Type of Symptoms/signs Diagnosis Complications

Disease
TB in general Fever (up to 80% Tuberculin skin test (but may
patients), loss of appetite, be negative early, in
weight loss, night sweats, disseminated disease or if
lassitude immunocompromised)
Chest x-ray
Microscopy, culture or
histology of relevant
tissue/body fluid
Primary Usually symptomless or Tuberculin skin test Pressure on bronchi
infection mild illness resolving Chest x-ray causing cough, wheeze,
spontaneously lung collapse
Erythema nodosum Caseation/rupture of
parabronchial or
paratracheal nodes
Pulmonary Cough, sputum (usually Chest x-ray (abnormal in Pleural effusion
(lung) purulent, sometimes nearly all cases) Haemorrhage from the
blood-streaked) Sputum microscopy/culture lungs
Aching or pleuritic chest Pleural biopsy TB empyema or
pain discharging sinus
Lymph nodes, Usually painless, slowly Microscopy/culture of Abscess, rupture with
e.g. neck, groin, enlarging nodes, often aspirated pus or biopsy resulting discharging
mediastinum bilateral material sinus
Mediastinum: cough Mediastinal nodes may
erode trachea, bronchi
or major blood vessels.
Orthopaedic Back pain, local X-ray Psoas abscess
(bone/joint), tenderness, rarely nerve Biopsy Abscess of long bones
most commonly root pain, kyphosis with extending into joints
spine (Pott’s or without paraparesis or Permanent damage to
disease), also paraplegia joints
knee, ankle, hip, Pain in relevant
any other bone bone/joint
or multiple sites
Abdominal Intestinal tract: diarrhoea, X-ray Bowel obstruction
abdominal pain, rapid Biopsy
weight loss Peritoneal aspiration/biopsy
Peritoneal: chronic
recurrent abdominal pain,
bowel irregularity,
abdominal swelling
Pericarditis Chest pain, shortness of X-ray, pericardial Heart failure
(Heart) (‘dry’ or breath, pericardial rub aspiration/biopsy
with pericardial
effusion)
Genito-urinary Kidney may be X-ray Cold abscess
(kidney, ureter, symptomless for years; Microscopy/culture of early Chronic renal
bladder) loin pain, back ache morning urine insufficiency
Frequency, dysuria, Cystoscopy and biopsy Hydronephrosis due to
haematuria (usually ureteric obstruction
microscopic though may Ulceration/fibrosis
be frank) and/or shrinkage of
Ureteric colic bladder
Haematuria/pyuria with
sterile urine on routine
culture
TB meningitis Headache, nausea and X-ray Permanent neurological
Tuberculoma vomiting, drowsiness, Microscopy/culture of CSF deficit
irritability, behavioural
change, epilepsy, altered
consciousness
Disseminated Dry cough, Chest x-ray (but may be Pleural effusion(s)
(miliary) breathlessness normal) Organ failure
Choroidal tubercles Microscopy/culture of
sputum, urine, blood, pleural
fluid etc
Microscopy/culture/histology
of biopsy material, e.g. liver,
lymph node, bone marrow,
bronchoscopic lung biopsy
Skin (lupus Ulcerating granulomas of Microscopy/culture of
vulgaris). the skin, usually face discharge or biopsy material
Read the story
of M - a boy in
Malawi
Larynx Hoarseness of voice Sputum microscopy Usually associated with
Pain Laryngoscopy/biopsy advanced pulmonary
Dysphagia TB