In the modern world, there are many diseases that pose a great danger to humanity. The open form of tuberculosis is one of them. Every year the number of cases increases, and the mortality rate from this infection reaches 2% for every 100 thousand population.
Today it is infection very well studied. The microorganisms that cause this infection, their forms, routes of transmission, and methods of treatment are known. But with all the availability of information, every person can be at risk of infection with this terrible bacillus - Koch's bacillus.
Forms and routes of infection
Main hallmark open and closed forms of tuberculosis during diagnosis will be the isolation of bacteria (BC “+” or BC “-”). In the open form of tuberculosis, in addition to Koch's bacilli, mucus and specific tuberculous pus can be found in the sputum.
If we examine the discharge from the bronchi through a simple microscope, then mycobacteria will be detected only if there are a large number of them. Modern hardware diagnostics can even detect traces of mycobacteria.
In medicine, there are three forms of tuberculosis, each of which can pose a threat of infection. More details about this in the table.
| Manifestations of tuberculosis | Possibility of infection |
|---|---|
| Primary | Observed:
An infected person may not even be aware that he is a carrier of the infection - mycobacteria are released through coughing, sneezing, or saliva (open tuberculosis) |
| Latent | The tuberculosis bacillus can be in the body of an infected person in an inactive form, but under favorable circumstances, it becomes activated and the patient develops primary tuberculosis (10% of the total number of cases) |
| Secondary | The source of bacteria can be located not only in the lungs, but also in any other organ; another name for this form is miliary tuberculosis |
All three forms include signs of the open form of tuberculosis.
How is tuberculosis transmitted and how can you become infected? Most often, infection occurs through airborne droplets. But it is not necessary to be in close contact with a sick person. The Koch bacillus, secreted when coughing, is very stable in the external environment.
It retains its vital activity in dry sputum, on the ground, and on household objects. Mycobacterium tuberculosis is resistant to acids, alkalis, and many disinfectants.
Very rarely, the disease can be transmitted through cuts and wounds (contact with a patient with tuberculosis) or through the digestive tract (this route of transmission of open tuberculosis is also dangerous).
First symptoms and risk of infection
There are a number of symptoms, by the presence of which a diagnosis is made and the disease can be determined: open form of tuberculosis. The most common symptoms are:
The most reliable information about infection can only be obtained through laboratory diagnostics. With 100% accuracy, the correct diagnosis of “open pulmonary tuberculosis” can be made by isolating mycobacteria from sputum (determining test). Bacteria are grown on special media and special staining.
The following studies also include effective diagnostic methods:
- bronchoscopy (lung tissue is collected and examined);
- endoscopic examination of other organs (as indicated);
- radiography.
It should be noted that the open form of tuberculosis is treated exclusively in specialized medical institutions– anti-tuberculosis dispensaries.
The first signs of tuberculosis as a disease can be detected using staged tests: the Mantoux or Diaskintest test. If the results are positive, a consultation with a TB doctor and additional examination is required.
There are several categories of people who belong to groups increased risk. These include:
The risk of infection is greatly influenced by the degree and duration of contact with a sick person:
- a one-time meeting is less dangerous than short-term but frequent communications;
- Living in the same apartment (transmission of infection) increases the risk of infection to almost 90%.
Therapy and prevention
It is very important to consult a doctor at the first sign or suspicion of tuberculosis infection. Self-medication can lead to irreversible consequences. A disorderly and uncontrolled reception medicines only mycobacteria will develop stable resistance to them.
Treatment periods for open forms of tuberculosis range from six months to two years. Drug therapy is selected strictly individually (consulted by the attending physician), and for the first few months the patient is in the hospital (until the active release of Koch's bacillus stops). It is strictly forbidden to interrupt the course of treatment.
There are a number of treatment regimens based on the following drugs:
- Pyrazinamide;
- Rifampicin;
- Isoniazid;
- Ethambutol.
If over the course of two to three months the selected treatment regimen does not have the desired effect, another one is selected, and the method of administering the drugs is also changed. After completing the course of treatment, laboratory and diagnostic examination for the release of Koch's bacillus into the environment.
When taking the above drugs, a number of symptoms may occur and spread to the body. side effects shown in the table below.
As a result, it should be concluded that to select drug therapy and only a doctor should treat open tuberculosis.
The most effective method of preventing open tuberculosis in children today is vaccination - the first vaccination is given to the child while still in the maternity hospital.
For the adult population, vaccination is carried out according to indications. The main prevention for them is compliance sanitary standards and improving working conditions. It is necessary to undergo a preventive examination every year, not to expose your health harmful effects, harden the body.
