Editing Tuberculosis (section)

== Signs and symptoms ==

[[File:Tuberculosis symptoms.svg|thumb|upright=1.5|The main symptoms of variants and stages of tuberculosis are given,<ref>{{cite web|url=http://www.emedicinehealth.com/tuberculosis/page3_em.htm|title=Tuberculosis Symptoms|publisher=eMedicine Health| vauthors = Schiffman G |date=15 January 2009|url-status=live|archive-url=https://web.archive.org/web/20090516075020/http://www.emedicinehealth.com/tuberculosis/page3_em.htm|archive-date=16 May 2009}}</ref> with many symptoms overlapping with other variants, while others are more, but not entirely, specific for certain variants. Multiple variants may be present simultaneously.]]
[[File:Tuberculosis lip (1).jpg|thumb|Tuberculosis of the lip, secondary to open pulmonary TB]]
There is a popular misconception that tuberculosis is purely a disease of the lungs that manifests as [[cough]]ing.<ref>{{cite book |vauthors=Kamboj A, Lause M, Kamboj K |year=2023 |chapter=The Problem of Tuberculosis: Myths, Stigma, and Mimics |veditors=Rezaei N |title=Tuberculosis |series=Integrated Science |volume=11 |publisher=Springer |doi=10.1007/978-3-031-15955-8_50 |pages=1046–1062 |isbn=978-3-031-15954-1}}</ref> Tuberculosis may infect many organs, even though it most commonly occurs in the lungs (known as pulmonary tuberculosis).<ref name="Adkinson-2010"/> Extrapulmonary TB occurs when tuberculosis develops outside of the lungs, although extrapulmonary TB may coexist with pulmonary TB.<ref name="Adkinson-2010"/>

General signs and symptoms include fever, [[chills]], night sweats, [[Anorexia (symptom)|loss of appetite]], weight loss, and [[fatigue (medical)|fatigue]].<ref name="Adkinson-2010"/> In severe cases, [[nail clubbing]] may also occur.<ref name="Gibson_BMJ_2005">{{cite book|url=http://www.wiley.com/WileyCDA/WileyTitle/productCd-072791605X.html|title=Evidence-Based Respiratory Medicine|date=2005|publisher=BMJ Books|isbn=978-0-7279-1605-1|veditors=Gibson PG, Abramson M, Wood-Baker R, Volmink J, Hensley M, Costabel U|edition=1st|page=321|archive-url=https://web.archive.org/web/20151208072842/http://www.wiley.com/WileyCDA/WileyTitle/productCd-072791605X.html|archive-date=8 December 2015|url-status=live}}</ref>

=== Latent tuberculosis ===
The majority of individuals with TB infection show [[Asymptomatic carrier|no symptoms]], a state known as inactive or [[latent tuberculosis]].<ref name="CDC_2025" /> This condition is not contagious, and can be detected by  the [[Mantoux test|tuberculin skin test]] (TST) and the [[Interferon gamma release assay|interferon-gamma release assay]] (IGRA); other tests should be conducted to eliminate the possibility of active TB.<ref name="Price_2024">{{Citation |title=Latent Tuberculosis |vauthors=Price C, Nguyen AD |date=11 January 2024 |work=StatPearls |url=https://www.ncbi.nlm.nih.gov/books/NBK599527/ |access-date=2025-03-17 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=38261712}}</ref> Without treatment, an estimated 5% to 15% of cases will progress into active TB during the person's lifetime.<ref name="Price_2024" />

=== Pulmonary ===

If a tuberculosis infection does become active, it most commonly involves the lungs (in about 90% of cases).<ref name="Lawn-2011"/><ref>{{cite book| vauthors = Behera D |title=Textbook of Pulmonary Medicine|year=2010|publisher=Jaypee Brothers Medical Publishers|location=New Delhi|isbn=978-81-8448-749-7|page=457|url=https://books.google.com/books?id=0TbJjd9eTp0C&pg=PA457|edition=2nd|url-status=live|archive-url=https://web.archive.org/web/20150906185549/https://books.google.com/books?id=0TbJjd9eTp0C&pg=PA457|archive-date=6 September 2015}}</ref> Symptoms may include [[chest pain]], a prolonged cough producing [[sputum]] which may be bloody, tiredness, temperature, loss of appetite, [[wasting]] and general [[malaise]].<ref name="Lawn-2011"/><ref>{{Cite web |date=20 April 2023 |title=Tuberculosis (TB) |url=https://www.nhs.uk/conditions/tuberculosis-tb/ |access-date=2025-03-17 |website=National Health Service |language=en}}</ref> In very rare cases, the infection may erode into the [[pulmonary artery]] or a [[Rasmussen aneurysm]], resulting in massive bleeding.<ref name="Adkinson-2010"/><ref>{{cite journal | vauthors = Halezeroğlu S, Okur E | title = Thoracic surgery for haemoptysis in the context of tuberculosis: what is the best management approach? | journal = Journal of Thoracic Disease | volume = 6 | issue = 3 | pages = 182–85 | date = March 2014 | pmid = 24624281 | pmc = 3949181 | doi = 10.3978/j.issn.2072-1439.2013.12.25 }}</ref> 

