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What Are The Different Types Of Tuberculosis?

Tuberculosis (TB) does not only affect the lungs — it can also affect other areas of the body, known as extrapulmonary TB. Types of extrapulmonary TB include gastrointestinal TB, skeletal TB, liver TB, and more.

TB is a disease that occurs due to an infection with Mycobacterium tuberculosis bacteria.

It mostly affects the lungs but can also affect other areas of the body, including the liver, bones, reproductive system, and gastrointestinal tract.

People may have either active TB, which is contagious and causes symptoms, or latent TB, which does not cause symptoms or spread to others.

This article covers the different types of TB, testing for the disease, and more.

TB spreads through breathing in air particles containing the TB bacteria. If a person inhales these particles, TB bacteria enter the lung tissue.

Latent TB occurs if people have TB bacteria within their body, but it is inactive. Latent TB does not cause symptoms and cannot pass on to other people. However, latent TB can become active TB if the immune system weakens.

Active TB causes symptoms and is contagious. Doctors refer to active TB as TB disease. Symptoms of active TB include:

People with a weakened immune system have a higher risk of developing active TB from a TB infection. This is because the immune system is less able to fight the lung infection.

With active TB, the bacteria multiply and spread through the body.

Pulmonary TB affects the lungs. The lungs are the primary site of TB in up to 87 in 100 cases. Pulmonary TB may be latent or active, and around 10 in 100 people develop symptoms.

Around one-third of people may develop respiratory symptoms with pulmonary TB, but prolonged fever is the most common symptom.

Extrapulmonary TB affects organs and tissues outside of the lungs. Extrapulmonary TB accounts for around 15 in 100 of all TB cases.

People with a weakened immune system may develop extrapulmonary TB, such as people with HIV.

TB lymphadenitis

TB lymphadenitis affects the lymph nodes and is the most common form of extrapulmonary TB. Symptoms of TB lymphadenitis include:

enlarged lymph nodes, which may appear as painless lumps on both sides of the head and neck

fever

night sweats

fatigue

Skeletal TB

Skeletal TB is a type of TB that has spread to the bones. Around 10in 100 extrapulmonary TB cases are skeletal TB. The most commonly affected area for skeletal TB is the thoracic spine, which is the middle section of the spine.

Symptoms of skeletal TB include:

pain

weakness or changes in movement and muscle function

other TB symptoms, such as fever and malaise

Miliary TB

Miliary TB is a form of both pulmonary and extrapulmonary TB. Miliary TB appears as millet-seed-like lesions on the lungs and other organs in the body.

Miliary TB may affect the blood, bones, lymphatic system, central nervous system, or organs.

Symptoms of miliary TB depend on which organs it affects, but people can experience general symptoms such as:

weakness

fever

cough

unexplained weight loss

lack of energy

Genitourinary TB

Genitourinary TB affects the genitals, urinary tract, or kidneys. Bladder TB usually occurs after a TB infection in the kidneys.

Genital TB is rare, but in females, it may cause infertility. Genitourinary TB does not usually cause any symptoms.

Liver TB

Liver TB usually affects those with an advanced HIV infection or other immunodeficiency. Liver TB may appear as multiple, small nodules on imaging scans.

Gastrointestinal TB

Gastrointestinal TB affects the gastrointestinal tract. TB is rare in the intestines but more common in the ileocecal area, between the end section of the small intestine and the beginning of the large intestine.

Intestinal TB may share similar symptoms and features with Crohn's disease. Complications include intestinal obstructions and perforations.

TB meningitis

TB meningitis is an infection of the meninges, the membranes covering the spinal cord and brain.

The TB infection may travel from the lungs through the lymph nodes to reach the meninges.

TB meningitis causes symptoms of meningitis, including:

TB peritonitis

Peritoneal TB affects the peritoneum, which is the lining of the abdomen. Peritoneal TB usually occurs alongside other types of abdominal TB. Peritoneal TB may cause ascites, which is a buildup of fluid in the abdomen.

