Pulmonary Tuberculosis: Causes, Symptoms & Treatments

Tuberculosis: pulmonary manifestations


Pulmonary tuberculosis (TB) is a contagious bacterial infection that mainly involves the lungs, but may spread to other organs. It is a potentially deadly disease, but it’s curable if you get medical help right away and follow your doctor’s instructions.

The cause of Pulmonary Tuberculosis

The bacterium (germ) that causes TB is called Mycobacterium tuberculosis. This germ causes other kinds of TB, but the most common is pulmonary TB. You can get sick with TB if you inhale the droplets exhaled by a person who has the disease. Although TB can be treated and preventable, according to the World Health Organization, up to 66% of people who get sick with TB will die if they do not get proper medical care. (WHO) If you believe that you have pulmonary tuberculosis, see your doctor immediately. If you’ve been exposed to pulmonary TB, ask for a TB test. 

The following are at high risk of active TB:

  • Elderly
  • Infants
  • People with weakened immune systems, for example due to AIDS, diabetes, chemotherapy, or medicines that weaken the immune system

Your risk of catching TB may increases if you:

  • Are around people who have TB (such as during overseas travel)
  • Live in a crowded or unclean living conditions
  • Have poor nutrition

The following factors increases the rate of TB infection in a population:

  • Increase in HIV infections
  • Increase in number of homeless people (poor environment and nutrition)
  • Appearance of drug-resistant strains of this disease

Symptoms of Pulmonary Tuberculosis

The primary stage of the disease usually doesn’t cause symptoms. When the symptoms of pulmonary TB occur, these may include:

  • Cough (sometimes producing phlegm)
  • Coughing up blood
  • Excessive sweating, especially at night
  • Fatigue
  • Fever
  • Unintentional weight loss

Other symptoms may also occur with this disease:

  • Breathing difficulty
  • Chest pain
  • Wheezing

Treatment of Pulmonary Tuberculosis

The goal of treatment is to cure the infection with drugs that fight the pulmonary TB bacteria. Treatment of active pulmonary TB will always involve a combination of many drugs (usually 4 drugs). All of the drugs are continued until lab tests show which medicines work best. 

Commonly used drugs include:

  • Isoniazid
  • Rifampin
  • Pyrazinamide
  • Ethambutol

Other drugs that may be used to treat TB includes:

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

You may need to take many different pills at different times of the day for 6 months or longer. It’s very important that you take the pills the way your health care provider instructed. 

When people do not take their TB medications as instructed, the infection become much more difficult to treat. The TB bacteria can become resistant into treatment. This means that the drugs no longer work.

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

You may need to stay in your home or be admitted in 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 assures that you receive the best care.

Possible Complications

Pulmonary TB causes permanent lung damage if not treated early. 

Medicines used to treat TB may cause side effects, these includes:

  • Changes in vision
  • Orange or brown-colored tears and urine
  • Rash
  • Liver inflammation

A vision test may be done before the treatment so your doctor can monitor any changes in the health of your eyes. 

Call your health care provider if:

  • You think or know that you have been exposed to TB
  • You develop symptoms of TB
  • Your symptoms continue despite the treatment
  • New symptoms develop


TB is preventable, even in those who have been exposed to an infected person. Skin testing for TB is used in a high risk populations or in people who may have been exposed to the TB, such as health care workers.

People who’ve been exposed to TB should be skin tested immediately and have a follow-up test at a later date, if the first test is negative.

A positive skin test means you have come into contact with the TB bacteria. It doesn’t mean that you have active disease or are contagious. Talk to your doctor on about how to prevent getting tuberculosis.

Prompt treatment is extremely important to prevent the spread of TB from those who have active TB disease to those who have never been infected with TB.

Some countries with a high incidence of TB give people a BCG vaccination to prevent this disease. But, the effectiveness of this vaccine is limited and it is not routinely used in the United States.

People who have had BCG may still be skin tested for TB. Discuss the test results (if positive) with your doctor.