Overview of Tuberculosis

- Lymph nodes

- Spine ( Pott's disease)

- Brain (meningitis)

- Kidneys

- Pleura (lining around the lungs)

- Bones and joints

- Pericardium (lining around the heart)

- Genitourinary tract (urinary organs and reproductive organs)

The symptoms of extrapulmonary TB can vary depending on the affected organ. For example, TB of the spine can cause back pain, while TB of the brain can cause meningitis symptoms like headaches, fever and confusion. Extrapulmonary TB is not as contagious as pulmonary TB but can still be transmitted through respiratory droplets in some cases.

Extrapulmonary TB can be challenging to diagnose and treat due to its diverse clinical presentations and the need for specialized diagnostic tests and treatment approaches. Prompt diagnosis and treatment of both pulmonary and extrapulmonary TB are essential to prevent the spread of the disease, minimize complications and improve treatment outcomes.

Types of Tuberculosis:

There are two main categories of TB infection, depending on whether the bacteria are actively multiplying and causing symptoms:

- Latent TB Infection (LTBI): In this case, a person is infected with the TB bacteria but their immune system is able to contain the bacteria, preventing them from developing active disease. People with Latent TB Infection don't have any symptoms and aren't contagious.

- Active TB Disease: This is the form of TB that causes symptoms and is contagious. The bacteria are actively multiplying and causing damage to the lungs or other organs.

What causes Tuberculosis?

The bacterium Mycobacterium tuberculosis is the cause of tuberculosis.

This bacteria is tough and can stay alive in the air for a long time. Here’s a step by step breakdown of how Tuberculosis is transmitted:

- Transmission: When someone with active TB coughs, sneezes, talks, sings, or even laughs, they expel the bacteria into the air in tiny droplets.

- Inhalation: If you breathe in these infected droplets, the bacteria can enter your lungs.

- Infection: In most cases, your body's immune system is able to contain the bacteria, creating a state called latent TB infection (LTBI). People with LTBI don't have symptoms and aren't contagious.

- Active TB: However, in some individuals, particularly those with weakened immune systems, the bacteria can overcome the body's defenses and multiply, causing active TB disease. This is the form of TB that produces symptoms and is contagious.

Several factors can increase the risk of TB transmission and infection, including:

• Close Contact: Spending time with someone who has active TB disease increases the risk of transmission, especially in crowded or poorly ventilated settings.
• Weakened Immune System: Individuals with weakened immune systems, such as those living with HIV/AIDS, malnutrition, or certain medical conditions like diabetes are more susceptible to TB infection and are at higher risk of developing active TB disease.
• Certain Health Conditions: Individuals with chronic kidney disease (CKD), certain types of cancer are at a heightened risk of developing Tuberculosis.
• Drug Resistance: The emergence of drug-resistant strains of M. tuberculosis, including multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), poses a significant challenge for TB control and treatment.
• Exposure to TB in Healthcare Settings: Healthcare workers and individuals in healthcare settings may be at increased risk of TB infection due to exposure to TB patients and inadequate infection control measures.
• Living Conditions: Overcrowding, poor ventilation, and inadequate access to healthcare contribute to the spread of TB, particularly in resource-limited settings and marginalized populations.
• Travel to High TB Burden Areas: Traveling to regions with high rates of TB increases the risk of exposure to TB bacteria.
reasons of Tuberculosis

What are the signs and symptoms of Tuberculosis?

The signs and symptoms of tuberculosis (TB) can vary depending on whether the infection is latent (asymptomatic) or active.

Symptoms of tuberculosis (Active TB) may include:

- Cough: A persistent cough that lasts for more than three weeks is one of the most common symptoms of active TB. The cough may produce sputum or phlegm, which can be bloody in some cases.

- Fever: Low-grade fever, typically occurring in the afternoon or evening, is a common sign of Tuberculosis. Chills may accompany a fever in many cases.

- Night Sweats: Profuse sweating, particularly at night, is another characteristic symptom of TB.

- Chest Pain: Pain or discomfort in the chest may occur, especially when coughing or breathing deeply.

- Fatigue and weakness

- Unexplained weight loss and loss of appetite

- Shortness of Breath: Difficulty breathing or shortness of breath may develop as the infection progresses.

- Coughing Up Blood: Hemoptysis, or coughing up blood-tinged sputum, may occur in cases where TB has caused lung damage.

If you experience any one or more of these aforementioned symptoms, particularly a persistent cough, it's crucial to see a doctor to get checked for TB. Early diagnosis and treatment are essential to prevent complications and the spread of the disease.

