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:

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