Pulmonary and Extra pulmonary Tuberculosis.

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Intermittent episodes of fever in tuberculosis (TB) patients typically occur in the evening due to the diurnal pattern of fevers, which peak in the early evening. This phenomenon is linked to the release of pyogenic cytokines such as interleukin 1 (IL1), tumor necrosis factor (TNF), and interferon-alpha, which are regulated by the circadian rhythms of the hypothalamus. Night sweats, a common symptom in TB, are nonspecific and can result from bacteremia. It is important to note that while TB can present with these symptoms, many infections in otherwise healthy individuals are asymptomatic. The prevalence of positive TB tests is significantly higher than the number of symptomatic cases in developed countries, and the pyrogenic nature of the mycobacterium is more pronounced in patients with disseminated infections.
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I have a query that why in tuberculosis intermitent episodes of fever occur every evening ?
Although the pyogenic cytokines(fever causing) released due to immune activation can cause fever but why in the evening only ??
Also, TB is associated with night sweats ,how can it occur in a patient of TB everyday ??
 
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Manish7 said:
I have a query that why in tuberculosis intermitent episodes of fever occur every evening ?
Although the pyogenic cytokines(fever causing) released due to immune activation can cause fever but why in the evening only ??
Also, TB is associated with night sweats ,how can it occur in a patient of TB everyday ??

Fevers in general tend to be diurnal with maximums occurring in the early evening. TB and lymphoma tend to be identified more with these symptoms but there are a variety of other causes. Interleuken 1 (IL1), tumor necrosis factor (TNF) and interferon-\alpha release appear to be influenced by the circadian regulation by the hypothalamus. Nightsweats likewise are nonspecific and associated with bacteremia. You seem to believe that these symptoms are unique to TB and occur "every day". In fact, most TB infections in otherwise healthy people are asymptomatic. The number of people who test positive for TB is much larger than the number who become ill in developed countries. The mycobacterium that causes TB is particularly pyrogenic in those patients with disseminated (extrapulmonary) infection.

http://www.ncbi.nlm.nih.gov/books/NBK324/

http://www.ncbi.nlm.nih.gov/pubmed/9215292
 
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