Factors Affecting the Severity of TB Disease

The severity of TB disease is crucial for management strategies and treatment outcomes. 

• The severity of the disease is usually determined by the presence of cavities or bilateral disease on chest radiography or smear positivity in case of pulmonary TB.

• The site of disease is another determinant of the severity of TB. The following are severe forms of TB disease depending on the site:
  • Miliary TB
  • TB disease affecting multiple organs or disseminated TB
  • TB disease of the central nervous system 

• Resistance pattern is another important component determining the severity of TB disease. The severity of the disease increases with an increase in resistance to different TB drugs.

• Comorbidities like HIV and diabetes lead to fast progression to severe forms of TB disease. Thus, early identification of comorbidities and their management is essential to prevent a severe form of TB disease.

In children, the occurrence of advanced malnutrition or advanced immunosuppression may also be considered when determining disease severity.

Resources​

• Guidelines for Programmatic Management of Drug-resistant TB in India, 2021.

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