Post-tuberculosis lung disease (PTLD) is ongoing lung disease that is caused by tuberculosis (TB) but persists after the infection is cured. [1] PTLD can affect the airways, lung parenchyma, pulmonary vasculature, and pleura. [2]
Post-tuberculosis lung disease (PTLD) is ongoing lung disease that is caused by tuberculosis (TB) but persists after the infection is cured. [1] PTLD can affect the airways, lung parenchyma, pulmonary vasculature, and pleura. [2]
PTLD affects a substantial proportion of TB survivors [3] (of whom there were an estimated 155 million globally in 2020), estimated as much as 50 percent overall and more than 70 percent in survivors of multi-drug-resistant tuberculosis. [4] Around 10 percent have lost more than half of their lung function. [4] Delayed diagnosis of TB, multidrug-resistant tuberculosis, and repeated TB infections are correlated with greater incidence of PTLD. [2] People who have HIV are less likely to have PTLD, possibly because of their impaired immune response. [2] [3] Cigarette smokers are 25% more likely to have lung damage, and more severe damage, after cure of a TB infection. [5] People who cook with 3-4 stoves instead of 1-2 stoves are more likely to have lung damage. A lack of heating also increased how often symptoms occurred. Alcoholism also increased the risk of PTLD. Ambient air pollution did not increase the risk of PTLD. These kinds of pollution include methods of household lighting; modes of household ventilation; secondary cigarette smoking; urban, rural or traffic exposures. Food insecurity, eating cereals, and consuming oily food were strongly associated with symptomatic PTLD. Eating fruits and drinking juice at least once a week were associated with reduced odds of developing symptomatic PTLD. [6] Co-infection may make lung damage worse, and thus vaccination is recommended to prevent PTLD. [1] [2] Many studies have found a link between TB and later diagnosis with chronic obstructive pulmonary disease. [7]
A large number of people who survived tuberculosis still experience symptoms such as breathlessness and coughing. Although the severity is not well understood, some people have reduced quality of life and exercise capacity. [4] [2] In severe cases, people may experience hospitalizations and death related to respiratory causes. [2]
There is no accepted diagnosis criteria for PTLD, and existing research does not use a clearly defined study population. [7] [8]
Common radiological findings after TB include lesions to the airway, such as obstructive lung disease and bronchiectasis, lesions to the parenchyma, such as calcification, fibrosis, and Aspergillosis, chronic pleural disease, pulmonary hypertension, and other findings. [5] Radiological findings are distinct from chronic obstructive pulmonary disease (COPD) associated with cigarette smoking, although symptoms are similar. [5]
Although prospective data is not available, it is believed that people with PTLD have a lower life expectancy and higher risk of TB recurrence compared to those not affected. [2] Besides PTLD, tuberculosis survivors may be afflicted with "cardiovascular and pericardial disorders, neurological impairments, as well as psychological and socioeconomic effects.". [4]
PTLD is not mentioned in most TB treatment guidelines, or in the World Health Organization (WHO)'s End TB strategy. [9]
Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severity of the condition is variable.
Alpha-1 antitrypsin deficiency is a genetic disorder that may result in lung disease or liver disease. Onset of lung problems is typically between 20 and 50 years of age. This may result in shortness of breath, wheezing, or an increased risk of lung infections. Complications may include chronic obstructive pulmonary disease (COPD), cirrhosis, neonatal jaundice, or panniculitis.
Bronchiectasis is a disease in which there is permanent enlargement of parts of the airways of the lung. Symptoms typically include a chronic cough with mucus production. Other symptoms include shortness of breath, coughing up blood, and chest pain. Wheezing and nail clubbing may also occur. Those with the disease often get lung infections.
Nontuberculous mycobacteria (NTM), also known as environmental mycobacteria, atypical mycobacteria and mycobacteria other than tuberculosis (MOTT), are mycobacteria which do not cause tuberculosis or leprosy/Hansen's disease. NTM are able to cause pulmonary diseases that resemble tuberculosis. Mycobacteriosis is any of these illnesses, usually meant to exclude tuberculosis. They occur in many animals, including humans and are commonly found in soil and water.
Radiology (X-rays) is used in the diagnosis of tuberculosis. Abnormalities on chest radiographs may be suggestive of, but are never diagnostic of TB, but can be used to rule out pulmonary TB.
Tuberculosis is diagnosed by finding Mycobacterium tuberculosis bacteria in a clinical specimen taken from the patient. While other investigations may strongly suggest tuberculosis as the diagnosis, they cannot confirm it.
Pulmonary fibrosis is a condition in which the lungs become scarred over time. Symptoms include shortness of breath, a dry cough, feeling tired, weight loss, and nail clubbing. Complications may include pulmonary hypertension, respiratory failure, pneumothorax, and lung cancer.
