Early tuberculosis has no conscious symptoms and is detected during health screening. The common symptoms are mainly respiratory symptoms and systemic toxicity symptoms. I. Respiratory symptoms 1. Cough
Cough is an important early symptom of tuberculosis and a physiological response to exclude airway secretions. If the cough is not cured by continuous treatment for two weeks, sputum tuberculosis bacillus examination and chest X-ray examination should be done. If the cough is accompanied by bloody sputum, low fever, night sweats and easy fatigue, it is highly suggestive of TB. The frequency of coughing is higher in patients with infectious tuberculosis and tuberculosis with cavitation. Bai Xuepeng, Department of Thoracic Surgery, Shandong Chest Hospital, Shandong Province, China 2. Coughing sputum
In the early stage of tuberculosis patients, there is often no sputum, and the amount of sputum increases gradually when the tuberculosis disease progresses with caseous necrotic cavity formation or co-infection. Sputum is a favorable condition for checking tuberculosis bacilli. However, when the patient’s coughing sputum decreases and disappears after chemotherapy, the patient may have no sputum. 3.Blood sputum or hemoptysis
Hemoptysis is a common symptom in patients with pulmonary tuberculosis, with an incidence of 20% to 90%. When the tuberculosis lesion progresses, the cavity wall, bronchial endothelial tuberculosis and blood vessels are collapsed, bloody sputum or small amount of hemoptysis may appear. Ulceration of small arteries in the cavity wall can cause hemoptysis, leading to lethal hemoptysis. 4.Difficulty in breathing
Generally, patients with pulmonary tuberculosis do not have respiratory distress. When the trachea is compressed, the lung is not open, and the lesion is extensive and seriously affects the lung function, the patient feels the respiratory effort. Sudden onset of dyspnea and chest pain should be expected to complicate spontaneous pneumothorax or pulmonary embolism. Systemic symptoms 1. Early stage of tuberculosis may show discomfort, fatigue, weakness and night sweats. 2, fever: is one of the main symptoms of early active tuberculosis, mild patients are mostly low-grade fever, lesion deterioration, co-infection or severe patients may have chills and high fever. The fever of TB patients is characterized by a prolonged afternoon low fever that subsides before the next morning, also known as “hot flashes”. After anti-tuberculosis treatment, 50% to 60% of patients have fever that resolves within two weeks, 20% to 30% within 10 weeks, and 10% to 20% within three months.
The fever lasts until about three months. 3. Loss of appetite, nausea, abdominal distension, constipation or diarrhea, weight loss. In severe cases, long-term anorexia, chronic consumption leads to cachexia. 4.Menstrual disorders, amenorrhea and facial flushing and other symptoms of plant nervous disorder. 5. Allergic symptoms caused by tuberculosis metaplasia such as: tuberculosis rheumatism, mouth-eye-genital triad, vesicular conjunctivitis of the eye, erythema nodosum of the skin, and scrofulous face, etc. According to the third national tuberculosis epidemiological survey, of 4597 newly detected patients, 3633 (79%) were symptomatic. Among the bacillary-positive patients, 85.9% had symptoms, and among the cavitary patients, 90.1% had symptoms. The most common symptoms were cough and sputum. The following in order were fatigue, chest tightness and shortness of breath, chest pain, fever, loss of appetite, bloody sputum or hemoptysis, and weight loss.