Disseminated tuberculosis Health Article

Symptoms

The primary infection usually has no symptoms.

Symptoms of disseminated tuberculosis include:

• Cough
• Fatigue
• Fever
• General discomfort, uneasiness, or ill feeling (malaise)
• Shortness of breath
• Sweating
• Weight loss

Other symptoms that can occur with this disease:

• Abdominal swelling
• Chills
• Joint pain
• Pale skin due to anemia (pallor)
• Swollen glands

Note: The symptoms will depend upon the affected areas of the body.

Signs and tests

A physical exam may show:

• Swollen liver
• Swollen lymph nodes
• Swollen spleen

Tests for tuberculosis include:

• Biopsies and cultures of affected organs or tissues
• Bronchoscopy for biopsy or culture
• Chest x-ray
• Fundoscopy may reveal retinal lesions
• Open lung biopsy
• Pleural biopsy
• Sputum cultures
• Tuberculin skin test

This disease may also alter the results of the following tests:

• Mycobacterial culture of bone marrow
• Peripheral smear
• Serum calcium (may be elevated)

Treatment

The goal of treatment is to cure the infection with drugs that fight the TB bacteria. Treatment of active pulmonary TB will always involve a combination of many drugs (usually four drugs). All of the drugs are continued until lab tests show which medicines work best.

The most commonly used drugs include:

• Isonizid
• Rifampin
• Pyrazinamide
• Ethambutol

Other drugs that may be used to treat TB include:

• Amikacin
• Ethionamide
• Moxifloxacin
• Para-aminosalicylic acid
• Streptomycin

You may need to take many different pills at different times of the day for 1 year or longer. It is very important that you take the pills the way your health care provider instructed.

When people do not take their tuberculosis medications as recommended, the infection becomes much more difficult to treat. The TB bacteria may become resistant to treatment, and sometimes, the drugs no longer help treat the infection. For atypical tuberculosis infections, or drug-resistant strains, other drugs may be used to treat the infection.

When there is a concern that a patient may not take all the medication as directed, a health care provider may need to watch the person take the prescribed drugs. This is called directly observed therapy. In this case, drugs may be given 2 or 3 times per week, as prescribed by a doctor.

You may need to be admitted to a hospital for 2 - 4 weeks to avoid spreading the disease to others until you are no longer contagious.

Your doctor or nurse is required by law to report your TB illness to the local health department. Your health care team will be sure that you receive the best care for your TB.