What kinds of tests are used to diagnose Tuberculosis?

The diagnosis of Tuberculosis may involve a physical examination, a review of your medical history and recent travel to high TB burden regions along with one or more diagnostic tests:

• Tuberculin Skin Test (TST) or Mantoux Test: This Tuberculosis test involves injecting a small amount of tuberculin (a purified protein derivative derived from the bacterium Mycobacterium tuberculosis) into the skin, usually on the forearm. The injection site is then checked after 48 to 72 hours for a raised, red bump (induration). A positive reaction indicates exposure to TB but does not differentiate between latent TB infection and active TB disease.


• Interferon-Gamma Release Assays (IGRAs): These blood tests measure the immune response to TB by detecting the release of interferon-gamma by T cells in response to TB antigens. IGRAs, such as the QuantiFERON-TB Gold and T-SPOT.TB tests, are more specific for TB infection than the tuberculin skin test and are not affected by prior Bacillus Calmette-Guérin (BCG) vaccination. These tests also can’t provide insights on whether the TB is latent or active. Additional tests, such as chest X-rays and sputum cultures (analysis of mucus coughed up from the lungs), are often needed to diagnose active TB.


• Chest X-ray: Chest X-rays are commonly used to detect abnormalities in the lungs caused by TB infection. Chest X-rays can reveal characteristic changes such as lung infiltrates, cavities, or lymph node enlargement, which may indicate active TB disease.


• Sputum Smear Microscopy: This test involves examining sputum samples under a microscope to detect the presence of acid-fast bacilli (AFB), which are characteristic of Mycobacterium tuberculosis. Sputum smear microscopy is a rapid and inexpensive test to diagnose Tuberculosis but has lower sensitivity compared to other tests, particularly in cases of extrapulmonary TB.


• Sputum Culture: Sputum samples are cultured in specialized media to grow and identify Mycobacterium tuberculosis bacteria. Culture is the gold standard for diagnosing TB as it provides definitive confirmation of TB infection and allows for drug susceptibility testing to guide treatment.


• MGIT: Mycobacteria Growth Indicator Tube, often shortened to MGIT, is a liquid culture system used for the detection and isolation of mycobacteria, including Mycobacterium tuberculosis (the causative agent of tuberculosis), from clinical specimens. Compared to traditional solid culture, MGIT offers faster detection of mycobacterial growth. Mycobacteria typically grow more rapidly in liquid culture than in solid media, leading to a shorter time to detection.


• Nucleic Acid Amplification Tests (NAATs): NAATs, such as polymerase chain reaction (PCR) tests, detect the genetic material of M. tuberculosis in sputum samples. NAATs are rapid and highly sensitive diagnostic tests, particularly useful in cases where sputum smear microscopy is negative or for diagnosing extrapulmonary TB. In addition to TB diagnosis, NAAT provides simultaneous detection of rifampicin resistance, which is crucial for guiding appropriate treatment regimens, especially in cases of drug-resistant TB.


• Biopsy and Histopathological Examinations: In cases of suspected extrapulmonary TB, such as TB lymphadenitis or TB meningitis, a biopsy of the affected tissue or organ may be performed. Histopathological examination of the biopsy specimen can reveal characteristic granulomas and acid-fast bacilli, providing a definitive diagnosis of TB.

The choice of diagnostic test depends on various factors, including the clinical presentation, site of infection, availability of resources, and local epidemiology of TB. A combination of tests may be used to diagnose TB accurately, particularly in cases of extrapulmonary TB or in individuals with HIV infection or other immunocompromising conditions.

How is Tuberculosis treated?

Treatment of Tuberculosis is a multi-pronged approach, with the main goal being to eliminate the bacteria and prevent them from becoming resistant to antibiotics. The specific treatment regimen depends on factors such as the type of TB (drug-sensitive or drug-resistant), the site of infection, and the individual's overall health status.

Treatment of Active Tuberculosis or Drug Resistant TB:

Combination therapy: The cornerstone of TB treatment is a combination of antibiotics taken for an extended period or several months. This is crucial to prevent the bacteria from developing resistance to a single drug.

Standard regimen:

The standard treatment for drug-sensitive TB involves a combination of four antimicrobial drugs:

- Isoniazid (INH): Isoniazid is a first-line medication used to treat TB. It works by inhibiting the growth of Mycobacterium tuberculosis bacteria.

