Pediatrics Common Questions, Quick Answers

TB (Tuberculosis)

Donna D'Alessandro, M.D.
Lindsay Huth, B.A.
Peer Review Status: Internally Reviewed
Creation Date: October 2001
Last Revision Date: April 2002

Common Questions, Quick Answers

• What is tuberculosis?
• Who can get TB?
• What are the symptoms of TB?
• Is TB contagious?
• What are skin tests?
• How is TB treated?
• How long does TB last?
• How can TB be prevented?
• When should I call the doctor?

What is tuberculosis?

• Tuberculosis, or TB, is a disease caused by a bacterial infection.
• TB infects tissues in the human body, most commonly, the lungs. It makes small tumors that destroy the tissue.
• When the body is first infected, it's called primary TB. Healthy bodies can usually fight this infection.
• If the body's immune system can't fight the infection, the person will get pulmonary (in the lungs) TB.
• TB bacteria can stay in the body. The person will not be sick, then, weeks or even years later, it could cause another infection (called reactivation TB).

Who can get TB?

• Most people's bodies are strong enough to fight a TB infection with the help of medication.
• Infants are at greater risk of getting pulmonary TB because they have weak immune systems.
• The elderly, people with AIDS, people on chemotherapy, and people taking certain drugs also have weak immune systems. They are at greater risk of getting pulmonary TB because their bodies can't fight the infection. For the same reason, they are also at greater risk for getting reactivation TB.
• People living in unclean and crowded places are more likely to get TB.
• People who do not have healthy food to eat are more likely to get TB.

What are the symptoms of TB?
Most people with primary TB will not show symptoms, or symptoms will be mild. People with pulmonary TB or reactivation TB are more likely to show symptoms, and symptoms will be worse. Symptoms could include:

• Mild cough or coughing up blood
• Mild fever
• Weight loss, loss of appetite
• Feeling tired
• Wheezing
• Diarrhea, sweating
• Joint pain, chest pain, pain in the spine
• Clubbing (thickening fingers and toes), swollen glands

Some people with TB do not have symptoms. They only know they have TB because they had a positive skin test.

Is TB contagious?

• Yes. TB is contagious, but it is hard to spread.
• TB is spread by contact with infected persons or items. Bacteria can spread through sneezing and coughing.
• An infected person is contagious until 2-4 weeks after the start of treatment.

What are skin tests?

• There are two kinds of skin tests. One has tiny pins on a round button that is gently pressed into the skin on the arm. This is called a tine test and isn't used anymore.
• The other test is a tiny shot that is put in the skin and makes a little bubble on the arm. This is called a PPD or Mantoux test.
• The tests are read by a doctor or nurse 48-72 hours after they are put on the arm.
• Redness and a bump on the arm more than 10 millimeters (mm.) in length (or 1/2 inch) are signs of a positive test. The person should have more tests.
• BCG is a vaccine that helps prevent TB. People who have had BCG before may still have some redness and swelling after a skin test. Swelling and redness should not be greater than 10 mm. If so, the person needs more tests.

How is TB treated?

• If your child has symptoms of TB or has been exposed to TB, call the doctor.
• The doctor will take tests to see if your child has TB. The doctor usually starts by listening to the chest and will take a skin test if needed. If the skin test is positive, the doctor will take a chest x-ray and may take a culture (body fluid) test.
• Treatment for TB should begin soon after a positive test. Without treatment, the disease will get worse.
• Treatment helps the body fight the TB infection. Your child might have to take medication for 1 year. Some medications have side effects.
• Your child might have to take many different medications. It is important to take ALL of the medicine every day until the doctor says to stop.
• A child with TB may have to stay in the hospital so others do not catch the infection. People with TB should wear masks so the infection is not spread.

How long does TB last?

• A child infected with TB is contagious for 2-4 weeks after the start of treatment. She can play outside after these weeks.
• Symptoms usually get better in 2-3 weeks with treatment.

How can TB be prevented?

• Have children tested to prevent the spread of infection.
• Infants are tested for TB during routine exams, usually at 1 year old and again when the child is 5.
• Avoid contact with someone who has TB.

When should I call the doctor?

• Call the doctor if your child has been exposed to TB or had a positive skin test. She will need to be tested for TB at once.
• Call the doctor if your child has symptoms of TB or if symptoms don't get better with treatment.
• Call the doctor if your child gets new symptoms of TB.

  For more information about TB, contact:

  National Institute of Allergy and Infectious Disease

  Office of Communications

  Building 31, Room 7A-50

  31 Center Drive MSC 2520

  Bethesda, MD 20892-2520

  www.niaid.nih.gov

  Centers for Disease Control and Prevention

  1600 Clifton Rd., NE

  Atlanta, GA 30333

  Telephone: (404) 639-3311

  www.cdc.gov

  The American Lung Association

  Telephone: 1-800-LUNG-USA

  www.lungusa.org

Quick Answers

• Tuberculosis, or TB, is a disease that infects tissues in the human body, usually the lungs. It is caused by a bacterial infection.
• People with weak immune systems, people living in unclean and crowded places, and people who don't have healthy food to eat are more likely to get TB.
• Symptoms are usually mild and could include fever, coughing, wheezing, and pain.
• TB is contagious. It is spread by contact with infected persons or items.
• Skin tests help the doctor find out if you have TB.
• Treatment for TB should begin soon after a positive test.
• Symptoms usually get better in 2-3 weeks with treatment.
• Have children tested to prevent the spread of infection and avoid people with TB.
• Call the doctor if your child has been exposed to TB or if she has symptoms of TB.

References

• InteliHealth. Tuberculosis. 1999 March 2 (cited 2001 September 20). Available from: URL: http://www.intelihealth.com/IH/ihtPrint/WSIHW000/20722/10903.html?k=basePrint
• KidsHealth. Tuberculosis. (cited 2001 September 20). Available from: URL: http://www.kidshealth.org/PageManager.jsp?dn=KidsHealth&lic=1&ps=107&cat_id=&article_set=22844
• Lambert JG M.D. Pulmonary Tuberculosis. MEDLINEplus. 2001 May 16 (cited 2001 September 20). Available from: URL: http://www.nlm.nih.gov/medlineplus/ency/article/000077.htm#visualFile
• Mayo Clinic. Tuberculosis. 2001 April 22. Available from: URL: http://www.mayoclinic.com/home?id=DS00372&
• Medlineplus. Tuberculosis. Adam.com. 2001 May 16 (cited 2001 September 25). Available from: URL: http://www.nlm.nih.gov/medlineplus/ency/imagepage/17181.htm

See related Patient Topics Infections, Lungs and Breathing or Tuberculosis.

See related Provider Topics Infections, Lungs and Breathing or Tuberculosis.

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