Following simple rules will help you avoid contracting this terrible infection and will prevent it from spreading in society.
- a pathology in which the spread of the virus occurs, in most cases, when coughing.
When mycobacteria enter the lung tissue, cell destruction begins, with the formation of deep cavities.
Without timely treatment, a patient with active tuberculosis may die.
Therapist: Azalia Solntseva ✓ Article checked by doctor
Active tuberculosis is a condition in which the body's immune system is unable to fight tuberculosis bacteria, so bacterial shedding develops into the external or internal environment. Microorganisms spread through the air and usually affect the lungs, although they can also involve pathological process other organs and parts of the body.
If the body's resistance is low, for example due to aging, malnutrition, infections such as HIV, or other reasons, the bacteria become active and cause overt tuberculosis.
The World Health Organization estimates that every year, 8 million people worldwide develop active view illnesses and almost two of them die. One in ten people infected with pathogens may develop open tuberculosis. The risk of development is greatest in the first year after infection, but the form often develops many years later.
It is impossible to immediately infect an open form of the disease, since it is necessary to go through its first phase. When TB germs enter the body, they are inactive.
Dormant germs do not damage the body or cause symptoms of illness. This is called latent TB infection.
It may last for a short time or many years. When microbes become active, begin to grow and damage the body, then they appear specific signs pathology. This is called active or open tuberculosis.
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Main symptoms of pathology
Manifestations of active tuberculosis depend individual characteristics body.
The open form of tuberculosis can cause symptoms such as:
- a productive cough that lasts 3 weeks or longer;
- chest pain;
- secretion of sputum mixed with blood.
Nonspecific signs may include:
- weakness or fatigue;
- weight loss;
- anorexia;
- chills;
- fever;
- night sweats.
These possible symptoms tuberculosis are not reliable signs diseases. Other health problems can also cause these signs. Anyone with possible symptoms of the disease should consult a doctor as soon as possible so that the problem can be diagnosed and treated in a timely manner.
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Risk of infection - how you can become infected with a pathology
How can you become infected with open tuberculosis? Anyone can get infected dangerous disorder. When someone with pulmonary tuberculosis coughs, sneezes or talks, germs can be sprayed into the air. People nearby may inhale the agents. It is impossible to contract the disease from a handshake or from food, dishes, bedding and other items. People with weak immune systems are more susceptible to infection.
How can you become infected:
- abusing alcohol or drugs;
- having diabetes;
- with silicosis;
- having head or neck cancer;
- if you have leukemia or Hodgkin's disease;
- when diagnosing severe kidney disease;
- having low body weight;
- during certain types of treatment (eg, corticosteroids or organ transplantation);
- during the period of specialized therapy rheumatoid arthritis or Crohn's disease.
If pathogens are in the lungs, you must be careful to protect other people from germs, as the risk of infection increases severalfold with open TB. Ask your doctor or nurse, they will tell you what you need to do to prevent the transmission of germs to loved ones and how you can become infected yourself.
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How long do people live with this disease?
Pathology does not always lead to death. Without treatment, life expectancy can range from 5 to 30 years; how long people live with open tuberculosis depends on many external and internal factors.
First of all, the immune resistance of the body is influenced, as well as age and the presence of concomitant diseases.
You can expect to keep your job, stay with your family, and lead a normal life if you get TB. However, you should take the medicine regularly to ensure positive results and prevent infection of other people.
After therapy there is a chance for full recovery very high, but not 100% guaranteed. There are particularly severe forms of the disorder that are practically resistant to most antibacterial drugs.
Therefore, the importance of following the prescribed exposure regimen cannot be underestimated. Without treatment, the disease will progress and can lead to disability and even death.
Smoking more than 20 cigarettes a day creates a poor prognosis for life and a high risk. This increases the chance of pathology and dangerous complications two to four times. Diabetes also worsens the prognosis of the disease.
Other painful conditions that reduce the chances of recovery:
- alcoholism;
- end stage kidney disease;
- malnutrition;
- Hodgkin's lymphoma;
- chronic lung diseases.
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Open and closed form - comparison
People with latent infection do not get sick or have any symptoms. They are infected with the mycobacterium M. tuberculosis (Koch's bacillus), but do not show signs of disease.
The only confirmation is positive reaction a tuberculin skin test or a blood test for tuberculosis. Persons with the latent form are not contagious to others.
Overall, without treatment, 5-10% of infected people develop the full-blown form of the disease at some point in their lives. For half of them, this will happen within the first two years after infection.
In people whose immune systems are weak, especially in HIV-infected people, the risk of developing an active form of the disease is much higher than in patients with normal body defenses.
