Clinical manifestations of pulmonary and extra-pulmonary tuberculosis

Cough is the commonest presentation. Initially it may be nonproductive, but as inflammation and tissue necrosis ensue, sputum is produced. Haemoptysis is occasionally a presenting symptom but usually results from previous disease and may not indicate active tuberculosis. It may arise from tuberculous bronchiectasis, rupture of a dilated vessel in the wall of a cavity (Rasmussen’s aneurysm), bacterial or fungal infection (especially Aspergillus mycetoma) in a cavity or erosion into an airway (broncholithiasis). Inflammation of the lung parenchyma adjacent to a pleural surface may cause pleuritic pain. Dyspnoea is unusual unless there is extensive disease and may result in respiratory failure [11, 12]. Rales or crackles may be heard in the area of involvement and bronchial breathing indicating consolidation.