Tuberculosis

While the number of reported tuberculosis cases in this country is declining, the disease—once the number one cause of death in the U.S.—is still one of the deadliest diseases around the world, with approximately 2 million tuberculosis-related deaths each year. The team of experts from Pulmonary & Critical Care Medicine at the University of Michigan provides comprehensive, multidisciplinary care for people with tuberculosis, offering the latest treatments plus groundbreaking research for those with antibiotic resistance.

Tuberculosis is caused by a bacteria called Mycobacterium tuberculosis. While the bacteria generally attacks the lungs, other parts of the body can be affected, too, including the brain, kidney and spine.

There are two types of tuberculosis:

  • Latent tuberculosis: While you have a tuberculosis infection, your immune system is able to keep you from getting sick. You don’t have symptoms and can’t spread the disease. It is possible for latent tuberculosis to turn into active tuberculosis years later. Only 5-10% of people with latent tuberculosis who don’t receive treatment will eventually develop active tuberculosis.
  • Active tuberculosis: This type of tuberculosis can occur weeks or years after becoming infected. When tuberculosis attacks the lungs, you will have symptoms, and can spread the disease to others.

Tuberculosis is spread when a person breathes in tuberculosis bacteria from a person with active tuberculosis. The tiny droplets that contain the bacteria are released into the air when the infected person coughs, sneezes, laughs or sings.

More than 22,000 tuberculosis cases are reported each year in the U.S. An estimated 10 to 15 million people in the country have latent tuberculosis. If not treated properly, active tuberculosis can be fatal.

Tuberculosis Symptoms and Risk Factors

Symptoms of tuberculosis—these can include:

  • Cough
  • Fever
  • Night sweats
  • Unexplained weight loss
  • Weakness
  • Tiredness
  • Rapid heart beat
  • Coughing up bloody mucus (called sputum) from the lungs
  • Chest pain

If other parts of the body are affected, the symptoms differ and may include back pain if the disease attacks the spine, or blood in the urine if you have tuberculosis in your kidneys.

Risk factors for tuberculosis—while anyone can get tuberculosis, a number of factors can put you at higher risk:

  • Sharing the same breathing space with someone who has active tuberculosis
  • Living in or traveling to countries where tuberculosis is common
  • Living or working in a group home or prison
  • Having HIV/AIDS (tuberculosis is one of the leading causes of death for those infected with HIV worldwide)
  • Having little to no access to medical care, being homeless, or abusing drugs or alcohol
  • Being underweight or of advanced age
  • Having a medical condition such as diabetes or certain types of cancers

The disease is not spread by shaking hands, kissing, using public toilets or sharing food and drink.

Diagnosing Tuberculosis

If you think you may have been infected, it’s important to be tested. Our pulmonologists, who specialize in lung diseases, can properly diagnose and treat tuberculosis, or determine if your symptoms are related to another cause.

We will conduct a comprehensive exam, including listening to your lungs and checking your lymph nodes for swelling, collecting a thorough history and performing a skin test.

A skin test is simple and involves using a small needle to put tuberculin under the skin, usually on the inside of the arm. After the test, you must return in 48 to 72 hours to be checked for a reaction. If there is a reaction, the size of the reaction is measured. A negative test usually means you are not infected; however, the test may be falsely negative if you’ve been exposed very recently. It takes 2-10 weeks after exposure to tuberculosis for the skin test to react positive. A positive reaction usually means you have been infected with the tuberculosis bacteria. It does not necessarily mean you have active tuberculosis. A chest x-ray or sputum sample may be needed to determine if you have latent or active pulmonary tuberculosis.

The sputum (mucus from the lungs) sample is tested to see if there are tuberculosis bacteria present. To detect tuberculosis in another part of your body—called extrapulmonary tuberculosis—a biopsy, CT scan and/or MRI may be required.

Treating Tuberculosis

Tuberculosis is easily prevented and cured with medication, but treatment time is quite long, generally taking about six to nine months, sometimes longer. It’s crucial to take your medication as prescribed—for the entire duration of treatment—and not miss doses. Otherwise, you have to take the medication longer or start your treatment over again.

Latent tuberculosis usually only requires one antibiotic taken for nine months. For active tuberculosis, a combination of four antibiotics are typically prescribed as treatment, usually taken for six months.

Drug-resistant tuberculosis is a form of tuberculosis where the bacteria are resistant to some or all of the antibiotics used to treat the disease. This can also occur when antibiotics are misused, which is another reason it’s important to take all of your medication according to your doctor’s instructions. People with drug-resistant tuberculosis have less effective treatment options.

New Discoveries for Treating Tuberculosis

Researchers at the University of Michigan's Life Sciences Institute and College of Pharmacy have uncovered how tuberculosis builds drug resistance. The discovery could provide scientists with a new direction to try to combat drug-resistant tuberculosis and to head off the continued spread of this deadly infectious disease. Read the full article: Understanding tuberculosis drug resistance: super-drug inactivator revealed.

Make an Appointment

To schedule an appointment for tuberculosis evaluation or treatment, call us at 888-287-1084.