In a person with latent tuberculosis infection:
- usually a skin test or blood test result indicates an infection;
- normal x-ray chest and negative sputum test;
- tuberculosis bacteria in the body are alive but inactive;
- no symptoms;
- microorganisms do not spread to others.
In some people, bacteria overcome the defenses of the immune system and begin to multiply, which leads to progression from a closed to an open form of pathology. Some people get sick soon after infection, while others get sick later when their body's response becomes weaker.
People are considered infectious to the surrounding community. If suspected, patients should be referred for a full medical examination.
The open form of tuberculosis is very serious illness and can lead to death if left untreated. The closed form is always dangerous because a person cannot start drug therapy in a timely manner.
In an infected person with open form:
- a positive skin test or blood test result indicating infection;
- abnormal X-ray chest or positive sputum smear and culture;
- there are active tuberculosis bacteria in the body;
- multiple symptoms appear, such as cough for 3 weeks or longer, hemoptysis, chest pain, unexplained loss of weight and appetite, night sweats, fever, fatigue and chills;
- spread of bacteria to others may occur;
- treatment is mandatory.
First signs of illness
Manifestations of tuberculosis usually develop slowly, over several months and years, and are often masked by other conditions. Bacteria reproduce very slowly, so symptoms of the disease also appear slowly, usually from several months to many years. Many symptoms are vague and may have other causes.
Classic manifestations of active tuberculosis are:
- malaise;
- night sweats;
- generalized body pain;
- periodic fever;
- weight loss and appetite;
- fatigue.
From specific symptoms– the first signs of an open form of tuberculosis are a persistent cough, which in the morning may be with yellow or green sputum. Over time, traces of blood appear, although a large amount of it is unusual.
Cough is often thought to be related to smoking, asthma or a recent illness, but tuberculosis is often forgotten. The pathology causes increased night sweats, with the person waking up drenched in sweat.
As the disease progresses, fatigue and malaise increase, and weight loss and loss of appetite progress. Other common early symptoms are chest pain and shortness of breath. They may arise as a result of the formation pleural effusion- accumulation of fluid between the thin membranes that line the lungs and the inside of the chest wall.
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Tuberculosis and incubation period
The microbacterium Mycobacterium tuberculosis has an incredibly low infectious dose - less than 10 microorganisms to initiate disease. Bacteria have a long period Incubation: two to twelve weeks with a range from fourteen days to several decades.
They have the ability to both hide and initiate an active form of the disease. Mycobacteria inhaled by the host infect the lungs and are ingested by alveolar macrophages. After that they long time may remain dormant or begin to multiply within these cells, causing an open infection.
The duration of tuberculosis incubation varies depending on individual risk factors.
According to the data, within six weeks of infection, an infected person develops a primary infection in the lungs, which does not cause any symptoms.
The disorder then enters an inactive phase, which can last from several weeks to several years. The incubation period can be protracted. Therefore, everyone who comes into contact with a potentially infected person has a risk of becoming infected.
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How to protect yourself from open tuberculosis
Vaccination can help protect against the disease. The infectious disease is quite common among children. BCG is provided to all infants in countries where the disease is common.
In countries such as the UK, it is recommended for those at high risk. Before vaccination, a person is given a Mantoux skin test to detect the presence of latent tuberculosis. The infection is considered the most dangerous for infants.
Prevention consists of two main stages:
- prevent the appearance of people with an active phase in crowded places;
- preventing the development of the active phase in people with latent tuberculosis.
How to protect yourself at home:
- Houses must be sufficiently ventilated.
- Anyone who coughs has a responsibility to learn breathing etiquette, respiratory hygiene, and adhere to learned practices.
- If the smear results are positive, patients with tuberculosis should:
- spend as much time as possible on fresh air;
- sleep separately from other family members, in a well-ventilated area;
- spend as little time as possible on public transport and in places where large numbers of people gather.
Treatment of patients with a closed form of the disease is the most effective method of protection against the open form of the disease.
Many people with latent infection never develop active disease.
A special high-risk group includes:
- people with HIV infection;
- persons who became infected in the last 2 years;
- infants and young children;
- drug addicts;
- elderly.
if you have hidden infection, you need to take medications.
The open form of tuberculosis is a complex and serious disease, which in the past centuries of the 19th and 20th centuries took the lives of many people. Preventive measures, namely mandatory vaccination at birth and repeated at the age of 7 years, the risks of the disease were reduced in the second half of the 20th century. But a new panacea for getting rid of the disease has still not been invented. What is tuberculosis? This disease is not only infectious, but also social. It is necessary for every person to know what the signs are, because the disease affects not only the lower parts of the respiratory system, but can also have manifestations of tuberculosis of the bones and skin.
