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Difference Between Pneumonia and Tuberculosis


Pneumonia and tuberculosis are both diseases of the lungs. Pneumonia is an inflammatory condition within the lungs produced as a result of infection that primarily affects the alveoli. It is usually caused by viral or bacterial infections and also by some autoimmune diseases. The common signs of pneumonia include fever, chills, productive cough, and chest pain. Pneumonia is generally classified into three types—community acquired pneumonia, nosocomial (hospital acquired) pneumonia, and atypical pneumonia. In the former case, the causative pathogens are primarily viruses and gram-positive bacteria, while in the latter case, the causative pathogens are primarily gram-negative organisms. The most common bacteria involved are Streptococcus pneumoniae, Staphylococcus aureus, Escherichia coli, and Haemophilia influenzae. Atypical pneumonia is a type of pneumonia that is not caused by the traditional pathogens of “typical” pneumonia. The pathogens responsible for atypical pneumonia are Chlamydophila pneumoniae, Mycoplasma pneumonia, Legionella pneumophila, Moraxella catarrhalis, syncytial virus, and influenza A virus. The clinical features are also different from typical “lobar pneumonia.” The key symptoms of atypical pneumonia are fever, headache, sweating, and myalgia along with bronchopneumonia.

If untreated, the bacteria can gain access to the blood vessels and lead to a form of septicaemia (infection of the blood) called “bacteremia” that can lead to end organ damage and finally death. Viruses and bacteria from the throat and nasopharynx enter the lungs and attract alveolar macrophages and neutrophils to initiate immune reactions. This causes release of cytokines, which further potentiates macrophages to infiltrate the infected regions and cause inflammation. Atypical pneumonia is treated with macrolides like clarithromycin or erythromycin.

Tuberculosis is an infection of the lungs caused by Mycobacterium species, the most common pathogen being Mycobacterium tuberculosis. Tuberculosis chiefly occurs in the lungs; however, it may occur in other organs like bones. The organism is difficult to be eradicated by the immune system of the body. In fact the organism utilizes the macrophage environment and causes its destruction. Destruction of immune cells and other tissues leads to fibrosis and necrosis. Tuberculosis may be active or latent. Active tuberculosis is detected through nuclear amplification tests, while latent tuberculosis is detected through the Mantoux tuberculin test.

The total lung capacity of an individual affected by tuberculosis is reduced. The symptoms of tuberculosis include rapid and frequent breathing, chronic cough, haemoptysis, weakness, and fatigue. The upper lobe and the lower lobe of the lungs have equal probability of getting affected. Tuberculosis is a contagious disease and spreads more rapidly than pneumonia through sneezing and coughing. The risk factors for tuberculosis include malnutrition, smoking, silicosis, and use of medications like infiximab and corticosteroids.

Tuberculosis is managed by either a three-drug regimen or four-drug regimen. The combinations are rifampicin, isoniazid, ethambutol, and streptomycin. Vaccination is possible through the Bacillus Calmette-Guerin (BCG) vaccine to prevent episodes of tuberculosis.

A brief comparison of pneumonia and tuberculosis is represented below:

Clinical Features Pneumonia Tuberculosis
Type of Microorganisms Involved Bacteria, Virus, Fungi Bacterial
Species of Microorganisms Involved Streptococcus, Staphylococcus, Escherichia, Chlamydia, Legionella Mycobacterium Tuberculosis
Organ System Affected Lungs Lungs, Skeletal System, & Genito-Urinary System
Radiological Presentation Lobar Consolidation (Typical Pneumonia), Peripheral Consolidation and Infiltration (Atypical Pneumonia)






Fibrosis & Necrosis in Upper and Lower Lobe
Physical Signs Fever, Headache, Sweating, and Myalgia (Atypical Pneumonia Only) Chronic Cough, Weakness, Haemoptysis
Quantity and Nature of Sputum Bulk Sputum with Productive Cough Sputum Either Mild or Absent and Produces Nonproductive Cough
Diagnosis Chest Radiographs Mantoux TestNuclear Amplification TestsChest Radiographs
Treatment Regimen Infection Treated with Penicillin or Cephalosporin Infection Treated with Rifampicin, Isoniazid, Ethambutol & Streptomycin
Vaccination Possible (Against Streptococcus Pneumoniae) Possible Through Bacillus Calmette-Guerin (BCG) Vaccine
Contagious Low Very High.
Presence of Extra Pulmonary Symptoms No Yes
Risk Factors Nonspecific & Exposure to Nosocomial Settings Malnutrition, Smoking, Silicosis, and Use of Medications Like Infiximab and Corticosteroids

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  1. In the early 90’stages I was asked when I had TB. I answered that I’ve never had TB. I said as a child I had double pnuemonia. The TB specialist told me that my lungs have TB scarring.
    Hmmm. Wonder how it was cured.

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References :

[0]Bento, J; Silva, AS; Rodrigues, F. Duarte, R (2011). "[Diagnostic tools in tuberculosis]". Acta Médica Portuguesa 24 (1): 145-54.

[1]Cunha BA (May 2006). “The Atypical Pneumonias-Clinical Diagnosis and Importance.” Clin. Microbiol. Infect. 12 (Suppl 3): 12-24.

[2]McLuckie, A., ed. (2009). Respiratory disease and its management. New York: Springer, p. 51.


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