World TB Day- Understanding Tuberculosis

March 24th marks World Tuberculosis Day, commemorating the day in 1882 when Dr. Robert Koch announced the discovery of the Mycobacterium tuberculosis bacillus. Despite over a century of scientific progress, tuberculosis (TB) continues to challenge our public health systems, particularly in high-burden countries like India. According to the Global TB Report 2024, India contributes to over 28% of the world’s TB cases, making it the country with the highest disease burden, followed by Indonesia, China, the Philippines, and PakistanYet, TB remains curable and preventable — provided it is diagnosed early and treated appropriately.

Understanding Tuberculosis

Tuberculosis is an airborne bacterial infection that primarily affects the lungs but can also involve other organs. Common symptoms include a persistent cough for more than 2–3 weeks, fever, night sweats, unexplained weight loss, fatigue, and coughing up blood. The disease spreads through microscopic droplets released when an infected person coughs or sneezes.

Case Vignette: A Timely Bronchoscopy Saves a Young Professional

Ravi (name changed), a 32-year-old software engineer from Bangalore, had been experiencing a dry cough and low-grade fever for four weeks. He initially dismissed it as a post-viral cough, but when his symptoms worsened, he sought medical help. A chest X-ray revealed a patchy opacity in the right upper zone. Sputum samples were inconclusive, and GeneXpert testing came back negative.

Given the strong clinical suspicion and non-resolving radiographic findings, CT thorax was done followed by with a flexible bronchoscopy, a safe, minimally invasive procedure that allows direct visualisation and sampling from the lungs.  Bronchial washings were sent for TB PCR and culture. The result? Positive for Mycobacterium tuberculosis. Bronchoscopy sample also helped in getting further details like what appropriate medications to be given based on culture test. The early diagnosis allowed Ravi to start on the correct anti-tubercular therapy before further deterioration, preventing complications and reducing his infectiousness to others.

This case illustrates a critical lesson: in patients with atypical presentations or inconclusive sputum results, bronchoscopy can be a decisive diagnostic tool. It underscores the need for advanced diagnostic facilities to be made more accessible.

Why Awareness Matters

Despite being a preventable and curable disease, TB continues to carry a significant social stigma. Many individuals delay seeking care out of fear of discrimination. Delayed diagnosis leads to worse outcomes and continued community transmission.

What can we do as citizens?

1. Know the symptoms – any cough lasting more than two weeks deserves evaluation.
2. Do not ignore unexplained weight loss, fatigue, or night sweats.
3. Seek medical attention early.
4. Adhere strictly to treatment regimens.
5. Avoid stigmatising patients with TB — it is a treatable infection, not a moral failing.

 

Dr. Pavan Yadav, Lead Consultant – Interventional Pulmonology & Lung Transplantation, Aster RV Hospital