Study of respiratory symptoms among sputum positive

loss and persistent productive cough almost certainly has the disease if he
or she lives in an area where tuberculosis is endemic or if he or she is a
member of a group that has a high incidence ofthe disease, such as some of
immigrant communities in developed countries. The same symptoms in a
native of a developed country would not immediately suggest the diagnosis
and it would be more useful to consider other possibilities first (McNicol et
al., 1995).
Rossman and Mayock (1999), divided the symptoms into two
categories constitutional and pulmonary. The most common constitutional
symptom is fever, low grade at the onset but becoming marked ifthe
disease progresses. Characteristically, the fever develops in the late
afternoon and may not be accompanied by pronounced symptoms with
defervescence, usually during sleep, sweating occurs. The classic (night
sweats) other signs of toxemia such as malaise, irritability, weakness,
unusual fatigue, headache and weight loss, may be present with the
development of caseation necrosis and concomitant liquefaction, ofthe
"'1 caseation, the patient usually notices cough and sputum, often associated
LI I
with mild haemoptysis. Chest pain may be localized and pleuritic.
Shortness of breath usually indicates extensive disease with wide spread
involvement of the lung and parenchyma or some form oftracheobronchial
obstruction and therefore usually occurs late in the course ofthe disease.
Physical signs
There may be no physical signs in pulmonary tuberculosis even with
relatively advanced disease but there may be pallor, a hectic flush or
cachexia in sever disease (Leitch, 2000). Physical examination ofthe chest
is often completely normal early in the disease. The principal finding over
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