is infection with Mycobacterium tuberculosis, a type
of bacterium. It is estimated that approximately 15 million individuals in
the United States and as many as 30% of the world's population are infected.
Tuberculosis infection typically occurs after repeated or prolonged exposure
to the coughing of an actively infected person. Infection can involve any
organ in the body, but the lungs are the most common site of damage. In active infection, there is damage to organs. In latent infection the person carries the bacteria but does not have
current signs of active infection. Latent TB infection is important to diagnose
and treat because it can become active infection. Multidrug-resistant TB is resistant to (cannot be killed
by) standard antibiotics. This type of TB arises from improper or incomplete
treatment of TB infection or through exposure to a person infected with this
type of bacterium. The June 8, 2005, issue of JAMA is
a theme issue devoted to articles about TB.
Symptoms vary depending on the patient's age and which organs are infected.
Fever and sweating (particularly at night)
Unexplained weight loss
Loss of appetite
Persistent cough that may be associated with bloody sputum
Difficulty breathing or chest pain with breathing
In addition to a complete medical history and physical examination,
your doctor will perform a test for TB by injecting under the skin of your
forearm a small amount of protein derived from TB bacteria. This area must
be examined 48 to 72 hours later by a doctor or nurse who will measure any
reaction at the injection site. If you have an active cough, your doctor will
obtain a sample of your sputum to examine for the bacteria. Your doctor may
also order a chest x-ray (a picture of the lungs)
to look for signs of the infection or blood tests to determine whether other
organs are infected.
Appropriate treatment usually requires a regimen of 3 to 4 antibiotics
taken daily for a minimum of 6 to 9 months. Treatment of multidrug-resistant
TB requires additional medications and may last as long as 2 years. Medications
are given under close supervision to ensure that all doses are taken and to
monitor for any adverse effects.
American Lung Association800/LUNG-USAhttp://www.lungusa.org
National Center for HIV, STD, and TB PreventionDivision
of Tuberculosis Elimination 404/639-8140http://www.cdc.gov/nchstp/tb
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA 's Web site at http://www.jama.com. Previous
Patient Pages on tuberculosis were published on April 19, 2000 (testing for
tuberculosis), August 18, 1999 (the global implications of tuberculosis),
and November 18, 1998 (controlling the spread of tuberculosis).
Source: American Lung Association
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate
in most instances, but they are not a substitute for medical diagnosis. For
specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied
noncommercially by physicians and other health care professionals to share
with patients. Any other print or online reproduction is subject to AMA approval.
To purchase bulk reprints, call 718/946-7424.
TOPIC: INFECTIOUS DISEASES
This article was corrected on 11/30/2005, prior to publication of the correction in print.
Ringold S, Lynm C, Glass RM. Tuberculosis. JAMA. 2005;293(22):2820. doi:10.1001/jama.293.22.2820