TB pericarditis

TB pericarditis affects the pericardium, which is the membrane surrounding the heart. TB pericarditis affects around 1–2% of people with pulmonary TB.

Symptoms of TB pericarditis include:

Cutaneous TB

Cutaneous TB affects the skin and is a rare form of TB. Around 1–2% of all extrapulmonary TB cases are cutaneous TB. It is more common in people with HIV or other immunodeficiency.

Cutaneous TB can appear as any type of skin lesion, such as:

Tests for TB include the following:

Mantoux tuberculin skin test (TST): A doctor will inject a substance — tuberculin — into the skin on the arm to see if it creates a reaction, which can indicate whether a TB infection is present or not.

Blood tests: Doctors use blood tests known as interferon-gamma release assays (IGRAs) to test whether TB infection is present.

X-ray or CT scan: A doctor may carry out additional imaging scans if they think a TB infection is present in the lungs.

Sputum tests: A sputum test examines mucus that people cough up to see if a TB infection is present.

TB usually affects the lungs but can spread to affect other areas throughout the body. Symptoms may depend on the affected area but can include fatigue, night sweats, and fever.

A doctor may carry out skin and blood tests to check for TB infection and find out the location and type of TB.

What To Know About Bone Tuberculosis

Bone tuberculosis is a form of tuberculosis that spreads beyond the lungs and affects the bones. Recognizing bone tuberculosis symptoms early is essential for successful treatment.

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis bacteria.

The bacteria is transmitted when a person with the infection coughs, speaks, or sings. TB normally affects a person's lungs but can spread to any other part of the body. If TB spreads to the bone, it is known as bone tuberculosis.

Other names for bone TB are osteoarticular, musculoskeletal, or skeletal TB.

TB is normally preventable and treatable if treatment is started early. However, TB can be a fatal condition.

The Centers for Disease Control and Prevention (CDC) reported 8,300 cases of TB in the United States in 2022.

Read on to learn more about bone TB, including its causes and risk factors.

When a TB infection spreads beyond the lungs, it is called extrapulmonary TB (EPTB). According to the CDC, in 2020 21% of TB cases in the United States involved extrapulmonary TB.

If a person's extrapulmonary TB infection is in their bones, joints, or spine, they have bone TB. In 2020, 9% of all extrapulmonary TB cases in the United States were bone and joint extrapulmonary TB.

One common form of bone TB that affects a person's spine is Pott disease, also known as TB spondylitis.

People with TB in their lungs or throat can transmit the bacteria through their breath. People are most likely to contract TB from people they spend time with in person, such as family, friends, or co-workers.

People contract TB by breathing in the TB bacteria. The bacteria settle in their lungs or throat and then begin to grow. If the infection then spreads to their bones, it can cause the person to develop bone TB.

Bone TB alone is not infectious. If a person has only bone TB, they cannot transmit it to others. However, TB is transmissible if the bacteria are in their lungs or throat as well as their bones.

People with weakened immune systems are more likely to develop TB. This includes infants and people with the following conditions:

Certain treatments can also weaken the immune system, such as:

People have a higher risk of developing some types of bone TB if they have HIV or a vitamin D deficiency. These conditions affect the body's ability to counter the spread of TB bacteria in the body.

Symptoms of bone TB typically come on gradually, sometimes over months or years. Symptoms can include:

pain and tenderness around the affected bone area

loss of function around the affected bone, or finding it harder to move joints

swelling around the bone

muscle wastage

joint deformity

bone deformity

fever

night sweats

unexplained weight loss

People generally have bone TB in one area but may have it in multiple areas. People can have bone TB in any bone or joint. However, it is more common in the spine and weight bearing joints.

Symptoms of bone TB are different from TB in general. A person may have general TB symptoms, bone TB symptoms, or both. The symptoms depend on where the TB is in a person's body.

General TB symptoms include:

feeling sick or weak

fever

loss of appetite

night sweats

weight loss

coughing

coughing up blood

chest pain

If a person suspects they have TB or have been around people who have TB, they should seek testing from healthcare professionals. People with TB may experience severe and potentially fatal complications if they do not get sufficient treatment.

