Primary infection is usually asymptomatic, with active disease usually representing secondary reactivation.Onset can be insidious and non-specific.When symptoms occur, there are often systemic features: fatigue, malaise, fever, night sweats, weight loss, anorexia, and immunosuppression.
Chronic productive cough ± haemoptysis, clubbing.Can progress to pneumonia, pleural effusion, lobar collapse, and bronchiectasis.Accounts for 60% of TB cases in UK.
Frequency, dysuria, loin/back pain, haematuria.Can progress to renal TB, salpingitis, epididymitis, and cystitis.2nd commonest TB presentation in UK.
Skeletal TB: most commonly affects spine (Pott's disease). Can lead to vertebral collapse.Skin TB (aka lupus vulgaris): rough nodules, often on the face or shin, which are +ve for AFB. Other TB skin manifestations include scrofula ('cold' cervical lymphadenopathy), erythema nodosum, and erythema multiforme.Peritoneal TB: abdominal pain, diarrhoea, vomiting, ascites.TB meningitis: neurological signs are usually preceded by weeks of systemic symptoms. TB can also cause tuberculomas: tubercles in the brain.TB pericarditis: acute or constrictive pericarditis.
Affects multiple organs so symptoms are varied; there are often retinal signs.