Pulmonary and Extra pulmonary Tuberculosis.

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SUMMARY

Intermittent episodes of fever in tuberculosis (TB) patients typically occur in the evening due to the diurnal nature of fevers, influenced by cytokines such as Interleukin 1 (IL1), tumor necrosis factor (TNF), and interferon-α, which are regulated by the hypothalamus. Night sweats, commonly associated with TB, are nonspecific and can occur daily due to bacteremia. It is important to note that most TB infections in healthy individuals are asymptomatic, and the prevalence of positive TB tests is significantly higher than that of symptomatic cases in developed countries. The pyrogenic nature of Mycobacterium tuberculosis is particularly pronounced in patients with disseminated (extrapulmonary) infections.

PREREQUISITES
  • Understanding of cytokines, specifically Interleukin 1 (IL1) and tumor necrosis factor (TNF)
  • Knowledge of the circadian regulation of physiological processes
  • Familiarity with the clinical manifestations of tuberculosis
  • Basic concepts of bacteremia and its implications in infectious diseases
NEXT STEPS
  • Research the role of cytokines in fever response during infections
  • Study the circadian rhythms and their effects on immune responses
  • Explore the clinical features and management of extrapulmonary tuberculosis
  • Investigate the epidemiology of tuberculosis in developed versus developing countries
USEFUL FOR

Medical professionals, infectious disease specialists, and students studying tuberculosis and its clinical manifestations will benefit from this discussion.

Manish7
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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-[itex]\alpha[/itex] 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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