Tuberculosis

What is tuberculosis?

Tuberculosis (say: too-burr-cue-low-sis), also called TB, is an infection caused by a bacteria (germ). Tuberculosis usually affects the lungs, but it can spread to the kidneys, bones, spine, brain and other parts of the body.

There are 2 types of TB:

  • TB infection: The bacteria is present but is not making you sick or contagious; you are not able to spread the disease.
  • Active TB: The bacteria is present and is causing symptoms; you may be able to spread the disease.

How can my doctor check for tuberculosis?

The most commonly used method to check for tuberculosis is the PPD skin test. If you have a positive PPD, it means you have been exposed to a person who has tuberculosis and you have been infected with the bacteria that causes the disease.

If your PPD skin test is positive, you will likely have a chest X-ray and a physical exam to find out whether you have active TB and are currently contagious and able to spread the disease to other people.

It usually takes only a few days to tell whether you're contagious. Most people with a positive skin test are not contagious.

If I have a positive PPD test, do I have tuberculosis?

Usually not. A person can be infected with the bacteria that causes tuberculosis but not actually have active tuberculosis. Many people are infected with the bacteria that causes tuberculosis, but only a few of these people (about 10%) go on to develop active TB.

Healthy people who get infected with the tuberculosis bacteria are often able to fight off the infection and do not develop active TB. The bacteria is dormant (inactive) in their lungs. If the body is not able to contain the infection and the bacteria continues to grow, active tuberculosis develops.

If I do not have active TB, how will my doctor treat my tuberculosis infection?

To be sure that you remain healthy, your doctor may recommend that you take an antibiotic for 6 to 9 months to kill the tuberculosis infection. If you don't take the medicine, the bacteria will remain in your lungs, and you will always be in danger of developing active tuberculosis. The medicine used to treat tuberculosis infection is isoniazid (say: eye-so-nye-ah-zid), which is also called INH. You need to take 1 pill every day for at least 6 months. If you don’t take all your medicine, the tuberculosis may come back.

It is very important that you take the medicine every day. Keep your medicine in a place where you will always see it. Take it at the same time every day. It may help to write yourself a note or set a daily alarm to remind you to take it. Ask your doctor what to do if you forget to take a pill.

People who take INH may have side effects, but these usually do not happen very often. Side effects include a skin rash, an upset stomach or liver disease. Ask your doctor about other possible side effects.

Don't drink alcohol or take acetaminophen (one brand name: Tylenol) while taking INH because this can damage your liver. Always check with your doctor before you take any other medicine because some drugs interact with INH and can cause side effects.

Your doctor may want to monitor you every month. For example you may need to visit your doctor to get another prescription of the medicine you are taking and to monitor any side effects or problems you are experiencing from the medicine. If you are feeling well, your doctor will give you a prescription for the next month.

Could I still get active tuberculosis after I take the medicine for 6 months?

There is a small chance that you could develop active tuberculosis even after you take the medicine every day for 6 months. This is because some bacteria are resistant to the medicine. Staying healthy depends on having sensible living habits. You need enough sleep, regular exercise and a healthy diet to maintain your health and resistance to the tuberculosis bacteria.

Would I know if I developed active tuberculosis?

There is a slight chance you might not know that you have developed active tuberculosis. Tuberculosis bacteria can grow in your body without making you feel sick. However, most people with active tuberculosis experience symptoms. People who have active tuberculosis often feel tired and have a cough that won't go away. They may also lose weight, have a fever or break out in a sweat during the night (called night sweats). They may have trouble breathing.

If you develop active tuberculosis, you will most likely need regular checkups and chest X-rays for the rest of your life to make sure you stay free of the tuberculosis disease, even after you have taken the full course of tuberculosis medicine.

What is the treatment for active tuberculosis?

To treat active TB, it is necessary to take several antibiotics at the same time so that the TB does not become resistant to treatment. If you have active TB, your doctor will likely recommend that you take the 4 following medicines:
  • Isoniazid
  • Rifampin (one brand name: Rifadin)
  • Ethambutol (brand name: Myambutol)
  • Pyrazinamide
It's very important that you take all the medicine given to you. For the medicines to work effectively at curing your tuberculosis, you must not skip a single dose.

Avoid drinking alcohol or taking acetaminophen (brand name: Tylenol) while you're taking the tuberculosis medicine because this could damage your liver. Tell your doctor about any other medicines you may be taking.

Your doctor may also order several sputum and blood tests to be done while you are being treated for tuberculosis. (Sputum is phlegm coughed up from deep inside the lungs.) These tests can be done by the nurse or at a clinic.

Although side effects from tuberculosis medicine are not common, they can be serious. Call your doctor immediately if you have any of the symptoms listed here:

  • Nausea and vomiting
  • Abdominal pain
  • Blurred vision or color-blindness
  • Loss of appetite
  • Yellow color of the eyes or skin
  • Dark (coffee-colored) urine
  • Fever
  • Rash or itching
  • Tingling or burning feeling in your hands or feet
  • Tiredness without reason
  • Yellow color of eyes or skin

More Information

For more information talk to your doctor.

Source

Written by familydoctor.org editorial staff.

American Academy of Family Physicians

Reviewed/Updated: 10/08
Created: 11/96