When Your Child Has Tuberculosis

Man coughing, girl breathing bacteria in droplets into lungs.

Tuberculosis (TB) is a disease caused by bacteria (germs) that can spread from person to person. It's carried through the air in tiny droplets. Most often, TB infects the lungs, but it also can harm other parts of the body. When not treated properly, TB can be fatal. There are two types of TB: inactive and active. Most children who have TB have the inactive form.

Inactive TB (TB infection)

If your child has been diagnosed with inactive TB, it means your child:

  • Has live TB bacteria in the lungs, but the germs have been sealed off, much like a scab covers a wound. As a result, your child doesn’t have symptoms or feel sick and can't spread the germs to another person. The only way to know your child has inactive TB is with a TB test.

  • Can’t spread the infection to others, but may develop active TB in the future.

  • Will need medicine to prevent the infection from spreading to others.

Active TB (TB disease)

If your child has been diagnosed with active TB, it means your child:

  • Has symptoms of TB, such as a lasting cough, extreme tiredness (fatigue), fever, night sweats, or weight loss. Your child is likely to feel very sick.

  • Can spread the infection to others.

  • Must take medicine to help cure the disease.

How does TB spread?

TB bacteria are released into the air in tiny droplets when someone with the disease coughs, sneezes, or talks. The germs spread easily, especially in crowded spaces with poor airflow. Children who breathe the germs for weeks or months are likely to become infected. Children are at special risk of TB if they:

  • Spend time every day with someone who has active TB.

  • Live in a crowded place, such as a shelter or group home, where germs spread easily.

  • Travel to or come from a country where TB is common.

  • Have a weak immune system or infected with HIV.

What are the symptoms of TB?

In children, symptoms may include:

  • Fever

  • Fatigue or weakness

  • Weight loss

  • Night sweats

  • Weakness

  • Irritability

  • Enlarged glands

Symptoms of TB infection in the lungs include:

  • Difficulty or labored breathing

  • Breathing fast

  • Constant cough

  • Coughing up blood

How is TB diagnosed?

There are 2 tests that can help detect TB infection:

  • Skin test (PPD). A testing solution is placed just beneath the skin on your child’s arm to see if a reaction (such as a hard, red bump) occurs. Your child will need to return to the office in 2 or 3 days to have the arm checked. Be sure to keep the appointment. You will learn the test results during this visit.

  • Blood test. In this test, a small amount of blood is drawn and sent to a lab for testing. Your doctor can tell you whether this test is right for your child.

For TB disease, a saliva sample is taken to figure out if a person has active TB.

What do the test results mean?

  • A negative result usually means that your child’s body is free of TB bacteria.

  • A positive result means your child has been exposed to the germs that cause TB. Other tests, such as a chest X-ray, are needed to learn whether the infection is active. Your child’s healthcare provider may also take a sample of your child’s stomach secretions or mucus that comes up when your child coughs (sputum). These samples are sent to a lab and tested for TB bacteria. This helps the provider choose the best medicine for your child.

How is TB treated?

Both inactive and active TB are treated with medicines. A chest X-ray is done to see if the TB has infected your child's lungs. Children with active TB may take more medicine for a longer time. Your child should begin feeling better shortly after starting treatment. But your child must continue to take all the medicine prescribed. This is the only way to cure the disease. Not taking all the medicine means your child won’t get well and can keep spreading the disease to others.

What is DOT?

During treatment, your child may participate in a program called DOT (directly observed therapy). In this program, a nurse or health care worker gives the medicine to your child. This makes it easier to finish treatment in the least amount of time.

Caring for your child at home

To help your child recover fully from TB:

  • Make sure your child takes all the medicine as directed, even when symptoms improve. Your child will take the medicine for 6 months or longer. Sticking to this schedule takes patience. But stopping medicine early or skipping doses means your child won’t get well. And it can create TB germs that are more deadly and harder to treat.

  • Arrange for your child to sleep in a room with good airflow.

  • Be sure your child gets plenty of rest and eats healthy meals. A nutritious diet full of fresh fruits and vegetables helps the body fight infection.

  • Check with your child’s healthcare provider before using any prescription or over-the-counter medicines that haven’t been prescribed. Don’t give your child cough syrup. It won’t help and may be harmful.

Follow-up care

Be sure your child goes to all follow-up exams. These help ensure that the medicine is working and your child is getting better.

Preventing the spread of TB

To help keep others safe:

  • Ask family, friends, and anyone else in close contact with your child to get tested. If your child has active TB, the TB germs can spread to other people.

  • Teach children to wash their hands often, particularly after coughing.

  • Make sure your child coughs into a tissue.

  • Use a plastic bag to throw away used tissues and other supplies.

When to call your child's healthcare provider:

Call the healthcare provider if your child:

  • Has a fever (see fever and children section below)

  • Coughs more or coughs up blood

  • Has night sweats

  • Has chest pain

  • Has trouble breathing

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider.

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider.

Child age 3 to 36 months:

  • Rectal, forehead, or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider.

  • Armpit (axillary) temperature of 101°F (38.3°C) or higher, or as directed by the provider.

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider.

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

For more information on TB, contact your local health department or the American Lung Association at 800-586-4872.