person with TB, they should undergo testing for the condition.
  • If someone has a TB infection, they should practice proper hygiene when coughing or sneezing by avoiding close contact with others, wearing a face covering, and properly disposing of used tissues.

What symptoms of TB a person develops will depend on what type of TB they have and where in the body the infection occurs.

Symptoms of pulmonary TB include chest pain and a productive cough lasting 3 weeks or more. Other TB symptoms include weakness or fatigue, chills, fever, and night sweats.

Treatment for TB involves taking antibiotics. People should always take the full course of antibacterial drugs their doctor prescribes to prevent symptoms from returning and TB bacteria from becoming drug-resistant.