Symptoms of Pulmonary Tuberculosis

Systemic symptoms of pulmonary tuberculosis include persistent low-grade or high fever, fatigue, weakness, weight loss, and night sweats. Respiratory symptoms include cough, sputum production, hemoptysis, chest pain, and dyspnea.

Systemic Symptoms

1. Fever: Mostly low-grade fever in the afternoon, usually below 38°C. In severe cases and acute miliary tuberculosis, the temperature may exceed 39°C. Patients often feel hot in their hands and feet, with flushed cheeks.
2. Fatigue and Weakness: Easily fatigued with generalized weakness that persists even after rest.
3. Night Sweats: Excessive sweating during sleep, particularly on the neck, armpits, and genitals, sometimes soaking through undergarments in severe cases.
4. Loss of Appetite and Weight Loss: Gradual weight loss due to decreased appetite.
5. Menstrual Irregularities: Female patients may experience reduced menstrual flow, irregular menstruation, or even amenorrhea.

Respiratory Symptoms

1. Cough and Sputum Production: Patients with hematogenous or mild tuberculosis present with dry cough or small amounts of white sputum. Severe cases with caseous cavities or destructive tuberculosis exhibit severe coughing with increased sputum, often purulent when combined with infection.
2. Chest Pain: Occurs when tuberculosis affects the parietal pleura, causing inflammation or adhesion. Pain intensifies with coughing, deep breathing, or changes in posture.
3. Hemoptysis: Common when lung blood vessels are damaged. The amount of blood varies depending on the location and size of the vessel injury. Sputum tinged with blood can result from capillary damage in inflammatory lesions, while full-blood sputum is caused by small arteriovenous injuries. Massive hemoptysis involves large vessels, especially the pulmonary artery. In addition to hemostatic agents, patients with hemoptysis should undergo examinations such as chest X-rays and sputum tests to identify the cause.
4. Dyspnea: Typically absent in most patients, except in severe cases of pleurisy or extensive lung lesions, which may lead to dyspnea, shortness of breath, or cyanosis.

Clinically, the severity of symptoms in pulmonary tuberculosis patients often does not correlate directly with the extent of lung lesions. Some patients may be asymptomatic and only detected during routine physical examinations.