# Medical Pulmonary and Extra pulmonary Tuberculosis.

1. Oct 30, 2013

### Manish7

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 ??

2. Oct 30, 2013

### SW VandeCarr

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

Last edited: Oct 30, 2013