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Tuberculosis is a very common global disease and will present with bizarre lesions on an X-ray. It is something that your doctor may not have considered during his initial tests, depending on where you live, but do not forget about this dangerous disease.

Irregular or suspicious densities on the lungs are red flags for doctors when performing a routine chest X-ray. Most of the time, they are benign findings but it is possible that it could be a lesion of a lung cancer or a sign of a lung infection that will require further diagnosis. Pneumonia, bronchitis, and COPD are all common lung diseases that can have irregular chest X-rays but a diagnosis that doctors cannot forget about would be tuberculosis. Although this is a disease that is far less common than it once was, it is still a very possible bacteria to contract in the modern world. Here, we will cover some of the warning signs of tuberculosis and what you need to know about it. 

What is Tuberculosis? 

Tuberculosis (TB) may not be a disease you have heard of before but according to the World Health Organization (WHO), it is believed that currently, 2 billion people are infected with this disease, which is roughly 33 percent of the global population [1]. Tuberculosis (TB) is a bacteria that is found on every continent and most of the time, it will present without any symptoms. This is because TB has two distinct phases: an active phase and a latent phase.

As you can imagine, the active phase is when patients will present with noticeable symptoms of the disease while the latent phase occurs when a patient has the disease but it is not actively replicating or causing any symptoms [2]. Most of the time, this bacteria will be in a silent hibernation. 

Tuberculosis is caused by the bacteria Mycobacterium tuberculosis and can be spread through water or the air.

That's right, even breathing the same air as someone who actively has the disease can pass the infection along to you [3]. It will be an infection that typically migrates into the lungs and remains there for the duration of your life if you do not treat it. What makes this disease so dangerous is that it is able to also travel throughout your body and seems to target the testicles and brain most often in infected cases [4]. 

Traveling abroad can be one of the best ways to contract TB. Areas that seem to be the highest risk to tourists would be traveling to areas like sub-Sahara Africa, Eastern Europe, Southeastern Asia and South America. However, North America, Europe, and Australia still have a moderate risk for the disease. [5]

When Should You Suspect a TB Infection

Now that I have thoroughly scared you, I should point out that even if it is a very common global disease, roughly 1 million people die every year from the disease. On a global scale, that is a relatively small number and it is due to the fact that it is a very treatable disease.

You can begin to suspect that you have an active form of TB when you notice a persistent cough that does not resolve after 3 weeks.

Patients can even cough up blood in more aggressive forms of the disease. You may also have pain while breathing and will notice an unintentional weight loss even when you are eating your regular diet. A fever, night sweats and chills round-out the most likely symptoms that you will have with this disease. [6]

You should come to your doctor immediately if you notice any of the symptoms I have listed above. The longer you wait, the more likely you can spread the infection to a larger group of people, which this is a very serious matter.

You will start your diagnostic workup by having a chest X-ray: 

If you truly have TB, you will find a lesion in the upper lobes of your lung. The bacteria love this area of your lung because it has the highest concentration of oxygen and it will create a cocoon to live in while in the dormant phase. This protective barrier will make it hard for your immune system to launch a proper attack against the pathogen. [7] A TB skin test, also called the Mantoux test, can also be utilized to see if you have an active infection of this disease [8]. 

Once a doctor has seen the warning signs of tuberculosis and the suspicious density on the lungs, it is time for your treatment to begin to eradicate the bacteria. There is a combination of 4 medications that you will be prescribed in order to fight the bacteria, referred to as RIPE therapy.

You have to be aware that treatment with prophylactic medications will come with a combination of side effects that will make your life difficult during the treatment period. [9] There is some flexibility with your treatment so if side effects become too bothersome, medications can be switched out in some cases [10]. Treatments should last at least 9 months and close members of your family should also take prophylactic medications to make sure they do not contract the disease. 

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