People may also have TB but no symptoms. Doctors call this latent TB. People with latent TB cannot transmit it to others, but treatment is still needed.

Healthcare professionals may find it difficult to diagnose bone TB. This is because bone TB symptoms tend to occur gradually over a long time.

Doctors normally diagnose bone TB by:

analyzing a person's physical symptoms, including pain

analyzing samples, such as performing a TB blood test

testing for M. Tuberculosis bacteria

Doctors can also use different types of imaging scans to investigate and confirm a person's bone TB, such as:

Early treatment can prevent TB from developing further and causing issues, such as joint deformity or losing joint function.

Healthcare professionals usually treat bone TB with multiple anti-TB medications, such as chemotherapy.

If a person also has TB in their throat or lungs, doctors prescribe antibiotics for at least 6 months. Doctors may perform surgery in some cases of bone TB in the spine.

Healthcare professionals can vaccinate people against TB using the bacillus Calmette-Guérin (BCG) vaccine.

However, health authorities in the United States do not generally recommend the BCG vaccine because of the low risk of infection with TB bacteria. The BCG vaccine may also complicate some tests doctors use when prescribing TB treatment.

Bone tuberculosis (TB) develops if a person's TB infection spreads beyond the lungs to the bones.

TB is infectious. It is transmitted through the air in droplets when a person with pulmonary TB coughs, sneezes, spits, laughs, or talks. A person cannot directly transmit bone TB without also having TB in their lungs.

Bone TB symptoms often become noticeable very gradually. This can make it harder for doctors to diagnose the disease. Doctors typically treat bone TB with a combination of antibiotics, chemotherapy, and surgery.

If a person suspects they have TB or have been around people with TB, they should seek professional treatment as soon as possible.

Cat Stevens Was Forced To Take Time Out After Tuberculosis Battle - Symptoms Of Infection

Stevens is reported to have been close to death after contracting the infection and was admitted to King Edward VII Hospital, Midhurst, Sussex.

But the hitmaker describes his spell in hospital as "fairly brief". He told The Sun: "I couldn't do much work for about a year."

Stevens described how he had to take "terribly large, horse-sized antibiotic tablets".

But his time out was productive - he began writing songs that "came from an incredibly powerful urge to find meaning in my life and to go in a new direction".

Years later he regarded his break as a "gift", adding, "If more people were able to stop and think, they might change the direction of their lives completely".

What is tuberculosis?

Tuberculosis is an infection that usually affects the lungs and can be treated with antibiotics. But if left untreated it can be serious.

Symptoms usually come on gradually, but according to the NHS can include:

a cough that lasts more than three weeks – you may cough up mucus (phlegm) or mucus with blood in it

feeling tired or exhausted

a high temperature or night sweats

loss of appetite

weight loss

feeling generally unwell

If TB spreads to another part of the body, the following symptoms may occur:

swollen glands

body aches and pains

swollen joints or ankles

tummy or pelvic pain

constipation

dark or cloudy pee

a headache

being sick

feeling confused

a stiff neck

a rash on the legs, face or other part of the body

The NHS advises to see a GP if:

you've had a cough for more than three weeks

you're feeling tired or exhausted and you're not sure why

you have a high temperature or night sweats that do not go away

you often do not feel hungry

you keep losing weight without changing your diet or exercise routine

you've spent a lot of time with someone who has tuberculosis (TB) and has symptoms (for example, you live with someone who has it)

Ask for an urgent GP appointment or get help from NHS 111 if:

you're coughing up blood or mucus (phlegm) with blood in it

And call 999 or go to A&E if:

you have a stiff neck and a severe headache

it's painful to look at bright lights

you've had a seizure or fit

you've had a change in behaviour – such as sudden confusion

you have weakness or loss of movement in part of the body

These symptoms could signal TB has spread to your brain.

Cat Stevens will appear on stage at Glastonbury on Sunday 25 June at roughly 3:15pm.

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