Tuberculosis (TB)

Diagnosis

In order to determine whether you have tuberculosis (TB), your healthcare provider will do an examination that includes the following:

• Physical examination: The healthcare provider will perform a physical examination, which includes inquiring about symptoms and medical history, auscultating the patient’s lungs with a stethoscope, and evaluating any swollen lymph nodes. If tuberculosis is suspected due to factors such as living or being exposed to individuals with active TB, or if there’s a risk of developing active TB disease, the healthcare provider will request additional tests.
• Skin test: A healthcare provider administers a small injection of tuberculin just below the skin on one forearm. After 48 to 72 hours, the provider assesses any swelling at the injection site. The examination result is classified as either positive or negative based on the size of the raised skin. This test determines whether your body has reacted to TB or developed antibodies against it. A positive result suggests either active TB disease or latent TB infection, although individuals who have received the tuberculosis vaccine may also test positive without having the disease. A negative result indicates that your body did not react to the test, but it does not necessarily mean you are free from infection.
• Blood tests: A lab receives a blood sample. If particular immune system cells can “recognize” TB, it can be determined with one lab test. A positive test indicates that you either have active TB disease or a latent TB infection. If the condition is active, further blood tests may be able to identify it.
• Imaging test: An X-ray of the chest can reveal abnormal spots in the lungs, indicative of active TB disease.
• Sputum tests: Your healthcare provider may collect and test sputum, the mucus produced when you cough, to identify bacteria in your voice box or lungs if you have active TB disease. Laboratory testing can determine if the sputum contains the TB bacterium through a simple test, although it may also show bacteria with similar characteristics. Another laboratory test is required to confirm the presence of TB-causing bacteria. Results typically take a few weeks to be available. If the bacterium is found to be drug-resistant, a lab test can also detect this. Your healthcare provider utilizes this information to determine the most appropriate course of action.
• Other lab tests: Other test may include the following:
  • Breath test.
  • Cerebrospinal fluid test, this will test of the fluid around the spine and brain.
  • Removal of sputum from your lungs with a special tube.
  • Urine test.

Treatment

Your healthcare provider may start treatment with medication if you have a latent TB infection. This is particularly true for those who are at a higher risk of developing active TB disease due to other causes like HIV/AIDS. Treatment for latent tuberculosis often lasts three to four months and treatment for active tuberculosis might last four, six, or nine months. The optimal medications for you will be determined by healthcare provider.

• Medication: You may only need to take one or two types of medication if you have a latent TB infection. Many medications are needed to treat active TB disease. The following medications are frequently used to treat tuberculosis:
  • Ethambutol
  • Isoniazid.
  • Pyrazinamide.
  • Rifabutin
  • Rifampin
  • Rifapentine

If you have drug-resistant TB or other health conditions, alternative medications may be offered to you. It’s important to provide a list of all medications, dietary supplements, and herbal therapies you are currently using. Some of these may need to be discontinued during your treatment. It’s crucial to adhere to the prescribed dosage instructions and complete the entire course of treatment. This is essential for eradicating the bacteria in your body and preventing the emergence of new drug-resistant strains.