- Rifampin (RIF): Rifampin is another first-line medication commonly used in TB treatment. It works by disrupting the production of bacterial RNA, preventing bacterial replication.

- Pyrazinamide (PZA): Pyrazinamide is used in the initial phase of TB treatment to rapidly kill actively dividing bacteria. It penetrates TB lesions well and is particularly effective against intracellular TB bacteria.

- Ethambutol (EMB): Ethambutol is another first-line medication that is typically used in combination with INH, RIF, and PZA. It works by inhibiting bacterial cell wall synthesis, preventing the growth of Mycobacterium tuberculosis.

The standard treatment regimen for drug-sensitive TB typically consists of an initial intensive phase lasting two months, followed by a continuation phase lasting four to six months. During the intensive phase, all four medications are usually administered daily, whereas during the continuation phase, INH and RIF are typically continued while PZA and EMB may be discontinued.

Although uncommon, In some cases, doctors may recommend Directly observed therapy or DOT. Here, your doctor or a healthcare worker witnesses the patient taking their medication to ensure adherence, particularly during the initial phase of treatment.

In cases of drug-resistant TB, treatment regimens may involve a combination of second-line medications, which are less effective and often associated with more adverse effects compared to first-line drugs. Treatment for drug-resistant TB may require a longer duration of therapy (up to 18 to 24 months) and may involve multiple medications, including injectable drugs such as kanamycin, capreomycin, or amikacin.

It's essential for individuals undergoing TB treatment to adhere to their prescribed medication regimen and attend regular follow-up appointments with X rays and Sputum cultures to monitor treatment response and identify any potential adverse effects. Failure to complete treatment or non-adherence to medication regimens can lead to treatment failure, the development of drug- resistant TB and ongoing transmission of TB within communities.

In addition to antimicrobial treatment, supportive care measures such as nutritional support, management of adverse effects and addressing comorbid conditions are also important components of TB management. Collaboration between doctors and public health authorities is crucial for ensuring successful TB treatment and controlling the spread of TB within communities.

Treatment for Latent TB:

If you have latent TB (infected but not showing symptoms), a shorter course of preventive antibiotics (usually isoniazid alone or with rifapentine) might be recommended to prevent future development of active TB.

What can you do to prevent spreading Tuberculosis?

As mentioned earlier, Tuberculosis (TB) spreads through the air when an infected person coughs, laughs, sneezes, sings or even talks. Now you must be wondering how can we prevent tuberculosis if this is the case. The good news is that there are steps you can take to prevent the spread of TB:

• Individuals with symptoms of TB, such as cough lasting more than three weeks, fever, weight loss, night sweats and chest pain, should seek medical evaluation and diagnostic testing. Early diagnosis allows for prompt initiation of treatment, reducing the risk of transmission to others.


• Individuals diagnosed with active TB disease should be isolated and placed on respiratory precautions to prevent the spread of TB bacteria to others. This may involve staying at home or in a hospital until they are no longer infectious, usually after a period of treatment with anti-TB medications.


• Individuals with TB symptoms should cover their mouth and nose with a tissue or cloth when coughing or sneezing to reduce the spread of infectious droplets.


• Infected individuals should limit contact with others, especially during the initial stages of treatment when you're most contagious. Avoid close contact with people, particularly those at high risk such as elderly people, infants and immunocompromised individuals


• Ensuring adequate ventilation in indoor spaces, including homes, healthcare facilities, and workplaces, can help reduce the concentration of TB bacteria in the air, decreasing the risk of transmission.


• Healthcare workers and others caring for individuals with TB should wear appropriate respiratory protection, such as N95 masks or N95 respirators to prevent inhalation of infectious aerosols.


• Individuals diagnosed with TB should adhere to their prescribed treatment regimen, taking anti-TB medications as directed by their doctor. Completing the full course of treatment is essential to cure TB and the single most important step to prevent further transmission of TB within communities and the development of drug-resistant strains of TB.


• Contact Tracing or Identifying and screening individuals who have been in close contact with TB patients allows for early detection of TB infection and prompt initiation of treatment if necessary. Contact tracing helps prevent further transmission of TB within communities.


• Bacillus Calmette-Guérin vaccination or BCG vaccine can provide partial protection against severe forms of TB, such as TB meningitis and disseminated TB in children. While BCG vaccination is not routinely recommended, it may be beneficial in high- burden settings or for individuals at increased risk of TB exposure, such as healthcare workers.

Providing education and raising awareness about TB transmission, symptoms, and prevention measures can empower individuals and communities to take proactive steps to prevent the spread of TB.

