Symptoms of recurrent pulmonary tuberculosis

People with successful TB treatment are still at high risk of relapse or re-infection. Identifying risk factors and symptoms for recurrent pulmonary TB can help set goals for screening and post-treatment care.

Symptoms of pulmonary TB recurrence are defined as the diagnosis of the next episode of TB disease after completion of treatment or resolution of the disease at the end of the most recent course of treatment. Tuberculosis recurrence occurs after the first episode is classified as clinically cured. According to WHO guidelines, cure is defined as smears and cultures of negative sputum samples from the last month of treatment, at least once prior.

Patients who have recently completed TB treatment are at high risk for recurrent TB disease, either due to relapse or reinfection. When individuals are diagnosed with recurrent TB, they are less likely to complete treatment and have a higher mortality rate than those with an initial episode.
Tuberculosis recurrence rates can vary due to differences in epidemiology and risk factors, ranging from 4.9 to 47 per 100,000 population. Risks for TB recurrence include:
Poor adherence to TB treatment, male gender, poverty and malnutrition; Smoking, alcoholism and substance abuse; Other comorbidities such as diabetes mellitus, renal failure and malignancy. These factors may increase the risk of relapse because they make small numbers of mycobacteria more likely to persist after treatment, or are related to immunosuppression that predispose individuals to higher morbidity. after reinfection.
Current World Health Organization (WHO) guidelines use the term “relapse” to describe all TB relapses during the programmatic assessment. The term is largely generic and incorporates relapse due to relapse or reinfection. Two mechanisms of TB recurrence exist as essentially independent forms of TB infection, with different pathogenesis and implications for patients and TB control programmes.

The symptoms of recurrent pulmonary tuberculosis have been reported to be variable in clinical and radiological symptoms and are clinically indistinguishable from primary TB. In general, the symptoms of recurrent pulmonary TB usually last slowly and can vary from weeks to months. However, in young children and HIV-coinfected patients, a more acute onset of illness has been reported. Typical symptoms such as fever, night sweats, weight loss, and persistent cough that do not go away are considered the most common symptoms, reported in approximately 95% of patients with TB.
Patients with cavernous lung disease, synonymous with recurrent tuberculosis, often present with a chronic cough, mainly accompanied by fever and/or night sweats, and weight loss. Cough can be sputum or non-sputum in nature. The patient is producing sputum that may be mucus or coughing up blood. Other symptoms include chest pain and shortness of breath. Chest radiographs play an important role in the diagnosis of patients who are negative for sputum smears.
Relapsing pulmonary tuberculosis is a condition in which a patient infected with pulmonary tuberculosis has been cured but is re-infected. Recurrent pulmonary tuberculosis can occur when the resistance is weakened and frequent contact with people infected with TB is required. Therefore, TB patients should consciously adhere to treatment and take measures to prevent disease recurrence.