Tuberculosis

Tuberculosis
Other namesPhthisis, phthisis pulmonalis, consumption, great white plague
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.
SpecialtyInfectious disease, pulmonology
SymptomsChronic cough, fever, cough with bloody mucus, weight loss[1]
CausesMycobacterium tuberculosis[1]
Risk factorsSmoking, HIV/AIDS[1]
Diagnostic methodCXR, culture, tuberculin skin test, QuantiFERON[1]
Differential diagnosisPneumonia, histoplasmosis, sarcoidosis, coccidioidomycosis[2]
PreventionScreening those at high risk, treatment of those infected, vaccination with bacillus Calmette-Guérin (BCG)[3][4][5]
TreatmentAntibiotics[1]
Frequency25% of people (latent TB)[6] 10.6 million (active TB)[7]
Deaths1.3 million (2022)[6]

Tuberculosis (TB), also known colloquially as the "white death", or historically as consumption,[8] is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria.[1] 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 latent tuberculosis.[1] Around 10% of latent infections progress to active disease that, if left untreated, kill about half of those affected.[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.[9]

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][10] People with latent TB do not spread the disease.[1] Active infection occurs more often in people with HIV/AIDS and in those who smoke.[1] Diagnosis of active TB is based on chest X-rays, as well as microscopic examination and culture of bodily fluids.[11] Diagnosis of latent TB relies on the tuberculin skin test (TST) or blood tests.[11]

Prevention of TB involves screening those at high risk, early detection and treatment of cases, and vaccination with the bacillus Calmette-Guérin (BCG) vaccine.[3][4][5] Those at high risk include household, workplace, and social contacts of people with active TB.[4] Treatment requires the use of multiple antibiotics over a long period of time.[1] Antibiotic resistance is a growing problem, with increasing rates of multiple drug-resistant tuberculosis (MDR-TB).[1]

In 2018, one quarter of the world's population was thought to have a latent infection of TB.[6] New infections occur in about 1% of the population each year.[12] In 2022, an estimated 10.6 million people developed active TB, resulting in 1.3 million deaths, making it the second leading cause of death from an infectious disease after COVID-19.[7] As of 2018, most TB cases occurred in the regions of South-East Asia (44%), Africa (24%), and the Western Pacific (18%), with more than 50% of cases being diagnosed in seven countries: India (27%), China (9%), Indonesia (8%), the Philippines (6%), Pakistan (6%), Nigeria (4%), and Bangladesh (4%).[13] By 2021, the number of new cases each year was decreasing by around 2% annually.[7][1] About 80% of people in many Asian and African countries test positive, while 5–10% of people in the United States test positive via the tuberculin test.[14] Tuberculosis has been present in humans since ancient times.[15]

Video summary (script)
  1. ^ a b c d e f g h i j k l m n o p "Tuberculosis (TB)". who.int. Archived from the original on 30 July 2020. Retrieved 8 May 2020.
  2. ^ Ferri FF (2010). Ferri's differential diagnosis : a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders (2nd ed.). Philadelphia, PA: Elsevier/Mosby. p. Chapter T. ISBN 978-0-323-07699-9.
  3. ^ a b Hawn TR, Day TA, Scriba TJ, Hatherill M, Hanekom WA, Evans TG, et al. (December 2014). "Tuberculosis vaccines and prevention of infection". Microbiology and Molecular Biology Reviews. 78 (4): 650–71. doi:10.1128/MMBR.00021-14. PMC 4248657. PMID 25428938.
  4. ^ a b c Implementing the WHO Stop TB Strategy: a handbook for national TB control programmes. Geneva: World Health Organization (WHO). 2008. p. 179. ISBN 978-92-4-154667-6. Archived from the original on 2 June 2021. Retrieved 17 September 2017.
  5. ^ a b Harris RE (2013). "Epidemiology of Tuberculosis". Epidemiology of chronic disease: global perspectives. Burlington, MA: Jones & Bartlett Learning. p. 682. ISBN 978-0-7637-8047-0. Archived from the original on 7 February 2024. Retrieved 17 September 2017.
  6. ^ a b c "Tuberculosis (TB)". World Health Organization (WHO). 16 February 2018. Archived from the original on 30 December 2013. Retrieved 15 September 2018.
  7. ^ a b c "Tuberculosis (TB)". WHO. Archived from the original on 30 July 2020. Retrieved 16 October 2021.
  8. ^ The Chambers Dictionary. New Delhi: Allied Chambers India Ltd. 1998. p. 352. ISBN 978-81-86062-25-8. Archived from the original on 6 September 2015.
  9. ^ Adkinson NF, Bennett JE, Douglas RG, Mandell GL (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases (7th ed.). Philadelphia, PA: Churchill Livingstone/Elsevier. p. Chapter 250. ISBN 978-0-443-06839-3.
  10. ^ "Basic TB Facts". Centers for Disease Control and Prevention (CDC). 13 March 2012. Archived from the original on 6 February 2016. Retrieved 11 February 2016.
  11. ^ a b Konstantinos A (2010). "Testing for tuberculosis". Australian Prescriber. 33 (1): 12–18. doi:10.18773/austprescr.2010.005. ISSN 0312-8008.
  12. ^ "Tuberculosis". World Health Organization (WHO). 2002. Archived from the original on 17 June 2013.
  13. ^ "Global tuberculosis report". World Health Organization (WHO). Archived from the original on 30 December 2013. Retrieved 9 November 2017.
  14. ^ Kumar V, Robbins SL (2007). Robbins Basic Pathology (8th ed.). Philadelphia: Elsevier. ISBN 978-1-4160-2973-1. OCLC 69672074.
  15. ^ Lawn SD, Zumla AI (July 2011). "Tuberculosis". Lancet. 378 (9785): 57–72. doi:10.1016/S0140-6736(10)62173-3. PMID 21420161. S2CID 208791546.