Why There Is Night Sweating in a Patient With Tuberculosis

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According to the World Health Organization, tuberculosis (TB) accounts for 3 million deaths worldwide each year, while approximately 2 billion people have latent TB. If untreated, tuberculosis can be fatal within five years in 50 percent to 60 percent of cases.

Causes and Disease Process

  • Tuberculosis (TB) results from infection with the "Mycobacterium tuberculosis" bacteria. TB is transmitted through the air by the sneeze or cough of infected persons. When inhaled, the bacteria have several possible fates: they may be killed by the immune system; they may multiply and cause a primary TB infection; or they may become dormant and not cause any symptom. Following dormancy or primary TB, the bacteria can get reactivated and cause full-blown TB disease.

Types

  • Although TB usually affects the lungs (pulmonary TB), other organs may be involved in up to one-third of cases. Other types of TB include: tuberculous meningitis; skeletal TB (mostly in the spine); genitourinary TB; gastrointestinal TB; tuberculous lymphadenitis (usually affecting the neck); and cutaneous TB.

Signs and Symptoms

  • Night sweating often occurs early in the course of TB, along with malaise, weight loss and fever. Other common signs and symptoms of tuberculosis include shortness of breath, fatigue, loss of appetite, chest pain and a persistent cough (often with bloody sputum).

Possible Causes of Night Sweating

  • Sweating generally results from changes in the body's thermoregulatory center. Night sweating in TB patients may also be the result of cytokine production by specific cells of the immune system called "macrophages." Macrophages are the primary cells infected by M. tuberculosis and cytokines are proteins that are released to help regulate the body's immune response to the infection.

Symptom Development

  • Along with fever, night sweats often signal an infection. Fever is advantageous because it increases the mobility of immune cells, which fight infections like tuberculosis. If skin temperature rises too much, the body responds by sweating, to cool itself down. At night, however, since there's no air circulation between the sheets, the air is trapped and starts to get hot. As a result, the amount of sweat gradually increases, causing the patient to wake up sweaty and wet.

References

  • eMedicine
  • The Johns Hopkins Complete Home Guide to Symptoms and Remedies; Simeon Margolis, M.D., Ph.D.; 2004
  • "Harrison's Principles of Internal Medicine: Tuberculosis" (Chapter 158); Anthony S. Fauci, M.D. et al.; The McGraw-Hill Companies; 2008
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