Tuberculosis remains common across India, and it is curable — provided it is diagnosed accurately, treated with the right regimen, and followed through to completion. Dr. Ajit Yadav (MD, DNB, MNAMS) specialises in tuberculosis and respiratory diseases, and TB treatment in Rewari at Vaayu Care covers diagnosis including rapid molecular testing, treatment under the national programme regimens, and the follow-up that actually determines cure.
What tuberculosis is
TB is caused by Mycobacterium tuberculosis, a slow-growing bacterium spread through the air when someone with active lung TB coughs or sneezes. It most often affects the lungs, but it can involve lymph nodes, the pleura, bones and spine, abdomen, brain and almost any organ.
Infection does not always mean illness. Most people who inhale the bacterium contain it, and it lies dormant — latent TB, which causes no symptoms and is not infectious. A proportion later develop active TB, particularly if immunity falls through diabetes, HIV, malnutrition, steroid or immunosuppressive treatment, or advancing age.
Symptoms
Pulmonary TB: a cough lasting more than two weeks, at first dry and later productive; coughing up blood; fever, characteristically low-grade and in the evenings; drenching night sweats; loss of appetite and weight; fatigue; chest pain.
Extra-pulmonary TB depends on site — painless neck swelling in lymph node TB; breathlessness and chest pain with pleural involvement; persistent back pain in spinal TB; abdominal pain and swelling; headache and confusion in TB meningitis.
In India, any cough lasting more than two weeks should prompt testing for TB. This is the single most important message on this page.
Who is at higher risk
Close contacts of someone with active TB; people with diabetes, HIV, chronic kidney disease or malnutrition; those on steroids or immunosuppressants; smokers and heavy alcohol users; people living or working in crowded, poorly ventilated conditions; healthcare workers; and those with previous TB, COPD or silicosis.
How TB is diagnosed
- Sputum examination — at least two samples, examined by smear microscopy.
- Rapid molecular testing (CBNAAT/GeneXpert or TrueNat) is the current standard. It detects TB bacteria within hours and simultaneously identifies rifampicin resistance — information that changes the entire treatment plan and would otherwise take weeks.
- Chest X-ray, which may show infiltrates, cavitation, effusion or fibrosis.
- CT chest where the X-ray is unclear or complications are suspected.
- Bronchoscopy with lavage or biopsy where the patient cannot produce sputum or samples are repeatedly negative despite a suspicious picture — a common and important scenario.
- Medical thoracoscopy for pleural TB, which has a much higher diagnostic yield than blind pleural biopsy.
- Culture and drug sensitivity testing, which remains the reference standard and guides treatment in resistant disease.
- Tests for lymph node and other extra-pulmonary sites, plus screening for diabetes and HIV in every patient.
Treatment
TB treatment follows national programme regimens, with the drugs, doses and duration matched to the site of disease and the resistance pattern.
Drug-sensitive TB is treated in two phases — an intensive phase of four drugs for two months, followed by a continuation phase, typically completing six months in total. Longer courses are used for TB of the bone, spine or brain.
Drug-resistant TB requires a specialised, longer regimen selected on the sensitivity pattern, with closer monitoring. Newer oral regimens have improved both tolerability and outcomes considerably.
Alongside the drugs, treatment involves:
- Managing side effects rather than letting them derail treatment. Nausea, liver enzyme rise, joint pain, tingling in the hands and feet, and visual changes on ethambutol are anticipated and monitored. Pyridoxine is given to prevent nerve symptoms. Stopping treatment because of side effects, without review, is a major cause of failure and resistance.
- Monitoring response — symptoms, weight, repeat sputum tests at defined intervals, and liver function where indicated.
- Nutritional support, which meaningfully affects outcome.
- Controlling diabetes, which is strongly associated with TB and with poorer response.
- Contact screening of household members, especially children and anyone immunosuppressed.
- Infection control advice for the first weeks — ventilation, covering coughs, and separate sleeping arrangements where possible.
Completing the full course is what produces cure. Stopping early because symptoms have settled is the commonest route to relapse and to drug-resistant TB, which is far harder and longer to treat.
After treatment
Some patients are left with residual scarring, bronchiectasis or reduced lung function after cure. Persistent cough or breathlessness after completing treatment is not necessarily relapse, but it does need assessment — post-TB lung disease is common, under-recognised and treatable.
When to see a TB specialist in Rewari
Book a consultation if you have had a cough for more than two weeks, if you have coughed up blood, if you have evening fever with night sweats and weight loss, if you have been in close contact with someone with TB, if a scan has raised the possibility, if you cannot tolerate your TB medication, or if symptoms persist after finishing treatment. Book an appointment.
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Read →Frequently asked questions
Is TB completely curable?
Yes. Drug-sensitive tuberculosis is curable in the great majority of patients who complete the full course of the correct regimen. Even drug-resistant TB is curable, though it requires a longer, more specialised regimen with closer monitoring. The main threat to cure is stopping treatment early.
How long is TB treatment, and can I stop when I feel better?
Drug-sensitive pulmonary TB is usually treated for six months; TB of bone, spine or brain takes longer. You will feel considerably better within a few weeks, but the bacteria are not eradicated at that point. Stopping early is the commonest cause of relapse and of drug-resistant TB. Never stop or alter your medication without review.
Am I infectious, and for how long?
Someone with active pulmonary TB is infectious mainly before treatment and in the early weeks after starting it. Infectiousness falls rapidly once effective treatment begins — typically within two to three weeks in drug-sensitive disease. Ventilation, covering coughs and, where possible, separate sleeping arrangements are advised initially. Latent TB is not infectious at all.
What if my sputum test is negative but the doctor still suspects TB?
This is common — sputum smear misses a substantial proportion of cases. Rapid molecular testing is more sensitive. Where sputum remains negative but suspicion is high, bronchoscopy with lavage or biopsy obtains a sample directly from the affected part of the lung, and thoracoscopy is used for pleural disease. A negative sputum smear alone does not exclude TB.
Can I take my TB medicine if it upsets my stomach or affects my liver?
Side effects are common and are managed rather than accepted as a reason to stop. Timing, supportive medication and sometimes temporary adjustment of the regimen usually allow treatment to continue. Liver enzymes are monitored, and if they rise significantly the regimen is modified under supervision. Always report side effects rather than stopping on your own.
I finished treatment but still have a cough. Has it come back?
Not necessarily. Many patients are left with residual scarring, bronchiectasis or airway narrowing after cure — post-TB lung disease, which is common and often missed. It needs assessment with imaging and lung function testing, and much of it is treatable. Relapse must also be excluded, so persistent symptoms should always be reviewed.