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The onset of pulmonary tuberculosis is usually insidious, with lack of energy, weight
loss, and persistent cough. These symptoms do not subside, and the general health of
the patient deteriorates. Eventually, the cough increases, the patient may have chest pain
from pleurisy, and there may be blood in the sputum, an alarming symptom. Fever
develops, usually with drenching night sweats. In the lung, the lesion consists of a
collection of dead cells in which tubercle bacilli may be seen. This lesion may erode a
neighbouring bronchus or blood vessel, causing the patient to cough up blood
(hemoptysis). Tubercular lesions may spread extensively in the lung, causing large
areas of destruction, cavities, and scarring. The amount of lung tissue available for the
exchange of gases in respiration decreases, and if untreated the patient will die from
failure of ventilation and general toxemia and exhaustion.