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ymptoms and Complications Pulmonary Tuberculosis: Cough is the most common symptom of tuberculosis.

Because the disease develops slowly, infected people at first may blame the cough on smoking, a recent episode of flu, the common cold, or asthma. The cough may produce a small amount of green or yellow sputum in the morning. Eventually, the sputum may be streaked with blood, although large amounts of blood are rare. People may awaken in the night and be drenched with a cold sweat, with or without fever. Sometimes there is so much sweat that people have to change nightclothes or even the bed sheets. However, tuberculosis does not always cause night sweats, and many other conditions can cause night sweats. People also feel generally unwell, with decreased energy and appetite. Weight loss often occurs after they have been ill for a while. Rapidly developing shortness of breath plus chest pain may signal the presence of air (pneumothoraxsee Pleural Disorders: Pneumothorax) or fluid (pleural effusion) in the space between the lungs and the chest wall (see Pleural Disorders: Pleural Effusion). About one third of tuberculosis infections first show up as pleural effusion. Eventually, many people with untreated tuberculosis develop shortness of breath as the infection spreads in the lungs. Extrapulmonary Tuberculosis: The kidneys and lymph nodes are probably the most common sites for tuberculosis that develops outside the lungs. Tuberculosis can also affect the bones, brain, abdominal cavity, membrane around the heart (pericardium), joints (especially weightbearing joints, such as the hips and knees), and reproductive organs. Tuberculosis in these areas can be difficult to diagnose. Infectious Arthritis

Symptoms of extrapulmonary tuberculosis are vague, usually with fatigue, poor appetite, intermittent fevers, sweats, and possibly weight loss. Sometimes the infection causes pain, discomfort, a collection of pus (abscess), or other symptoms, depending on the area involved:

Lymph nodes: In a new tuberculosis infection, the bacteria may travel from the lungs to the lymph nodes that drain the lungs. If the body's natural defenses can control the infection, it goes no further, and the bacteria become dormant. However, very young children have weaker defenses, and in them, these lymph nodes may become large enough to compress the bronchial tubes, causing a brassy cough and possibly a collapsed lung. Occasionally, bacteria spread up the lymph vessels to the lymph nodes in the neck. An infection in lymph nodes in the neck may break through the skin and discharge pus.

Brain: Tuberculosis that infects the tissues covering the brain (tuberculous meningitis) is life threatening. In the United States and other developed countries, tuberculous meningitis most commonly occurs among older people or people with a weakened immune system. In developing countries, tuberculous meningitis is most common among children from birth to age 5. Symptoms include fever, constant headache, neck stiffness, nausea, and drowsiness that can lead to coma. Tuberculosis may also infect the brain itself, forming a mass called a tuberculoma. The tuberculoma may cause symptoms such as headaches, seizures, or muscle weakness. Pericardium: In tuberculous pericarditis, the pericardium thickens and sometimes leaks fluid into the space between the pericardium and the heart. These effects limit the heart's ability to pump and cause swollen neck veins and difficulty breathing. In parts of the world where tuberculosis is common, tuberculous pericarditis is a common cause of heart failure. Intestine: Intestinal tuberculosis occurs mainly in developing countries. This infection may not cause any symptoms but can cause abnormal swelling of tissues in the abdomen. This swelling may be mistaken for cancer.

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