Tuberculosis | |
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Other names | Phthisis, phthisis pulmonalis, consumption, great white plague |
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Chest X-ray of a person with advanced tuberculosis: Infection in both lungs is marked by white arrow-heads, and the formation of a cavity is marked by black arrows. | |
Specialty | Infectious disease, pulmonology |
Symptoms | Chronic cough, fever, cough with bloody mucus, weight loss. Latent TB infection is asymptomatic[1] |
Causes | Mycobacterium tuberculosis[1] |
Risk factors | Immunodeficiency[1] |
Diagnostic method | CXR, microbial culture, TB skin test, interferon gamma release assay[1] |
Differential diagnosis | Pneumonia, histoplasmosis, sarcoidosis, coccidioidomycosis[2] |
Prevention | Screening those at high risk, treatment of those infected, vaccination with bacillus Calmette-Guérin (BCG)[1] |
Treatment | Antibiotics[1] |
Frequency | 10.8 million new infections per year[1] |
Deaths | 1.25 million per year[1] |
Tuberculosis (TB), also known colloquially as the "white death", or historically as consumption,[3] is a contagious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria.[4] Tuberculosis generally affects the lungs, but it can also affect other parts of the body.[1] Most infections show no symptoms, in which case it is known as inactive or latent tuberculosis.[4] A small proportion of latent infections progress to active disease that, if left untreated, can be fatal.[1] Typical symptoms of active TB are chronic cough with blood-containing mucus, fever, night sweats, and weight loss.[1] Infection of other organs can cause a wide range of symptoms.[5]
Tuberculosis is spread from one person to the next through the air when people who have active TB in their lungs cough, spit, speak, or sneeze.[1][4] People with latent TB do not spread the disease.[1] A latent infection is more likely to become active in those with weakened immune systems.[1] There are two principal tests for TB: interferon-gamma release assay (IGRA) of a blood sample, and the tuberculin skin test.[1][6]
Prevention of TB involves screening those at high risk, early detection and treatment of cases, and vaccination with the bacillus Calmette-Guérin (BCG) vaccine.[7][8][9] Those at high risk include household, workplace, and social contacts of people with active TB.[8] Treatment requires the use of multiple antibiotics over a long period of time.[1]
Tuberculosis has been present in humans since ancient times.[10] In the 1800s, when it was known as consumption, it was responsible for an estimated quarter of all deaths in Europe.[11] The incidence of TB decreased during the 20th century with improvement in sanitation and the introduction of drug treatments including antibiotics.[12] However, since the 1980s, antibiotic resistance has become a growing problem, with increasing rates of drug-resistant tuberculosis.[1][13] It is estimated that one quarter of the world's population have latent or active TB.[14] In 2023, TB is estimated to have newly infected 10.8 million people and caused 1.25 million deaths, making it the leading cause of death from an infectious disease.[1][15]
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