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Tuberculosis
Other namesPhthisis, phthisis pulmonalis, consumption
Chest X-ray of a person with advanced tuberculosis: Infection in both lungs is marked by white arrow-heads, and the formation of a cavity is marked by black arrows.
Medical specialtyInfectious disease, pulmonology
SymptomsChronic cough, fever, cough with bloody mucus, weight loss[1]
CausesMycobacterium tuberculosis[1]
Risk factorsSmoking, HIV/AIDS[1]
Diagnostic methodCXR, culture, tuberculin skin test[1]
Differential diagnosisPneumonia, histoplasmosis, sarcoidosis, coccidioidomycosis[2]
PreventionScreening those at high risk, treatment of those infected, vaccination with bacillus Calmette-Guérin (BCG)[3][4][5]
TreatmentAntibiotics[1]
Frequency25% of people (latent TB)[6]
Deaths1.5 million (2018)[7]

Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria.[1] Tuberculosis generally affects the lungs, but can also affect other parts of the body.[1] Most infections show no symptoms, in which case it is known as latent tuberculosis.[1] About 10% of latent infections progress to active disease which, if left untreated, kills about half of those affected.[1] The classic symptoms of active TB are a chronic cough with blood-containing mucus, fever, night sweats, and weight loss.[1] It was historically called "consumption" due to the weight loss.[8] Infection of other organs can cause a wide range of symptoms.[9]

Tuberculosis is spread from one person to the next through the air when people who have active TB in their lungs cough, spit, speak, or sneeze.[1][10] People with latent TB do not spread the disease.[1] Active infection occurs more often in people with HIV/AIDS and in those who smoke.[1] Diagnosis of active TB is based on chest X-rays, as well as microscopic examination and culture of body fluids.[11] Diagnosis of latent TB relies on the tuberculin skin test (TST) or blood tests.[11]

Prevention of TB involves screening those at high risk, early detection and treatment of cases, and vaccination with the bacillus Calmette-Guérin (BCG) vaccine.[3][4][5] Those at high risk include household, workplace, and social contacts of people with active TB.[4] Treatment requires the use of multiple antibiotics over a long period of time.[1] Antibiotic resistance is a growing problem with increasing rates of multiple drug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB).[1]

As of 2018 one quarter of the world's population is thought to have latent infection with TB.[6] New infections occur in about 1% of the population each year.[12] In 2018, there were more than 10 million cases of active TB which resulted in 1.5 million deaths.[7] This makes it the number one cause of death from an infectious disease.[13] As of 2018, most TB cases occurred in the regions of South-East Asia (44%), Africa (24%) and the Western Pacific (18%), with more than 50% of cases being diagnosed in eight countries: India (27%), China (9%), Indonesia (8%), the Philippines (6%), Pakistan (6%), Nigeria (4%) and Bangladesh (4%).[13] The number of new cases each year has decreased since 2000.[1] About 80% of people in many Asian and African countries test positive while 5–10% of people in the United States population test positive by the tuberculin test.[14] Tuberculosis has been present in humans since ancient times.[15]

References

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  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 "Tuberculosis (TB)". www.who.int. Archived from the original on 30 July 2020. Retrieved 2020-05-08.
  2. Ferri, Fred F. (2010). Ferri's differential diagnosis : a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders (2nd ed.). Philadelphia, PA: Elsevier/Mosby. p. Chapter T. ISBN 978-0-323-07699-9.
  3. 3.0 3.1 Hawn TR, Day TA, Scriba TJ, Hatherill M, Hanekom WA, Evans TG, et al. (December 2014). "Tuberculosis vaccines and prevention of infection". Microbiology and Molecular Biology Reviews. 78 (4): 650–71. doi:10.1128/MMBR.00021-14. PMC 4248657. PMID 25428938.
  4. 4.0 4.1 4.2 Organization, World Health (2008). Implementing the WHO Stop TB Strategy: a handbook for national TB control programmes. Geneva: World Health Organization (WHO). p. 179. ISBN 978-92-4-154667-6. Archived from the original on 2 June 2021. Retrieved 28 July 2020.
  5. 5.0 5.1 Harris, Randall E. (2013). Epidemiology of chronic disease: global perspectives. Burlington, MA: Jones & Bartlett Learning. p. 682. ISBN 978-0-7637-8047-0. {{cite book}}: External link in |ref= (help)
  6. 6.0 6.1 "Tuberculosis (TB)". World Health Organization (WHO). 16 February 2018. Archived from the original on 19 September 2018. Retrieved 15 September 2018.
  7. 7.0 7.1 "Global Tuberculosis Report" (PDF). WHO. WHO. 2019. Archived (PDF) from the original on 17 December 2019. Retrieved 24 March 2020.
  8. The Chambers Dictionary. New Delhi: Allied Chambers India Ltd. 1998. p. 352. ISBN 978-81-86062-25-8. Archived from the original on 6 September 2015.
  9. Adkinson, N Franklin; Bennett, John E; Douglas, Robert Gordon; Mandell, Gerald L (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases (7th ed.). Philadelphia, PA: Churchill Livingstone/Elsevier. p. Chapter 250. ISBN 978-0-443-06839-3.
  10. "Basic TB Facts". Centers for Disease Control and Prevention (CDC). 13 March 2012. Archived from the original on 6 February 2016. Retrieved 11 February 2016.
  11. 11.0 11.1 Konstantinos A (2010). "Testing for tuberculosis". Australian Prescriber. 33 (1): 12–18. doi:10.18773/austprescr.2010.005.
  12. "Tuberculosis". World Health Organization (WHO). 2002. Archived from the original on 17 June 2013.
  13. 13.0 13.1 "Global tuberculosis report". World Health Organization (WHO). Archived from the original on 30 October 2017. Retrieved 2017-11-09.
  14. Kumar, Vinay; Robbins, Stanley L. (2007). Robbins Basic Pathology (8th ed.). Philadelphia: Elsevier. ISBN 978-1-4160-2973-1. OCLC 69672074.
  15. Lawn SD, Zumla AI (July 2011). "Tuberculosis". Lancet. 378 (9785): 57–72. doi:10.1016/S0140-6736(10)62173-3. PMID 21420161. Archived from the original on 27 August 2021. Retrieved 28 July 2020.