Tuberculosis may cause extensive scarring of the lungs, which persists after successful treatment of the disease. Survivors continue to experience chronic respiratory symptoms such as cough, sputum production, and [[shortness of breath]].<ref>{{cite journal | vauthors = Gai X, Allwood B, Sun Y | title = Post-tuberculosis lung disease and chronic obstructive pulmonary disease | journal = Chinese Medical Journal | volume = 136 | issue = 16 | pages = 1923–1928 | date = August 2023 | pmid = 37455331 | pmc = 10431356 | doi = 10.1097/CM9.0000000000002771 }}</ref><ref>{{Cite web | vauthors = Basire D |date=2024-04-23 |title=Post-TB lung health: Lasting impact beyond treatment |url=https://www.breathingmatters.co.uk/our-findings/post-tb-lung-health-lasting-impact-beyond-treatment/ |access-date=2025-03-18 |website=Breathing Matters - UCL Respiratory |language=en}}</ref>

=== Extrapulmonary ===
{{Main|Extrapulmonary tuberculosis}}
In 15–20% of active cases, the infection spreads outside the lungs, causing other kinds of TB.<ref>{{cite book| veditors = Jindal SK |title=Textbook of Pulmonary and Critical Care Medicine|publisher=Jaypee Brothers Medical Publishers|location=New Delhi|isbn=978-93-5025-073-0|page=549|url=https://books.google.com/books?id=EvGTw3wn-zEC&pg=PA549|year=2011|url-status=live|archive-url=https://web.archive.org/web/20150907185434/https://books.google.com/books?id=EvGTw3wn-zEC&pg=PA549|archive-date=7 September 2015}}</ref> These are collectively denoted as extrapulmonary tuberculosis.<ref name="Golden-2005">{{cite journal | vauthors = Golden MP, Vikram HR | title = Extrapulmonary tuberculosis: an overview | journal = American Family Physician | volume = 72 | issue = 9 | pages = 1761–68 | date = November 2005 | pmid = 16300038 }}</ref> Extrapulmonary TB occurs more commonly in people with a [[Immunosuppression|weakened immune system]] and young children. In those with HIV, this occurs in more than 50% of cases.<ref name="Golden-2005"/> Notable extrapulmonary infection sites include the [[Pleural cavity|pleura]] (in tuberculous pleurisy), the [[central nervous system]] (in [[tuberculous meningitis]]), the [[lymphatic system]] (in [[Tuberculous cervical lymphadenitis|scrofula]] of the neck), the [[genitourinary system]] (in [[urogenital tuberculosis]]), and the [[bone]]s and joints (in [[Pott disease]] of the spine), among others. A potentially more serious, widespread form of TB is called "disseminated tuberculosis"; it is also known as [[miliary tuberculosis]].<ref name="Adkinson-2010"/> Miliary TB currently makes up about 10% of extrapulmonary cases.<ref name="Habermann-2008"/>

Symptoms of extrapulmonary TB usually include the general signs and symptoms as above, with additional symptoms related to the part of the body which is affected.<ref>{{Cite web |date=2024-05-08 |title=Clinical Symptoms of Tuberculosis |url=https://www.cdc.gov/tb/hcp/clinical-signs-and-symptoms/index.html |access-date=2025-03-17 |website=Centers for Disease Control and Prevention |language=en-us}}</ref> [[Urogenital tuberculosis]], however, typically presents differently, as this manifestation most commonly appears decades after the resolution of pulmonary symptoms. Most patients with chronic urogenital TB do not have pulmonary symptoms at the time of diagnosis. Urogenital tuberculosis most commonly presents with urinary 'storage symptoms' such as increased frequency and/or urgency of urination, flank pain, [[hematuria]], and nonspecific symptoms such as fever and malaise.<ref name="Figueiredo-2017">{{Cite journal |last1=Figueiredo |first1=André A. |last2=Lucon |first2=Antônio M. |last3=Srougi |first3=Miguel |date=2017-02-24 |editor-last=Schlossberg |editor-first=David |title=Urogenital Tuberculosis |journal=Microbiology Spectrum |language=en |volume=5 |issue=1 |doi=10.1128/microbiolspec.TNMI7-0015-2016 |issn=2165-0497 |pmc=11687435 |pmid=28087922}}</ref>