Miliary tuberculosis is a form of tuberculosis that is characterized by a wide dissemination into the human body and by the tiny size of the lesions (1–5 mm). Its name comes from a distinctive pattern seen on a chest radiograph of many tiny spots distributed throughout the lung fields with the appearance similar to millet seeds—thus the term "miliary" tuberculosis. Miliary TB may infect any number of organs, including the lungs, liver, and spleen. Miliary tuberculosis is present in about 2% of all reported cases of tuberculosis and accounts for up to 20% of all extra-pulmonary tuberculosis cases.
Respiratory diseases, or lung diseases, are pathological conditions affecting the organs and tissues that make gas exchange difficult in air-breathing animals. They include conditions of the respiratory tract including the trachea, bronchi, bronchioles, alveoli, pleurae, pleural cavity, the nerves and muscles of respiration. Respiratory diseases range from mild and self-limiting, such as the common cold, influenza, and pharyngitis to life-threatening diseases such as bacterial pneumonia, pulmonary embolism, tuberculosis, acute asthma, lung cancer, and severe acute respiratory syndromes, such as COVID-19. Respiratory diseases can be classified in many different ways, including by the organ or tissue involved, by the type and pattern of associated signs and symptoms, or by the cause of the disease.
Aspergillosis is a fungal infection of usually the lungs, caused by the genus Aspergillus, a common mould that is breathed in frequently from the air, but does not usually affect most people. It generally occurs in people with lung diseases such as asthma, cystic fibrosis or tuberculosis, or those who are immunocompromised such as those who have had a stem cell or organ transplant or those who take medications such as steroids and some cancer treatments which suppress the immune system. Rarely, it can affect skin.
Bird fancier's lung (BFL), also known as bird breeder's lung, is a type of hypersensitivity pneumonitis. It can cause shortness of breath, fever, dry cough, chest pain, anorexia and weight loss, fatigue, and progressive pulmonary fibrosis. It is triggered by exposure to avian proteins present in the dry dust of droppings or feathers of a variety of birds. The lungs become inflamed, with granuloma formation. It mostly affects people who work with birds or own many birds.
Bronchitis is inflammation of the bronchi in the lungs that causes coughing. Bronchitis usually begins as an infection in the nose, ears, throat, or sinuses. The infection then makes its way down to the bronchi. Symptoms include coughing up sputum, wheezing, shortness of breath, and chest pain. Bronchitis can be acute or chronic.
Obstructive lung disease is a category of respiratory disease characterized by airway obstruction. Many obstructive diseases of the lung result from narrowing (obstruction) of the smaller bronchi and larger bronchioles, often because of excessive contraction of the smooth muscle itself. It is generally characterized by inflamed and easily collapsible airways, obstruction to airflow, problems exhaling, and frequent medical clinic visits and hospitalizations. Types of obstructive lung disease include asthma, bronchiectasis, bronchitis and chronic obstructive pulmonary disease (COPD). Although COPD shares similar characteristics with all other obstructive lung diseases, such as the signs of coughing and wheezing, they are distinct conditions in terms of disease onset, frequency of symptoms, and reversibility of airway obstruction. Cystic fibrosis is also sometimes included in obstructive pulmonary disease.
Restrictive lung diseases are a category of extrapulmonary, pleural, or parenchymal respiratory diseases that restrict lung expansion, resulting in a decreased lung volume, an increased work of breathing, and inadequate ventilation and/or oxygenation. Pulmonary function test demonstrates a decrease in the forced vital capacity.
An acute exacerbation of chronic obstructive pulmonary disease, or acute exacerbations of chronic bronchitis (AECB), is a sudden worsening of chronic obstructive pulmonary disease (COPD) symptoms including shortness of breath, quantity and color of phlegm that typically lasts for several days.
Alcoholic lung disease is disease of the lungs caused by excessive alcohol. The term 'alcoholic lung disease' is not a generally accepted medical diagnosis, and "the association between alcohol abuse and acute lung injury remains largely unrecognized, even by lung researchers".
Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by chronic respiratory symptoms and airflow limitation. GOLD 2024 defined COPD as a heterogeneous lung condition characterized by chronic respiratory symptoms due to abnormalities of the airways and/or alveoli (emphysema) that cause persistent, often progressive, airflow obstruction.
Chronic pulmonary aspergillosis is a long-term fungal infection caused by members of the genus Aspergillus—most commonly Aspergillusfumigatus. The term describes several disease presentations with considerable overlap, ranging from an aspergilloma—a clump of Aspergillus mold in the lungs—through to a subacute, invasive form known as chronic necrotizing pulmonary aspergillosis which affects people whose immune system is weakened. Many people affected by chronic pulmonary aspergillosis have an underlying lung disease, most commonly tuberculosis, allergic bronchopulmonary aspergillosis, asthma, or lung cancer.
Emphysema is any air-filled enlargement in the body's tissues. Most commonly emphysema refers to the permanent enlargement of air spaces (alveoli) in the lungs, and is also known as pulmonary emphysema.
Diagnostic delay is the time interval between the onset of symptoms and confirmed diagnosis of a disease. For a variety of reasons, including the mitigation of disease severity and financial expense, it is desirable for this delay to be minimized.