Respiratory

Pulmonary Tuberculosis — Clinical Reference

Last reviewed 2026-06-19 · TruelyserMD Clinical Reference
For Patients & General Readers

Pulmonary Tuberculosis (TB) is an infectious disease caused by bacteria that primarily affects the lungs. It spreads through the air when an infected person coughs, sneezes, or speaks. TB can be serious if not treated, leading to significant lung damage and potentially spreading to other parts of the body.

Clinical Overview

Pulmonary tuberculosis (PTB) is a chronic infectious disease caused by *Mycobacterium tuberculosis*, typically affecting the lungs. It is characterized by granulomatous inflammation and can manifest as active disease or latent infection, with reactivation posing a significant public health challenge.

Clinical Presentation

Signs & Symptoms

Symptoms (Patient-Reported)

  • Persistent cough
  • Coughing up phlegm or blood
  • Feeling tired all the time
  • Losing weight without trying
  • Fever
  • Chills
  • Night sweats
  • Pain in the chest

Signs (Clinician-Observed)

  • Cachexia (severe weight loss and muscle wasting)
  • Crackles or diminished breath sounds on auscultation
  • Hilar or mediastinal lymphadenopathy on imaging
  • Pleural effusion on imaging or physical examination

Differential Diagnoses

ConditionDistinguishing Feature
Bacterial PneumoniaTypically presents with more acute onset of fever, purulent sputum, and lobar consolidation on imaging; often responds rapidly to antibiotics.
Fungal PneumoniaMay present with similar symptoms but often occurs in immunocompromised individuals or endemic areas; diagnosis relies on fungal stains and cultures.
Lung CancerCan cause chronic cough, weight loss, and hemoptysis, but often presents as a discrete mass or nodule on imaging and may have other paraneoplastic syndromes.
SarcoidosisPresents with bilateral hilar lymphadenopathy and interstitial lung disease, but typically lacks caseating granulomas and systemic symptoms like night sweats and hemoptysis.
BronchiectasisCharacterized by chronic cough with copious purulent sputum and recurrent infections, but imaging shows dilated airways rather than infiltrates or cavities.
Non-tuberculous Mycobacterial (NTM) InfectionSymptoms can overlap with TB, but NTM infections are more common in patients with underlying lung disease and require specific culture identification.

Red Flags — Seek Immediate Care

Key Investigations

Management Overview

Management of pulmonary tuberculosis involves a multi-drug, directly observed therapy (DOT) regimen for at least six months, guided by drug susceptibility testing. Treatment aims to cure the infection, prevent transmission, and minimize the risk of drug resistance.

Disclaimer: This article is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. TruelyserMD does not replace clinical judgement.