tuberculosis-symptoms-in-children

STARTLING FACTS ON ‘TUBERCULOSIS THE DISEASE’ & TB symptoms

Tuberculosis the disease, is known to exist for more than thousand years. It is also designated shortly as “TB”. Historical writings describe this as one of the most tragic diseases of all time. Tuberculosis symptoms can manifest in children in various ways. 

Believe it or not, some of these symptoms and signs of TB are so unusual, that a layman will barely suspect it to be tuberculosis. In this article we will talk over different types tuberculosis disease and TB symptoms in children. 

Prevalence of tb in adult and children

Global magnitude of Tuberculosis is quite high. As per WHO reports, in the year 2021 round about 10.6 million people got affected with tuberculosis disease. Out of which 1.2 million were children. 

Though Tuberculosis the disease, can pass on to a wide range of age groups, but severe form of tuberculosis is seen more in children compared to adults. However after BCG vaccine for tuberculosis came into play, rates of severe TB disease has dropped down significantly. 

Tuberculosis the disease in developed vs developing countries

Distribution of TB is not even. Tuberculosis is more prevalent in developing countries. Data suggest that, south east Asia and Africa carry maximum load of overall TB cases worldwide. And among all countries, India bears most disease burden of TB followed by China. 

Primary underlying reasons why tuberculosis is more prevalent in developing countries are as below:

  1. Unhygienic condition and lack of sanitation 
  2. Overcrowding, which favours droplet transmission of Tuberculosis bacteria from person to person through air 
  3. Environmental condition like temperature and humidity that promotes bacteria growth
  4. Malnutrition in children is again an independent risk factor for tuberculosis 

Tuberculosis infection vs tuberculosis the disease ; Latent vs Active tb

Tuberculosis infection is not same as tuberculosis the disease. You say it is “TB infection”when tuberculosis bacteria invade human body and stays there. It may or may not proliferate causing further symptom.

If after TB infection there is no symptom, then it is called “latent TB”. This accounts for around 90-95% of all infections. 

On the other hand if this TB infection manifests into symptoms, then this is labelled as “TB disease” or “Active TB”.

Important note: 

Thus TB disease is a subset of TB infection. 

WHAT ARE DIFFERENT TYPES OF TUBERCULOSIS & TB symptoms

Tuberculosis is a slow growing bacteria. But if diagnosis is missed, then it is potentially fatal. That is why recognizing tuberculosis symptoms early is vital. Accordingly we have discussed about tuberculosis symptoms in details here.

Mycobacteria can basically impact almost every organ in human body, provided there is blood supply to it. Based on what organ TB is affecting, it can be of various types as stated below.

 

  1. TB Lungs
  2. TB Pleura
  3. Lymph node tuberculosis 
  4. Tuberculosis of gut
  5. TB joints
  6. Spine TB
  7. Brain TB
  8. Skin TB
  9. Miliary Tuberculosis 
  10. Genital and Urinary TB

Ergo, tuberculosis can show up with a variety of symptoms. There is a funny saying about TB symptoms that –

“Tuberculosis can present with anything and everything, except pregnancy”.

Below we have detailed down types of tuberculosis the disease with its corresponding tuberculosis symptoms. 

1.TB of lungs / Tuberculosis lungs

tuberculosis-the-disease

Whatever TB cases I have seen so far as a physician, the most common variety is tuberculosis of lungs. Mycobacterium ( tuberculosis bacteria ) is fond of oxygen. That is why its preferred location is lungs. It can cause pneumonia, cavity and varieties of other abnormalities in lungs.

Symptoms of tuberculosis lungs are persistent cough, expectoration ( sputum in cough ), blood in sputum etc. Thus if someone has cough lasting for more than 2 weeks or there is blood tinged sputum then it could be TB lungs.

A typical feature of lung tuberculosis is persistent pneumonia, that may continue for more than a month. In case a child gets admitted for pneumonia and take course of antibiotics for it, but still there is no recovery then physicians consider TB lungs as a probable alternative diagnosis. 

Constitutional symptoms:

Whatever organ may tuberculosis infect, patient may suffer from constitutional symptoms. This is common to all types of TB . These include following,

 

  1. Fever with chills and night sweats 
  2. Poor appetite 
  3. Fatigue
  4. Weight loss 

 

Never shut eyes to these general ill-health symptoms.