The tuberculosis bacillus was discovered by scientist Robert Koch, and the bacterium was named after him. To combat the disease, tuberculin was created, which was previously applied to an open wound. The French physician Charles Mantoux improved this process and, as a result, tuberculin was introduced under the skin.
There are three forms of the disease:
- initial stage;
- latent period;
- open form of tuberculosis.
The initial stage is characterized easy process inflammation. Doctors have come to a consensus that such a hidden gap lasts from two to three months. The infectious focus turns into a nodule called caseosis. In the X-ray of the lungs, this compaction is clearly visible.
The latent stage is dormant and this virus may not manifest itself. As soon as the immune system weakens, it will make itself felt. If the bacilli have settled in the body with weak immunity, then they can remain there until pneumonia appears. It is impossible to become infected from a person who has a latent form of the disease; viruses will not be transmitted. But there is a danger that the latent form will become open.
The open form of tuberculosis is when the infectious focus breaks through and the bacilli penetrate into respiratory organs. The membrane that protects the bacterium from the action of immune cells breaks. The lungs weaken and inflammation may begin. In this case, the infection spreads through the blood to other organs and the lining of the brain. Open tuberculosis in the lungs produces painful miliary Milium bacilli, which are called "millet". Milium is translated from Latin as millet.
A person with an open form of tuberculosis becomes the object of transmission of bacteria by coughing, sneezing or through household contact. The most accessible place for them is lung tissue. Symptoms of the open form of tuberculosis may not be obvious at the first stage; a person can go to work, communicate with people and spread a bad infection
Risk groups susceptible to the disease
The following people are likely to get this disease:
- HIV infected. Tuberculosis develops as a complication in them.
- Doctors take first place because when treating patients they have direct contact with them. A mask and gloves are a must for any medical worker.
- Pensioners, children and pregnant women. The pulmonary factor of these people is characterized by instability of endocrine and nervous functions.
- Antisocial people: homeless people and drug addicts, alcoholics and people released from prison, migrants and refugees, displaced persons.
- Persons with weakened immune systems, patients with cancer and diabetes. This group is susceptible to the disease due to reduced immunity
How can you get tuberculosis?
The open form is considered the most dangerous. You need to know a minimum of knowledge about open tuberculosis and how it is transmitted.
You can infect:
- by air and droplets through breath and saliva;
- through household items that are shared with a sick person;
- In rare cases, the culprit of the disease may be livestock. If an animal is sick, then its milk contains a pathogen and, if it gets into food, it is transmitted to humans.
The bacillus is not afraid of either acid or alkali. Even if it hits objects, it does not die. If a sick person coughs or sneezes, the bacilli are transmitted to nearby people. Open-form Koch bacilli are so dangerous that sick people are placed in special institutions.
Clear signs
They are obvious and indicate the presence of infection:
- severe cough during exertion and at night, possibly with blood discharge;
- excessive sweating at night;
- heat;
- severe weakness of the body, apathy and depression;
- copious sputum production;
- frequent shortness of breath, signs of pulmonary failure can be observed;
- sudden weight loss;
- headache;
- lack of appetite.
Types of diagnostics
The disease in its early stages requires comprehensive examination. Medical workers carry out the following types of diagnostics:
Mantoux test. If tuberculosis is suspected, tuberculin is administered. If the first signs indicate an increase in the button by more than 5 cm, then infection can be safely diagnosed.
Diasken test. This is a modern version of Mantoux. This test has a valid answer.
X-ray. The picture will show lumps or the lungs will look like bags of millet.
Sputum check. This The best way checking for bacteria.
Bronchoscopy. It is carried out when it is not possible to obtain sputum.
Blood analysis. It is used as an additional method.
To isolate from other people, patients with open tuberculosis are placed in a special room at a tuberculosis dispensary.
Treatment
Usually, when people learn about open tuberculosis, they begin to panic. The state of people is understandable when they find out that they have been in contact with a sick person, and the sick person is afraid that he may lose his job and friends. If a person is not treated with an open form, then in a maximum of six months he will die.
Treatment, first of all, involves isolating patients in special institutions. Tuberculosis, especially if it is open, is treated with special antibacterial drugs and a complex of vitamins, as well as oxygen therapy. Patients use only personal utensils and bedding. The sputum is spat into a special container that is tightly covered. Paper napkins are burned. If happened destructive changes lungs, then surgery is prescribed.
The bacillus is resistant to antibiotics. Long-term use of potent drugs affects the general condition of the patient. Even after treatment, a person has to recover for a long time. Treatment can last from six months to two years. after treatment it leaves scars and marks on the lungs.
