Our lungs are amazing, quietly doing their thing to keep us breathing and alive. But when they are compromised by disease, the effects can be devastating. Two of the diseases that can have a serious impact on lung function are Tuberculosis (TB) and Pulmonary Fibrosis. While both result in respiratory symptoms and lung injury, they are radically different in cause, course, and management. It is essential that these differences be recognized for proper diagnosis and proper management.

In an exclusive interaction with the editorial team of Onlymyhealth, Dr Bhumesh Tyagi, Consultant, General Medicine and Physician, Shardacare, Health City, Noida, explained the difference between tuberculosis and pulmonary fibrosis. Here is what he shared with us!

Tuberculosis is a communicable illness that is mostly brought about by the bacterium Mycobacterium tuberculosis. It's a disease that has haunted human beings for ages, and even though there have been tremendous medical developments, it continues to be a serious global health issue, especially in most regions of the globe, such as India.

TB is extremely contagious and airborne when an infected person coughs, sneezes, or speaks, emitting minute airborne droplets of bacteria.

Symptoms include a chronic cough (with sputum streaked with blood), fever, night sweats, unintentional weight loss, weakness, and chest pain. These may appear over time. The bacteria remain latent in the body for many years without manifesting any symptoms (latent TB). If the immune system is weakened, the bacteria become active (active TB) and disease-causing. It mainly attacks the lungs (pulmonary TB), but it can also occur in other areas of the body (extrapulmonary TB) such as the kidneys, spine, or brain.

TB is diagnosed by means of such tests as sputum smears and cultures, chest X-rays, and molecular tests (e.g., GeneXpert). Tuberculin skin tests (TST) or blood tests (IGRA) are utilized to determine TB infection. TB is treated by a series of several antibiotics taken for a period of several months (usually 6-9 months). Strict adherence to the entire treatment regimen is essential in order to avoid the development of drug resistance.

Prevention of TB spread depends on vaccination (BCG vaccine, although its effectiveness varies), early treatment and diagnosis of active cases, and infection control measures.

Pulmonary fibrosis, however, is a chronic and progressive lung condition where lung tissue becomes scarred or thickened. The scarring stiffens the lungs and makes them less elastic, diminishing their capacity for oxygen transfer into the blood.

Pulmonary fibrosis is not infectious like TB. No one knows the cause of most types of pulmonary fibrosis, specifically Idiopathic Pulmonary Fibrosis (IPF). It can be secondary to some autoimmune conditions, exposure to environmental toxins (e.g., asbestos, silica), some medications, radiation therapy, and even some hereditary factors.

Symptoms commonly consist of progressive shortness of breath, a dry, recurring cough, tiredness, and clubbing of fingers and toes (in advanced stages). The symptoms gradually increase in severity. The scarring is permanent and gradually worsens over time, causing progressive loss of lung function.

Pulmonary fibrosis is diagnosed with a combination of imaging studies (high-resolution CT chest), lung function tests, and sometimes a lung biopsy. Pulmonary fibrosis has no treatment, and treatment is aimed at controlling symptoms, slowing disease progression, and enhancing quality of life. This can involve anti-fibrotic drugs, oxygen therapy, pulmonary rehabilitation, and, in some, lung transplantation. Since the cause is not usually known, there are limited specific prevention measures, although avoidance of known environmental precipitants can be useful in a few instances.

Delays or misdiagnosis of either condition can carry important ramifications. Untreated active disease in TB can be lethal and lead to spread in the community. In pulmonary fibrosis, early diagnosis permits early treatment with options that can halt disease progression and enhance patient outcomes.

Essentially, Tuberculosis is a bacterial infection curable by antibiotics and contagious, while Pulmonary Fibrosis is a non-infectious progressive disorder with irreversible lung scarring with the management of symptoms being aimed at slowing down its progression. Both are capable of affecting the lungs and sharing similar symptoms such as cough and shortness of breath, but knowing their different causes, contagious nature, and treatment methods is crucial. If you have ongoing respiratory symptoms, a visit to the doctor is important for proper diagnosis and treatment. Early treatment can make a big difference in the course of either of these difficult lung diseases.