Symptoms of Tuberculosis (TB)

If you have latent TB, you will not have any symptoms because your body is effectively working to keep the bacteria you are infected within check. When your immune system isn't strong enough to do so, latent TB becomes active TB, the most common symptom of which is a persistent cough that may produce blood-tinged phlegm. TB that spreads beyond the lungs can involve symptoms related to the kidneys, bones, brain, and other areas of the body.

pulmonary tuberculosis symptoms
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Frequent Symptoms 

The vast majority of TB cases occur and remain in the lungs. This is called pulmonary TB. Symptoms of active, pulmonary TB include:

  • A cough that lasts for more than three weeks
  • A cough that produces green or yellow sputum (phlegm) that may also be streaked with blood 
  • Shortness of breath or chest pain
  • Fatigue
  • Loss of appetite and weight loss
  • Night sweats
  • Fever

Rare Symptoms

Occasionally, active TB will spread beyond the lungs into the lymph nodes, kidneys, bones, brain, abdominal cavity, membrane around the heart (pericardium), joints (especially weight-bearing joints, such as the hips and knees), and reproductive organs. When this happens, it is known as extrapulmonary tuberculosis.

Symptoms of extrapulmonary tuberculosis depend on the area involved and can include: 

Lymph nodes: Lymph nodes that drain the lungs may become large enough to compress the bronchial tubes, causing a cough and possibly a collapsed lung. If bacteria spread to lymph nodes in the neck, it is possible for the nodes to break through the skin and discharge pus. 

Kidneys: TB infection of the kidneys may cause fever, back pain, and sometimes blood in the urine. Infection commonly spreads to the bladder, causing painful and frequent urination.

Brain: Tuberculosis that infects the brain, called tuberculous meningitis, is life-threatening. In the United States and other developed countries, tuberculous meningitis most commonly occurs among older people or people with a weakened immune system. Symptoms include fever, constant headache, neck stiffness, nausea, and drowsiness that can lead to coma. 

Pericardium: In tuberculous pericarditis, the pericardium thickens and sometimes leaks fluid into the space between the pericardium and the heart. This can weaken the heart, causing swollen neck veins and difficulty breathing. 

Genitals: Tuberculosis can also spread to the genitals. In men, genital tuberculosis causes the scrotum to enlarge. In women, it causes pelvic pain and menstrual irregularities and increases the risk of an ectopic pregnancy (in which the egg implants itself outside of the uterus).

Sub-Group Indications

Certain populations need to be especially aware of any symptoms that may indicate TB, as they are at most risk for complications from the illness. These include:

  • People with HIV: Since the AIDS outbreak in the 1980s, the number of cases of tuberculosis has increased dramatically. HIV infection suppresses the immune system, making it difficult for the body to control TB bacteria. Worldwide, TB is one of the leading causes of death among those with HIV.
  • Pregnant women: Babies born to women with untreated TB may have lower birth weight than is optimal, and may be born with TB themselves. Pregnant women should receive treatment if the likelihood of them having TB is moderate to high. 

In addition, anyone with a compromised immune system is at higher risk for active TB infection and related complications. 

When to See a Doctor

If you have been exposed to someone with TB, have chest pain or a persistent cough with or without phlegm, call your doctor, who will give you a skin test. TB is a serious illness and can be fatal if not treated.

Causes and Risk Factors of Tuberculosis
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