 

2.TB of pleura

Pleura is the layer or membrane that covers both lungs. In general it is very closely attached to lungs. Off and on tuberculosis can affect pleura as well.

In pleural TB, there may be fluid accumulation between pleura and lungs, which is known medically as effusion. In pleural effusion, patient will endure breathlessness. 

At times there may be inflammation ( soreness ) of pleura. This is called ‘pleurisy’. Here patient will experience gruelling chest pain, especially during coughing or during breathing in deeply.

3.Lymphnode tuberculosis

It is common for TB to infect lymph-nodes or lymph glands ( in lay man’s language ). Here  painless swellings becomes evident especially on neck and arm pits. These may discharge out liquid material. 

4.Tuberculosis of gut

TB may localise to gut. This happens when a child consumes unboiled or unpasteurised milk, or else swallows its own infected sputum. 

Gut tuberculosis may unfold as pain in tummy, vomiting, distended abdomen ( features of gut obstruction ) or sometimes diarrhoea. 

5.TB joints

Tuberculosis can involve weight bearing joints. Knee and hip joints are most common in this regard. Here patient complains of joint pain, swelling around joints and stiffness of joints. Patient may struggle while walking too.

6.Spine TB

Tuberculosis the disease may involve spine. Doctors call it as “Pott spine”. This disease progresses at a slow pace. Presenting symptoms are back pain, spine deformity along with other constitutional symptoms like fever, weight loss, fatigue etc. If not treated, then it leads to paralysis of legs. 

7.Brain TB

Membrane that covers brain and spinal cord is called meninges. When TB bacteria infect meninges it is called TB meningitis. Children less than 4 years age, in developing countries are more at risk of TB meningitis. 

Classic symptoms of TB meningitis are as below 

 

  • severe headache 
  • vomiting 
  • altered mental status 
  • stiff neck
  • seizure or fits 
  • paralysis of limbs, face etc. 

BCG vaccine of tuberculosis defends against severe tuberculosis diseases like TB meningitis. Thus every newborn in developing countries should receive this vaccine. 

ALSO READ : WHO SHOULD RECEIVE BCG VACCINE ?  Latest tuberculosis vaccine schedule simplified

Tuberculosis of brain may cause leison inside brain tissue called ‘tuberculoma’. This again can induce seizure and paralysis. 

8.Skin TB

Rarely TB bacteria may infiltrate into skin. In this type of tuberculosis, the lesion is a reddish to yellowish bump ( papule or nodule ). Sometimes it may ulcerate.

9.Miliary Tuberculosis

This is a serious form of TB that occurs especially in individuals with low immunity. It is more common in children less than 4 years of age. Because of reduced immunity, tuberculosis bacteria circulates through blood and disseminates all over body. 

This results in multiple small 1-2mm ( millet sized ) foci of bacteria in various organs particularly in lungs, liver and bone marrow etc. This is a potentially lethal condition. 

 

10.Genital and Urinary TB

Tuberculosis can possibly affect genital system as well as urinary system ( including kidney ). Signs of involvement of genital system are pain and swelling over lower abdomen, menstrual irregularities, infertility etc. 

If urinary system is affected there may be increased frequency of passing urine, urgency of urination, pain and burning sensation etc. Also there may be cloudy urine or blood in urine. 

Challenges in tuberculosis treatment

mdr-and-xdr-tb-challenging-treatment-of-tuberculosis-lungs
Following two main challenges physician are facing for tuberculosis treatment.

Because of increase incidence of HIV, tuberculosis cases are also going up. Basically lack of immunity in a person makes him/her susceptible to Tuberculosis.

MDR-TB  ( Multi Drug Resistance TB ) and XDR-TB  ( Extensively Drug resistant TB ) , are two conditions where a TB patient doesn’t respond to conventional anti tuberculosis medications.

 

Conclusion

Tuberculosis is such an infectious disease that sets off around 4.5 lac deaths in children per year. Severe tuberculosis can be prevented by using BCG vaccine. Also Tuberculosis disease is completely curable by anti-tuberculosis medications.

“The goal here is early diagnosis and treatment.”

Share this article to maximum, so that people, especially parents will become aware about symptoms of TB early. 

Caution

All the informations provided here are for educational and awareness purpose only. Kindly do not use these as alternative to medical consultation.

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