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Tuberculosis (TB)

What is tuberculosis?

Tuberculosis (TB) is a chronic bacterial infection that usually infects the lungs, although other organs are sometimes involved. TB is primarily an airborne disease.

There is a difference between being infected with the TB bacterium and having active tuberculosis disease.

There are three important ways to describe the stages of TB. They are as follows:

  1. Exposure: This occurs when a person has been in contact, or exposed to, another person who is thought to have or does have TB. The exposed person will have a negative skin test, and normal chest x-ray, and no signs or symptoms of the disease.
  2. TB infection: This occurs when a person has the TB bacteria in his/her body, but does not have symptoms of the disease. This person would have a positive skin test, but a normal chest x-ray.
  3. TB disease: This describes the person that has signs and symptoms of an active infection. The person would have a positive skin test and a positive chest x-ray.

The predominant TB bacterium is Mycobacterium tuberculosis (M. tuberculosis). Most people infected with M. tuberculosis never develop active TB. However, in people with weakened immune systems, especially those with HIV (human immunodeficiency virus), TB organisms can overcome the body's defenses, multiply, and cause an active disease.

Who is at risk for developing TB?

TB affects all ages, races, income levels, and both genders. Those at higher risk include the following:

  • people who live or work with others who have TB
  • medically underserved populations
  • homeless people
  • people from other countries where TB is prevalent
  • people in group settings, such as nursing homes
  • people who abuse alcohol
  • people who use intravenous drugs
  • people with impaired immune systems
  • the elderly
  • healthcare workers who come in contact with high-risk populations

What are the symptoms of TB?

The following are the most common symptoms for TB. However, each individual may experience symptoms differently.

  • cough that will not go away
  • fatigue
  • loss of appetite
  • loss of weight
  • fever
  • coughing blood
  • night perspiring

The symptoms of TB may resemble other lung conditions or medical problems. Consult a physician for a diagnosis.

What causes TB?

The TB bacterium is spread through the air; however, repeated exposure to the germs is usually necessary before a person will become infected. It is not likely to be transmitted through personal items, such as clothing, bedding, or other items that a person with TB has touched. Adequate ventilation is the most important measure to prevent the transmission of TB.

How is TB diagnosed?

TB is diagnosed with a TB skin test. In this test, a small amount of testing material is injected into the top layer of the skin. If a certain size bump develops within two or three days, the test may be positive for tuberculosis infection. Additional tests to determine if a person has TB disease include x-rays and sputum tests.

TB skin tests are suggested for those:

  • in high-risk categories.
  • who live or work in close contact with people who are at high-risk.
  • who have never had a TB skin test.

Recommendations for skin testing in children, from the American Academy of Pediatrics are as follows:

Immediate testing:

  • If the child is thought to have been exposed in the last 5 years.
  • If the child has an x-ray that looks like TB.
  • If the child has any symptoms of TB.
  • A child who is coming from countries where TB is prevalent.

Yearly skin testing:

  • Children with HIV.
  • Children who are in jail.

Testing every two to three years:

  • Children who are exposed to high-risk people.

Consider testing in children from ages 4 to 6 and 11 to 16 if:

  • A child's parent has come from a high-risk country.
  • A child has traveled to high-risk areas.
  • Children who live in densely populated areas.

Treatment for tuberculosis:

Specific treatment will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the disease
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

Treatment may include:

  • short-term hospitalization
  • medications - isoniazid, rifampin, pyrazinamide, ethambutol, or streptomycin, may be prescribed for a period of time up to six months or more for the medication to be effective. Patients usually begin to improve within a few weeks of the start of treatment. The patient is not usually contagious once treatment begins, provided that treatment is carried through to the end, as prescribed by a physician.

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