27-year-old Pankaj Rana was shaken up when he found out that his persistent cough was more than just a seasonal infection. At the medical clinic, when he revealed he had been suffering from a cough since the past three weeks, the doctor immediately prescribed some tests. The results were shocking. He was in complete disbelief when he learned that he had Tuberculosis (TB). 

Harmless coughs can often be difficult to distinguish from the more dangerous ones. This confusion and overlapping nature of the symptom can lead to delayed diagnosis and treatment. In an interaction with the OnlyMyHealth team, Dr Sandeep Nayar, Principal Director & HOD, Pulmonology, BLK-Max Super Speciality Hospital, Pusa Road, New Delhi, discusses ways to identify a cough caused by seasonal infection and those that indicate TB. 

Also Read: How Long Does A Cough Last If You Have Tuberculosis (TB)

Cough Amid Changing Seasons

Dr Nayar said, “Variation in temperature provides an ideal environment for pathogens to thrive. Usually these pathogens, rather than weather, are responsible for illness and symptoms during a seasonal change.”

He added, “The most common infection during the changing season are the respiratory tract infections. Hence, many patients present with coughs, which are usually dry due to the inflammation or prevalent allergic reaction. “

In addition, patients may also experience coughs due to increase in pollution level especially when there is fog outside. “Polluted air, especially smoke, gets mixed with fog resulting in smog, which is very harmful and may cause dry irritating cough,” he explained further. 

How To Know If Your Cough Is Tuberculosis (TB)

According to Dr Nayar, TB usually manifests in the form of chronic coughs, which may be present for more than 2-3 weeks. 

Sharing the characteristics of a cough associated with TB, the doctor said, “It can be dry or productive (wet), and usually responds to antitubercular treatment… Cough in TB is also accompanied by low grade fever and loss of weight and appetite.”

“Occasionally a history of contact with tuberculosis patients in family or friends is also there,” he added, suggesting that it is always a challenge to distinguish tubercular cough from other causes but recommending a chest X-Ray and sputum examination, which can help in identifying the condition.

It is also important to note that TB infection can live in your body without making you sick. This is also known as latent TB infections. According to the US Centers for Disease Control and Prevention (CDC), one may have no symptoms, may not feel sick, may not be contagious, and may develop TB disease if they do not receive treatment on time. 

Other Warning Signs

Tuberculosis is caused by Bacteria Mycobacterium tuberculosis. Lungs are the most common organ involved, even though other organs in the body can also develop TB. Some of the most common symptoms associated with TB include: 

• Cough
• Breathlessness
• Expectoration or coughing up sputum 
• Hemoptysis or coughing of blood)
• Loss of appetite and weight 
• Fever (generally low grade)

Dr Nayar said, “Other symptoms may vary according to the site which is infected. Example burning micturition in urogenital TB, or bone pain with pus in TB osteomyelitis or so on.”

Also Read: Not Just Your Lungs, Tuberculosis Can Also Affect Other Organs In Your Body: Explained

TB Can Affect Other Organs Apart From The Lungs

TB is generally classified as ‘pulmonary’ when lungs are involved or ‘extrapulmonary’ when any other site other than lungs are involved,” explained Dr Nayar.  

He added, “Extrapulmonary TB involves lymph nodes, covering of lungs and heart, leading to accumulation of fluid known as pleural effusion, and pericardial effusion, respectively. TB may also affect the kidney, liver, bones, joints, skin, and spinal cord.”

Treatment Approach

When it comes to TB, a doctor requires a detailed medical history of the patient to confirm the diagnosis. 

Chest X-Ray and sputum examination helps in diagnosing pulmonary TB, whereas other investigations depend upon the organ involved. For instance, an X-Ray, MRI, or CT scan of bone and joint for bone TB. 

“Identifying the bacteria remains the gold standard for TB diagnosis,” said Dr Nayar, concluding that in case the bacteria can’t be cultured, biopsy of the tissue shows granulomatous inflammation point toward TB. Once the diagnosis is confirmed, the patient is started on antitubercular medication. If diagnosed early and the patient receives appropriate antitubercular medication for recommended duration, TB can be treated with high success.”