Conclusion
The paradox of this disease is that the open form of tuberculosis has been well studied, but no new drugs have been invented to treat this disease. The negative thing is that Koch's bacillus is resistant to antibiotics. Treatment is carried out with the same drugs that were used 20 years ago. Currently more than modern medicines: Rifampicin, Ethambutol, Pyrazinamide and Isoniazid.
Of course, I would like to know the answer to the question: is tuberculosis curable? We can say yes. If the treatment regimen was applied correctly and all instructions were followed, then pulmonary tuberculosis can be cured even in such a stage as the open form.
To prevent illness, you must follow simple instructions:
- get rid of the bad habit of smoking and alcohol;
- exercise;
- every person should know how this disease is transmitted;
- maintain hygiene, wash your hands before eating and upon arriving home;
- do fluorography annually;
- consume vitamins and beneficial microelements.
The treatment course of the disease is 85% successful, however, there are situations when open tuberculosis takes the form of chronic. If the disease is treated inadequately, then such patients live no more than six years. But good therapy Alternative medicine, reorganization of life in bad habits can significantly affect positive result. It is difficult to say how long the treated people live in total, because life factors, medications, balanced diet and much more can play a role here.
The disease tuberculosis has been known to mankind under the name consumption since ancient times. The disease was first described by the physician Hippocrates, who believed that it was genetic disease. Another ancient doctor, Avicenna, found that the disease can be transmitted from one person to another. In the 19th century, the German scientist Robert Koch proved the infectious nature of the disease by discovering a mycobacterium that caused the disease. The causative agent of the disease, Koch's bacillus, is named after its discoverer. For his discovery the scientist received Nobel Prize.
Tuberculosis in our time is still one of the most common diseases in all countries of the world. According to WHO, many cases of tuberculosis infection are registered annually in the world - about 9 million. In Russia, 120,000 people become ill with tuberculosis every year. The mortality rate from infection in Russia is higher than in European countries.
So what is tuberculosis? How does a person become infected with tuberculosis, and is this disease always dangerous? What treatment is effective and can tuberculosis be completely cured? Let's look at these questions in detail.
What kind of disease is tuberculosis?
The causative agent of tuberculosis is mycobacterium (Mycobacterium tuberculosis). Tuberculosis is an infectious disease. The most common route of transmission of tuberculosis is airborne. The tuberculosis bacillus is transmitted through contact during talking, sneezing, singing or coughing, as well as through household items. The immune system healthy person copes with the infection by destroying the Koch bacillus in respiratory tract. Too massive an infection or frequent contact with a sick person can cause illness even in a healthy person. In people with a weakened immune system, its cells are not able to destroy mycobacteria.
The incubation period of pulmonary tuberculosis is from 3 to 12 weeks. Symptoms of the disease during the incubation period include mild cough, weakness, slight increase temperature. During this period, the disease is not contagious. However, the absence is striking severe symptoms incubation period explains why tuberculosis is dangerous for the person infected. After all, mild symptoms are not noticeable special attention, they can be mistaken for a respiratory disease. If the disease cannot be recognized at this stage, it becomes pulmonary. The main cause of tuberculosis is low level quality of life. Crowding of people contributes to the spread of the disease, especially in prisons. Decreased immunity or concomitant diabetes mellitus contributes to infection and its progression.
The first signs of tuberculosis
Signs of pulmonary tuberculosis in the early stages vary depending on the form, stage and localization of the process. In 88% of cases, the infection takes a pulmonary form.
Symptoms of pulmonary tuberculosis at an early stage of its development:
- cough with phlegm for 2–3 weeks;
- periodically elevated temperature up to 37.3 °C;
- night sweats;
- sudden weight loss;
- presence of blood in sputum;
- general weakness and loss of strength;
- chest pain.
The initial manifestations of tuberculosis infection can be mistaken for any other disease. Exactly at initial stage the patient is dangerous to others. If the patient does not consult a doctor in a timely manner, the tuberculosis infection will progress and spread in the body. That is why it is so important to undergo annual fluorography, which will promptly identify the source of the disease.
Forms of tuberculosis according to clinical course
There are primary and secondary tuberculosis. Primary develops as a result of infection with Koch's bacillus in an uninfected person. The process most often affects children and adolescents. The manifestation of the disease in old age means activation of tuberculosis of the lymph nodes suffered in childhood.
In children, tuberculosis occurs in the form of the primary tuberculosis complex. IN infancy the process affects a lobe or even a segment of the lung. Symptoms of pneumonia include cough, fever up to 40.0 °C and chest pain. In older children, the lesions in the lung are not so extensive. The disease in the lungs is characterized by an increase in cervical and axillary lymph nodes.
The primary complex consists of 4 stages of disease development.
- Stage I - pneumonic form. X-ray shows a small lesion in the lung, enlarged The lymph nodes at the root of the lung.
- Stage II of resorption. During this period, the inflammatory infiltrate in the lungs and lymph nodes decreases.
- Next stage Stage III, it is manifested by compaction of residual lesions in lung tissue and lymph nodes. In these places, the X-ray image shows small pinpoint pockets of lime deposits.
- In stage IV, calcification of the former infiltrate occurs in the pulmonary and lymphatic tissue. Such calcified areas are called Ghon lesions and are detected by fluorography.
The primary tuberculosis process in children and adults often occurs in chronic form. In this case, the active process in the lungs and lymph nodes persists for many years. This course of the disease is considered chronic tuberculosis.
Open and closed forms of tuberculosis infection
Open form of tuberculosis - what is it and how does it spread? Tuberculosis is considered to be in open form if the patient secretes mycobacteria in saliva, sputum, or secretions from other organs. Isolation of bacteria is detected by culture or microscopy of the patient's secretions. Bacteria spread through the air very quickly. When talking, the infection with saliva particles spreads over a distance of 70 cm, and when coughing it reaches up to 3 meters. The risk of infection is especially high for children and people with reduced immunity. The term “open form” is more often used in relation to patients with the pulmonary form of the disease. But the release of bacteria also occurs during an active tuberculosis process in the lymph nodes, genitourinary system and other organs.
Symptoms of open tuberculosis:
- dry cough for more than 3 weeks;
- pain in the side;
- hemoptysis;
- causeless weight loss;
- enlarged lymph nodes.
A patient in open form is dangerous to everyone around him. Knowing how easily open tuberculosis is transmitted, in case of prolonged and close contact with a patient, you need to undergo examination.
If the bacteriological method does not detect bacteria, this is a closed form of the disease. Closed form of tuberculosis - how dangerous is it? The fact is that laboratory methods do not always detect Koch's bacillus; this is due to the slow growth of mycobacteria in the culture for sowing. This means that a patient who has no bacteria detected can practically excrete them.
Is it possible to become infected with tuberculosis from a patient with a closed form? With close and constant contact with a sick person, in 30 cases out of 100 you can become infected. In a patient with a closed form, the process in the lungs or any other organ can be activated at any time. The moment the process transitions into an open form is initially asymptomatic and is dangerous for others. In this case, closed-form tuberculosis is transmitted, like open tuberculosis, through direct contact during communication and through household items. Symptoms of the closed form of tuberculosis are practically absent. Patients with a closed form do not even feel unwell.
Types of pulmonary tuberculosis
Based on the degree of spread of tuberculosis, there are several clinical forms diseases.
Disseminated tuberculosis
Disseminated pulmonary tuberculosis is a manifestation of primary tuberculosis. It is characterized by the development of multiple lesions in the lungs. Infection in this form spreads either through the bloodstream or through lymphatic vessels and bronchi. Most often, mycobacteria begin to spread hematogenously from the mediastinal lymph nodes to other organs. The infection settles in the spleen, liver, meninges, bones. In this case, an acute disseminated tuberculosis process develops.
The disease is manifested by high fever, severe weakness, headache, and general serious condition. Sometimes disseminated tuberculosis occurs in a chronic form, then sequential damage to other organs occurs.
The spread of infection through the lymphatic tract occurs from the bronchial lymph nodes to the lungs. With a bilateral tuberculosis process in the lungs, shortness of breath, cyanosis, and cough with sputum appear. After a prolonged course, the disease is complicated by pneumosclerosis, bronchiectasis, and pulmonary emphysema.
Generalized tuberculosis
Generalized tuberculosis develops due to the spread of infection through the hematogenous route to all organs simultaneously. The process can occur in acute or chronic form.
The reasons for the spread of infection are different. Some patients do not comply with treatment regimen. In some patients it is not possible to achieve the effect of treatment. In this category of patients, the generalization of the process occurs in waves. Each new wave of the disease is accompanied by the involvement of another organ. Clinically, a new wave of the disease is accompanied by fever, shortness of breath, cyanosis, and sweating.
Focal tuberculosis
Focal pulmonary tuberculosis manifests itself as small foci of inflammation in the lung tissue. The focal type of the disease is a manifestation of secondary tuberculosis and is more often detected in adults who suffered from the disease in childhood. The source of the disease is localized in the apices of the lungs. Symptoms of the disease include loss of strength, sweating, dry cough, and pain in the side. Hemoptysis does not always appear. The temperature during tuberculosis rises periodically to 37.2 °C. A fresh focal process is easily cured completely, but with inadequate treatment the disease takes on a chronic form. In some cases, the lesions level out on their own with the formation of a capsule.
Infiltrative tuberculosis
Infiltrative pulmonary tuberculosis occurs during primary infection and chronic form in adults. Caseous foci are formed, around which a zone of inflammation forms. The infection can spread to the entire lobe of the lung. If the infection progresses, the caseous contents melt and enter the bronchus, and the vacated cavity becomes a source of formation of new lesions. The infiltrate is accompanied by exudate. At favorable course the exudate does not completely dissolve; in its place, dense strands of connective tissue. Complaints from patients with the infiltrative form depend on the extent of the process. The disease can be almost asymptomatic, but can manifest itself acute fever. The early stage of tuberculosis infection is detected by fluorography. In people who have not undergone fluorography, the disease develops into a widespread form. Possible death due to pulmonary hemorrhage.
Fibrous-cavernous tuberculosis
symptom of fibrocavernous tuberculosis - weight loss
Fibrous-cavernous pulmonary tuberculosis is formed as a result of the progression of the cavernous process in the lungs. With this type of disease, the walls of caverns (empty cavities in the lung) are replaced by fibrous tissue. Fibrosis also forms around the cavities. Along with caverns, there are foci of contamination. Cavities can connect with each other to form a cavity big size. The lung and bronchi are deformed and blood circulation in them is disrupted.
Symptoms of tuberculosis at the onset of the disease include weakness and weight loss. As the disease progresses, shortness of breath, cough with sputum, and temperature rise. The course of tuberculosis occurs continuously or in periodic outbreaks. It is the fibrous-cavernous form of the disease that is the cause fatal outcome. A complication of tuberculosis manifests itself in the formation of cor pulmonale with respiratory failure. As the disease progresses, other organs are affected. A complication such as pulmonary hemorrhage or pneumothorax may be the cause fatal outcome.
Cirrhotic tuberculosis
Cirrhotic tuberculosis is a manifestation of secondary tuberculosis. Moreover, as a result of the age of the disease, there are extensive formations of fibrous tissue in the lungs and pleura. Along with fibrosis, there are new foci of inflammation in the lung tissue, as well as old cavities. Cirrhosis may be localized or diffuse.
Elderly people suffer from cirrhotic tuberculosis. Symptoms of the disease include cough with sputum and shortness of breath. The temperature rises as the disease worsens. Complications occur in the form of cor pulmonale with shortness of breath and bleeding in the lungs; they cause the death of the disease. Treatment consists of a course of antibiotics with sanitation bronchial tree. When the process is localized in the lower lobe, its resection or removal of a segment of the lung is performed.
Extrapulmonary types of tuberculosis
Extrapulmonary tuberculosis develops much less frequently. Tuberculosis infection of other organs can be suspected if the disease cannot be treated for a long time. According to the location of the disease, extrapulmonary forms of tuberculosis are distinguished, such as:
- intestinal;
- osteoarticular;
- genitourinary;
- cutaneous
Tuberculosis of the lymph nodes often develops during primary infection. Secondary tuberculous lymphadenitis may develop when the process is activated in other organs. The infection is especially often localized in the cervical, axillary and inguinal lymph nodes. The disease is manifested by enlarged lymph nodes, fever, sweating, and weakness. The affected lymph nodes are soft, mobile on palpation, painless. In case of complications, caseous degeneration of the nodes occurs, other nodes are involved in the process, and a continuous conglomerate is formed, fused to the skin. In this case, the nodes are painful, the skin over them is inflamed, a fistula is formed, through which the products of specific inflammation of the nodes are discharged. At this stage, the patient is contagious to others. If the course is favorable, the fistulas heal and the size of the lymph nodes decreases.
Tuberculosis of the female genital organs is more susceptible to young women 20–30 years old. The disease is often erased. Its main symptom is infertility. Along with this, patients are concerned about the violation menstrual cycle. The disease is accompanied by an increase in temperature to 37.2 °C and nagging pain lower abdomen. Used to make a diagnosis X-ray examination and a method of culture of uterine secretions. The x-ray shows displacement of the uterus due to adhesions and tubes with uneven contours. An overview image reveals calcifications in the ovaries and tubes. Complex treatment includes several anti-tuberculosis drugs and is carried out for a long time.
Diagnostics
How to diagnose tuberculosis at an early stage? Initial and effective method diagnostics is carried out in the clinic during fluorography. It is performed for each patient once a year. Fluorography for tuberculosis reveals fresh and old foci in the form of infiltration, focus or cavity.
If tuberculosis is suspected, a blood test is done. Blood counts are very different when varying degrees severity of infection. With fresh lesions, neutrophilic leukocytosis with a shift to the left is noted. At severe form lymphocytosis and pathological granularity of neutrophils are detected. ESR indicators increased by acute period diseases.
An important method examination for the detection of Koch bacillus is sputum culture for tuberculosis. Mycobacteria are almost always detected in culture if a cavity is visible on the x-ray. With infiltration in the lungs, Koch's bacillus is detected by culture only in 2% of cases. A 3-fold sputum culture is more informative.
A test for tuberculosis is a mandatory method for mass diagnostics. Tuberculin test() is based on the skin reaction after intradermal injection of tuberculin in various dilutions. The Mantoux test for tuberculosis is negative if there is no infiltrate on the skin. With an infiltrate of 2–4 mm, the test is doubtful. If the infiltrate is more than 5 mm, then the Mantoux test is considered positive and indicates the presence of mycobacteria in the body or anti-tuberculosis immunity after vaccination.
Treatment
Is it possible to recover from tuberculosis and how long will it take to therapeutic measures? Whether the disease will be cured or not depends not only on the location of the development of the infectious process, but also on the stage of the disease. The body's sensitivity to anti-tuberculosis drugs is of great importance in the success of treatment. These same factors influence how long the disease will take to be treated. If the body is sensitive to anti-tuberculosis drugs, treatment is carried out continuously for 6 months. In case of drug resistance, treatment of tuberculosis continues for up to 24 months.
The modern treatment regimen for tuberculosis infection includes taking a complex of drugs that have an effect only when used simultaneously. With drug sensitivity, complete cure of the open form is achieved in 90% of cases. At improper treatment An easily treatable form of infection turns into difficult-to-treat drug-resistant tuberculosis.
Complex treatment also includes physiotherapeutic methods and breathing exercises. Some patients require surgery. Rehabilitation of patients is carried out in a specialized dispensary.
Drug treatment is carried out according to a 3, 4 and 5 component scheme.
The three-component regimen includes 3 drugs: Streptomycin, Isoniazid and PAS (para-aminosalicylic acid). The emergence of resistant strains of mycobacteria has led to the creation of a four-drug treatment regimen called DOTS. The scheme includes:
- "Isoniazid" or "Ftivazid";
- "Streptomycin" or "Kanamycin";
- "Ethionamide" or "Pyrazinamide";
- "Rifampicin" or "Rifabutin".
This scheme has been in use since 1980 and is used in 120 countries.
The five-component regimen consists of the same drugs, but with the addition of the antibiotic Ciprofloxacin. This regimen is more effective for drug-resistant tuberculosis.
Medical nutrition
Nutrition for pulmonary tuberculosis is aimed at restoring body weight and replenishing the lack of vitamins C, B, A and minerals.
The diet for tuberculosis includes the following categories of products.
- An increased amount of proteins is required due to their rapid breakdown. Easily digestible proteins found in dairy products, fish, poultry, veal and eggs. Meat products should be boiled, stewed, but not fried.
- Healthy fats recommended to be obtained from olive, butter and vegetable oil.
- Carbohydrates contained in any foods (cereals, legumes). Honey and flour products are recommended. Easily digestible carbohydrates are found in fruits and vegetables.
Food should be high in calories and served freshly prepared. The diet consists of 4 meals a day.
Prevention
The main means of preventing tuberculosis is vaccination. But besides this, doctors recommend:
- lead a healthy and active lifestyle, including walks in the fresh air;
- consume foods containing fats of animal origin (fish, meat, eggs);
- do not eat fast food products;
- consume vegetables and fruits to replenish the body with vitamins and minerals that support immune system;
- In order to prevent infection, young children and elderly people should not have close contact with the sick. Even short-term contact with a sick person in an open form can cause them to become infected.
Vaccination
Prevention of tuberculosis in children and adolescents comes down to preventing infection and preventing the disease. Most effective method tuberculosis prevention is vaccination. The first vaccination against tuberculosis is carried out in maternity hospital for newborns on days 3–7. Revaccination is done at 6–7 years of age.
What is the tuberculosis vaccine called? Newborns receive the gentle tuberculosis vaccine BCG-M. Vaccination during revaccination is done with the BCG vaccine.
As a result, we come to the conclusion that tuberculosis is a common infection and poses a danger to everyone around us, especially to children and people with reduced immunity. Even patients with a closed form are potentially dangerous to others. Tuberculosis is dangerous due to its complications and often ends in death. Treatment of the disease requires a lot of time, patience and money. A severe and debilitating disease deprives a person of their quality of life. The best measure to prevent the disease is vaccination.