Complications of TB Treatment:

While tuberculosis (TB) treatment is generally effective, it can sometimes lead to complications, particularly if not managed properly. Some potential complications of TB treatment include:

- The medications used to treat TB can cause side effects ranging from mild to severe. Common side effects include gastrointestinal symptoms including abdominal pain, vomiting and nausea, liver toxicity, skin rashes and peripheral neuropathy.

- Serious side effects such as hepatitis, optic neuritis and drug-induced hepatitis may occur in some cases.

- TB medications can interact with other medications, potentially reducing their efficacy or causing adverse effects. For example, rifampin, a key component of TB treatment, can induce liver enzymes and affect the metabolism of other drugs, including oral contraceptives, antiretroviral drugs for HIV, and anticoagulants.

- Inadequate treatment adherence or incomplete treatment can lead to the development of drug-resistant TB strains, including multidrug-resistant TB (MDR-TB) and extensively drug- resistant TB (XDR-TB).

- In individuals with HIV infection and TB co-infection who start antiretroviral therapy (ART) during TB treatment, Immune Reconstitution Inflammatory Syndrome or IRIS may occur. IRIS is characterized by an exaggerated inflammatory response to TB antigens, leading to worsening of TB symptoms or the development of new TB-related complications.

- Some TB medications, particularly isoniazid and rifampin, can cause hepatotoxicity or liver toxicity. Regular monitoring of liver function tests is essential to detect and manage hepatotoxicity promptly.

- Other TB medications such as ethambutol, can cause optic neuritis and vision changes.

Even after successful completion of TB treatment, there is a risk of TB relapse, especially in individuals with risk factors such as immunosuppression, ongoing exposure to TB, or inadequate treatment. Close monitoring and follow-up after completing TB treatment are essential to detect and manage relapse promptly.

To minimize the risk of complications, it's crucial for individuals undergoing TB treatment to adhere to their prescribed medication regimen, attend regular follow-up appointments and communicate any symptoms or concerns with their doctor.

If Tuberculosis test price has got you worried or if you are wondering where I can find a reliable and affordable diagnostic center for Tuberculosis screening near me then look no further than Vijaya Diagnostics. With over 140+ NABL accredited and ISO compliant labs across 20+ cities, you’re sure to find a Vijaya Diagnostic center near you!

What’s more? We are bringing diagnostic tests right to your doorstep with our home sample collection option. Book a convenient time slot using our app and enjoy exclusive discounts, cashbacks and more on the Vijaya Diagnostic app!

Frequently Asked Questions

1. Who is at risk of Tuberculosis?

Ans - Individuals with weakened immune systems, such as those living with HIV/AIDS, malnutrition or certain medical conditions like diabetes, are at a higher risk. Additionally, people in close contact with individuals with active TB, those living in crowded or poorly ventilated conditions and individuals in high TB burden areas are also at increased risk.

2. Can Tuberculosis affect other parts of the body besides the lungs?

Ans - Yes, Tuberculosis can affect other parts of the body, a condition known as extrapulmonary Tuberculosis. Common sites of extrapulmonary TB include lymph nodes, bones, joints, kidneys, brain, and spine.

3. Can Tuberculosis be transmitted through casual contact?

Ans - No, Tuberculosis is usually spread through the air when an infected person coughs, sneezes, or speaks. Casual contact such as shaking hands, sharing food or drink, or touching surfaces is unlikely to transmit Tuberculosis.

4. How long does it take to recover from Tuberculosis?

Ans - The duration of TB treatment varies depending on factors such as the type of Tuberculosis (latent or active) and the individual's response to treatment. Standard Tuberculosis treatment typically lasts 6 to 9 months for drug-sensitive Tuberculosis. However, drug-resistant Tuberculosis may require longer and more intensive treatment regimens.

5. Can Tuberculosis affect pregnant women and their babies?

Ans - Yes, pregnant women with Tuberculosis are at increased risk of complications such as preterm birth, low birth weight, and transmission of TB to their babies during childbirth or through breastfeeding. Prompt diagnosis and treatment are crucial to minimize risks to both the mother and the baby.

6. How often should individuals be screened for Tuberculosis?

Ans - Screening for Tuberculosis depends on individual risk factors and local epidemiology. High-risk individuals, such as healthcare workers, caregivers and loved ones of TB patients and those living in high TB burden settings may need to be screened more frequently. Generally, individuals in high-risk groups should undergo TB screening at least once every year