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Active Tuberculosis

(Active TB; Active Tuberculosis Infection; Active TB Infection)

Definition

Tuberculosis (TB) is an infection. It may be either active or latent. Active TB infection is most common in the lungs, but it can occur in other places in the body. People with latent TB are infected but do not have the disease.

Causes

TB is caused by a specific bacterium. It is easily spread between people. The bacteria travels through the air in droplets from a person with an active TB infection. The droplets are released with coughs, sneezes, or talking. The bacteria in the droplets can be breathed in by other people.
Pathway to the Lungs
Air pathway breathing
Bacteria is inhaled through the mouth and nose, and travels down into the lungs causing TB.
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Risk Factors

Babies, young children, and older adults are more likely to get TB when exposed.
Other things that may raise the risk of TB exposure are:
  • Close contact with a person with active TB
  • Living or traveling to an area where TB rates are high
  • Working in certain jobs, such as farming, funeral homes, and healthcare
  • Living or working in crowded, indoor conditions, such as prisons, hospitals, homeless shelters, or nursing homes
Things that may raise the risk of active TB are:
  • TB bacteria infection in the last two years
  • Chronic diseases that weaken the immune system, such as HIV infection
  • Taking medicine that weakens or suppresses the immune system, such as chemotherapy drugs or organ transplant anti-rejection medicine
  • Smoking or exposure to second hand smoke
  • Alcohol or substance use disorder

Symptoms

Active TB may cause:
  • Chills
  • Fever
  • Night sweats
  • Weakness or fatigue
  • Weight loss
  • Lack of hunger
  • Pain in the chest
  • Severe cough that lasts more than 2 to 3 weeks
  • Coughing up blood and mucus

Diagnosis

Active TB may be found during a routine check-up. You will be asked about your symptoms and health history. You will also be asked about your TB exposure. A physical exam will be done.
These tests will be done to look for signs of infection:
  • Skin test
  • Blood tests
These tests may be done to rule out active TB:
  • Chest x-ray to look for changes caused by TB
  • Samples of sputum to look for the bacteria

Treatment

The infection will need to be treated. This can be done with a combination of medicines. Treatment often lasts 6 months or longer. All the medicine must be finished to prevent drug-resistant TB.
Someone with active TB can easily spread the infection to others. This can be prevented by staying home and avoiding contact with others.

Prevention

To lower the risk of TB:
  • Avoid contact with people who have active TB.
  • Limit travel to areas with high rates of TB.

RESOURCES

American Lung Association
http://www.lung.org
National Institute of Allergy and Infectious Disease
https://www.niaid.nih.gov

CANADIAN RESOURCES

Health Canada
https://www.canada.ca
The Lung Association
https://www.lung.ca

References

Chee CBE, Reves R, et al. Latent tuberculosis infection: Opportunities and challenges. Respirology. 2018 Oct;23(10):893-900.
Pulmonary tuberculosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/pulmonary-tuberculosis-27 . Accessed October 13, 2020.
Tuberculosis (TB). Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/tb/topic/basics/default.htm. Accessed October 13, 2020.

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