What Are the Symptoms of TB Outside the Lungs?

Yes, tuberculosis (TB) can spread to other parts of your body. While we usually think of TB as a lung infection, the bacteria can travel through your bloodstream or lymphatic system to almost any organ. When TB develops outside the lungs, it is called extrapulmonary tuberculosis (EPTB).

The symptoms of extrapulmonary TB depend entirely on which organ is affected. Most people with EPTB do not cough up TB bacteria, meaning this type of TB is generally not contagious—unless you also have an active TB infection in your lungs.

General Symptoms

Regardless of where the TB bacteria settle, they can cause “constitutional” symptoms—general signs that your body is fighting a chronic infection. These can include:

• Unexplained weight loss ^[1]
• Persistent fevers and chills ^[1]
• Drenching night sweats ^[2]

Common Sites and Their Symptoms

Tuberculosis can affect almost any tissue, but it most frequently targets a few specific areas. Because standard sputum or blood tests may not detect EPTB, your doctor may need specific imaging (like MRIs) or biopsies (tissue samples) of these areas to confirm the diagnosis ^[3].

1. Lymph Nodes (Tuberculous Lymphadenitis)
The lymph nodes are the most common site for TB outside the lungs ^[4]. It most often affects the lymph nodes in the neck.

• Symptoms: You may notice a painful or painless swelling, lump, or mass in your neck ^[5]. Over time, if left untreated, these swollen nodes can fluctuate in size or even break through the skin, creating a draining sinus (an open sore that leaks fluid) ^[5].

2. The Lining of the Lungs (Tuberculous Pleurisy)
TB can infect the pleura, the thin membrane that surrounds your lungs and lines your chest cavity.

• Symptoms: The most common symptom is sharp chest pain that worsens when you take a deep breath or cough (pleuritic chest pain) ^[6]. This is often accompanied by fever and a dry cough ^[7]. It typically causes fluid to build up around the lungs, known as a pleural effusion ^[6].

3. The Bones and Joints (Spinal TB or Pott’s Disease)
When TB attacks the bones, it most frequently targets the spine.

• Symptoms: The primary symptom is chronic back or neck pain ^[8]. As the disease progresses, it can damage the vertebrae and compress the spinal cord. This can lead to leg pain, weakness, numbness, or even paralysis (paraplegia) ^[9]. Advanced cases may cause visible spinal deformities (kyphosis) ^[9].

4. The Brain and Spinal Cord (Tuberculous Meningitis)
TB can infect the membranes surrounding the brain and spinal cord.

• Symptoms: It can cause severe headaches, fever, confusion, and changes in behavior ^[10]. Prompt diagnosis and specialized antibiotic treatment are absolutely critical here to prevent severe neurological complications, such as vision changes, seizures, or stroke ^[11].

5. The Kidneys and Urinary Tract (Genitourinary TB)
TB in the urinary and reproductive tract is often called the “great masquerader” because its symptoms mimic common, everyday urinary infections ^[12].

• Symptoms: You might experience flank pain (pain in your side or mid-back) and painful urination (dysuria) ^[13]. Men may develop painful swelling or lumps in the scrotum ^[14], while women may experience pelvic pain or menstrual irregularities. A classic sign is having symptoms of a urinary tract infection (like needing to pee frequently or blood in the urine) but having a standard urine culture come back negative for typical bacteria ^[15].

Is Extrapulmonary TB Contagious?

In general, extrapulmonary TB is considered non-contagious. TB is primarily an airborne disease, meaning it spreads when a person with active lung TB coughs, speaks, or sneezes the bacteria into the air. If the bacteria are confined to your spine, brain, or kidneys, they cannot be coughed out.

However, many people diagnosed with extrapulmonary TB also have a silent (subclinical) TB infection in their lungs ^[16]. This is not the same as “latent TB”—a subclinical infection means the bacteria are actively multiplying in your lungs, but simply haven’t caused a cough yet. Even if you feel fine, it is absolutely critical that your doctor screens you for lung involvement (usually with a chest X-ray and a sputum test) to ensure you are not unknowingly contagious to your friends and family ^[16].