Is Bone Tuberculosis Contagious? Symptoms, Causes & Treatment of Bone TB

Tuberculosis (TB) is a potentially fatal infectious disease that primarily affects the lungs. Mycobacterium tuberculosis, the bacterium that causes it, can be transferred from person to person through the air, usually when a person who has tuberculosis of the lungs or throat coughs, sneezes, talks, or sings. As per the World Health Organization, tuberculosis is the second most common infectious killer globally, trailing only COVID-19 and surpassing HIV and AIDS.

Different Types of Tuberculosis

There are various ways that tuberculosis can present itself, and each has unique traits. The typical types are as follows:

Pulmonary Tuberculosis: This is the most common form of TB and affects the lungs.

Extrapulmonary Tuberculosis: This kind happens when tuberculosis (TB) travels to other areas of the body from the lungs.

Miliary Tuberculosis: This is a severe form where TB bacteria invade the bloodstream and can affect multiple organs at once.

Multidrug-Resistant Tuberculosis (MDR-TB): This variety is immune to two or more of the strongest anti-TB medications. 

Extensively Drug-Resistant Tuberculosis (XDR-TB): This particular strain of MDR-TB is uncommon and resistant to more anti-TB medications.

Lastly, there’s Bone Tuberculosis. This form of TB occurs when the bacteria spread to the bones or joints. While it constitutes a small percentage of all TB cases, its effects can be debilitating and, in some cases, life-threatening if left untreated.

What is Bone Tuberculosis?

Bone Tuberculosis, also known as osteoarticular tuberculosis or skeletal tuberculosis, is a type of extrapulmonary tuberculosis that affects the bones and joints. It occurs when the Mycobacterium tuberculosis bacteria, which primarily cause pulmonary tuberculosis (TB in the lungs), spread to the bones or joints through the bloodstream. This form of TB can affect any bone or joint in the body, but it most commonly affects the spine.

Symptoms of Bone TB

Bone and joint tuberculosis typically manifests with a variety of symptoms, which may vary depending on the specific bone or joint affected. Here is a list of common symptoms observed in individuals with bone and joint tuberculosis:

Persistent and Progressive Pain

The most common symptom is persistent and progressive pain in the affected area. This pain often intensifies at night or with physical activity.

Swelling

Swelling in the joint or bone area can also occur, which may be noticeable to the naked eye.

Stiffness

The affected area may become stiff, leading to a reduced range of motion.

Abscess Formation

In some cases, a noticeable lump or mass may be present if an abscess forms due to the infection.

Systemic Symptoms

Systemic symptoms of tuberculosis, such as fever, night sweats, and unexplained weight loss may also manifest in individuals with bone and joint TB.

These symptoms, however, are not exclusive to this form of TB and can occur in all types of the disease.

Causes of Bone TB

The primary cause of bone and joint TB is the spread of Mycobacterium tuberculosis bacteria from an initial site of infection, usually the lungs, to the bones or joints through the bloodstream. This form of spreading is known as hematogenous dissemination.

While anyone can contract tuberculosis, certain individuals are more susceptible to developing bone and joint TB. Those with weakened immune systems, such as individuals with HIV/AIDS, those undergoing chemotherapy, or those with other conditions that suppress the immune system, are at a higher risk. Additionally, individuals with a history of pulmonary tuberculosis who did not receive full treatment can have a reactivation of the disease that may spread to the bones and joints.

Treatment for Bone TB

The treatment for bone and joint TB often involves a lengthy course of multiple anti-TB medications. A typical treatment regimen may last for at least six months to two years, depending on the severity of the disease and the patient’s response to medication.

A combination of antibiotics, such as isoniazid, rifampin, pyrazinamide, and ethambutol, is typically used as the first line of treatment. In some cases, second-line drugs may be used for patients who do not respond to the first-line drugs or for those with drug-resistant strains of TB.

In severe cases, surgery may be required to remove infected tissue or to prevent or correct deformities caused by the disease. This can include procedures such as debridement, joint replacement, or spinal fusion.

Early diagnosis and treatment are key in preventing serious complications, such as joint destruction and paralysis, and ensuring a successful recovery from bone and joint TB. Effective treatment also requires adherence to prescribed medication regimens and routine follow-up appointments.

The Importance of Prompt Medical Attention and Mitigation Measures

To sum up, bone tuberculosis is a dangerous illness that has to be treated right away. It is critical to get medical attention right away if you or someone you know exhibits any of the symptoms listed above. The key to avoiding major complications and guaranteeing a full recovery from this type of tuberculosis is early diagnosis and treatment.

Although bone TB is not contagious in the same manner as pulmonary TB, the bacteria that causes tuberculosis, Mycobacterium tuberculosis, can be transferred from person to person through microscopic droplets expelled into the air during coughing and sneezing. Therefore, if you are living with or caring for someone with active TB (in any form), it’s essential to take preventive measures to protect yourself and others.

These measures include:

Proper Hygiene

Regular hand washing, wearing a mask when in close contact with a person with active TB, and avoiding sharing personal items like towels or utensils can help prevent the spread of TB bacteria.

Vaccination

In some countries, the BCG vaccine is given to children to help protect against TB. While the vaccine doesn’t always prevent TB, it can help prevent severe forms of the disease in children.

Regular Health Checks

Regular check-ups and tests are important, particularly for those at higher risk, such as people with weakened immune systems or those in close contact with a person with active TB.

Prompt Treatment

If you have been diagnosed with TB (even if it’s not bone TB), it’s vital to follow the prescribed treatment regimen closely. This not only helps in your recovery but also reduces the risk of spreading the bacteria to others.

Remember, tuberculosis – in any form – is a treatable and often curable condition. The key lies in early detection, prompt treatment, and diligent adherence to preventive measures. Stay informed, stay vigilant, and stay healthy.