1. Symptoms of Lung TB:

“Long-standing cough + low-grade fever + weight loss = think TB”.

Long-standing cough and low-grade fever coupled with weight loss are the commonest symptoms, because TB occurs mostly (80%) in the lungs.

So, the first real clue to TB is: A long duration of sickness (e.g. ‘cough & low grade fever’) with ‘weight loss’; more so if the person also has one of the following 2 conditions:

  • He has had in the past a close contact with an infective TB patient (say a family member).
  • Or, he has a risk factor that makes a person more vulnerable to TB, once infected e.g.:


HIV infection.

Low immunity as is likely in poverty, under-nourishment, drug addiction, alcoholism etc.

Prolonged medication with:

Steroids (which are administered in asthma, skin disorders or fussy joint pains etc.).

Or some immunosuppressive drug (as given after organ transplant etc.).

In a high burden country like India where TB is common, all such high-risk individuals must remain extra vigilant and forewarned if ever “an illness of long duration with weight loss” should start to brew in them.

Please, always maintain a high index of suspicion in your mind, which is the key to early diagnosis. And don’t you worry; over-suspecting doesn’t hurt anyone; simple tests will easily rule out TB if that is so.

An illness of long duration + weight loss = suspect TB & investigate.

No awareness = No suspicion = No investigation = No diagnosis = No treatment = No cure.

Uncommonly, the person may cough out blood; the symptom triggers alarm – the ensuing panic in fact helps clinch early diagnosis – TB or no TB.


2. TB of organs other than lungs (Extra-pulmonary):

“Long duration of symptoms + low grade fever + weight loss = Think TB

(Please notice ‘cough’ stands replaced here with ‘symptoms’, which could be any and wide-ranging)

Even though TB occurs mostly in the lungs, it can occur anywhere in the human body – from head to toe, e.g. lymph nodes, bones, joints, intestines, liver, kidneys or genitals etc. In such cases, local symptoms will naturally vary widely – according to the organ affected e.g.:

  1. Palpable glands (often glued together in the form of a cluster) around the neck, underarms or groin etc.
  2. Persistent swelling over a bone or a joint.
  3. Deformity of backbone.
  4. A palpable mass or fluid collection in the abdomen.
  5. Chest pain, breathlessness and chest X-ray reveals fluid in pleural cavity or round shadows of glands.

The clinical picture, at times, can be quite confusing, even for doctors. However, a trained mind can discern the underlying “long duration of symptoms, low grade fever and weight loss”, which is invariably present, enough at least to arouse suspicion of TB – the first crucial step.

That’s why a temperature chart and weight records are invaluable tools for diagnosis.

‘Long duration of illness’ is the key pointer since TB is by nature a chronic disease. ‘What exactly are the symptoms’ is often less significant; ‘how long they have been troubling’ could be more suggestive of TB. Therefore, ask the patient “When were you absolutely alright?” This may turn out to be the most rewarding direct question by establishing the chronic nature.