Signs of Tuberculosis: First Symptoms in Adults and Children

A cough that drags on for weeks is easy to blame on the tail end of a cold, and fatigue on a heavy workload. Tuberculosis begins just as quietly. Below are the signs doctors look for, and the timeframes after which an examination stops being a formality.

First signs of tuberculosis

Tuberculosis is a bacterial infection caused by Mycobacterium tuberculosis. Most often it affects the lungs, but it can also involve other organs. The bacteria enter the air when a person with the active form coughs, sneezes, talks or sings. Tuberculosis is not transmitted through touch, kissing or shared dishes.

Symptoms build up gradually. Common early manifestations include:

• a cough lasting longer than 3 weeks;
• constant fatigue;
• elevated temperature or night sweats;
• loss of appetite;
• weight loss without effort.

There is also a latent form: the bacteria are present in the body, there are no symptoms, and the person cannot infect others. About one case in ten eventually becomes active. The active form is dangerous without treatment — which is why these signs are checked so persistently.

What kind of cough occurs in tuberculosis

The main guide is duration. A cough that does not go away within 3 weeks is already a reason for an examination, even if it is mild. It may be productive with sputum, sometimes with blood; hemoptysis more often appears at later stages.

Blood in the sputum is a reason to seek care the same day, without waiting for a scheduled appointment.

Signs of pulmonary tuberculosis in adults

The classic picture: a prolonged cough with sputum, a long-lasting low-grade fever, weakness, night sweats, reduced appetite and noticeable weight loss. Night sweats look like this: the person wakes up in a bed soaked with sweat. Chills, fever, chest pain and a feeling of general exhaustion are added.

If the bacteria spread beyond the lungs, enlarged lymph nodes, body aches, swollen joints or ankles, abdominal pain, constipation, dark or cloudy urine, headache, vomiting, irritability, and a rash on the legs or face come into play.

The risk is higher in people with weakened immunity — with HIV, diabetes, after a kidney transplant, on chemotherapy; in children under 5 years and the elderly; in those who live in prison or are homeless, smoke, drink alcohol, or use drugs.

Signs of tuberculosis in children

In children, the general symptoms are joined by what parents notice without any tests: the child gains weight poorly and lags in growth. Children under 5 years are at risk, especially if someone at home has the active form. A cough, fever and lost appetite are a reason to show the child to a doctor.

External signs: what a sick person looks like

A diagnosis is not made from the face. Among the signs are loss of weight and appetite, weakness and night sweats. Ancient physicians described the general appearance of a tuberculosis patient — emaciation, loss of strength, lack of appetite (habitus phtisicus); the old name of the disease is consumption.

If the infection has affected the lymph nodes, they become enlarged. Some people with the latent form have no symptoms, so a single glance is not enough.

How the diagnosis is confirmed and when to see a doctor

Tuberculosis is managed by phthisiology, and its specialists are called phthisiologists. The doctor orders an X-ray, CT, ultrasound or echocardiography of the chest or of the area where a focus is suspected. Sputum is tested; sometimes a biopsy is taken — a sample of tissue, cells or fluid. If there are no symptoms but there was close contact with a sick person, a Mantoux test or a blood test is done. Treatment with antibiotics, as a rule, lasts at least 6 months.

You should see a doctor if a cough persists longer than 3 weeks; fatigue does not pass without a reason; fever or night sweats do not let up; there is no appetite for weeks; weight keeps falling; you spent a long time near a person with active tuberculosis.

Tuberculosis by itself is not a reason to call an ambulance. 103 or 112 are needed if the neck becomes stiff and there is a severe headache, it hurts to look at bright light, there have been seizures, or sudden confusion or weakness and loss of movement in part of the body appear: this happens when the infection has reached the brain.

No single sign by itself means a diagnosis: cough and fatigue have other causes too. This material is for reference and does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer