All about TB treatment & symptoms and causes TB (Tuberculosis (TB) Facts)

All about TB treatment and causes TB (Tuberculosis (TB) Facts)

All about TB treatment and causes TB (Tuberculosis (TB) Facts)

Tuberculosis is an infectious disease transmitted from person to person.
There are many different types of tubers.
A bacterium, Mycobacterium tuberculosis causes the disease.
There are many risk factors for tuberculosis. Symptoms and clinical signs of pulmonary tuberculosis include fever, night sweats, cough, hemoptysis (cough with sputum stained in the blood), weight loss, fatigue, and chest pain.
Tuberculosis is contagious; Incubation periods may vary and contagion.
Doctors finally diagnosed tuberculosis by mycobacterial growth from sputum or biopsy specimens, but health professionals diagnosed tuberculosis presomptuellement by history, physical examination, skin tests and chest X-rays.
Treatment of tuberculosis infection is related to the type of TB infection and often requires prolonged treatment (months) with one or more anti-TB drugs.
Complications of tuberculosis are chronic problems of nothingness and death and include lung, kidney and liver problems, which can be serious.
The prognosis for TB infection is treated properly. The prognosis decreases in people who develop complications or who have had previous treatments for tuberculosis.
Preventing tuberculosis requires early treatment to reduce transmission and isolation of the infected person until they are no longer contagious. There is a vaccine against tuberculosis, but it is not routinely used in the US. Due to inefficiencies and other problems

What is tuberculosis?

What is tuberculosis?

Tuberculosis (TB) is a multisystem infectious disease caused by Mycobacterium tuberculosis, a rod in the form of bacteria. Tuberculosis is the most common cause of mortality from infectious diseases in the world (about 1.1 million to 1.7 million people each year, resulting in the world). The symptoms of tuberculosis can cover a wide range of which tuberculosis is called the "great imitator" by many of them studying infectious diseases like tuberculosis symptoms can mimic many different diseases. Additional terms are used to describe tuberculosis. The terms include consumption, Pott's disease, active, latent lung, skin and other (see next section) and appear in medical and non-medical literature. In most cases, the different terms refer to a specific type of TB with unique symptoms or outcomes. The most common site (approximately 85%) for tuberculosis to develop is in the pulmonary tract. Humans are the only known host for Mycobacterium tuberculosis (although the animals may be infected).

Tuberculosis has been humans for many centuries, probably infected; Signs of tuberculosis infection were found in bodies dating back to around 8000 BC. AD, so the disease has a long history of infection in humans. The Greeks called the disease Lost (tisis). In many European countries, tuberculosis killed approximately 25% of adults and was the leading cause of death in the United States until the early 1900s. Robert Koch discovered the cause of tuberculosis, Mycobacterium tuberculosis in 1882. with a greater understanding of Tuberculosis, public health initiatives, treatment methods such as isolation (quarantine) and development of drugs to treat tuberculosis, the incidence of disease, especially in developed countries has been significantly reduced. However, the CDC estimates that one-third of the world's population is infected with TB, with about 1.5 million deaths a year.

There is a wealth of detailed information available in the medical literature on all aspects of this debilitating and potentially lethal disease. The aim of this article is to introduce the reader to tuberculosis and to help them gain a general understanding of the cause, transmission, diagnostic tests, treatments and methods of tuberculosis prevention.

Are there different types of tuberculosis (TB)?

Are there different types of tuberculosis (TB)?

There are many types of tuberculosis, but the two main types are called active or latent tuberculosis. Active tuberculosis is when the disease is actively producing symptoms and can be transmitted to others; Latent is when the person is infected with Mycobacterium tuberculosis, but the bacteria do not produce symptoms (usually due to the body's immune system suppresses bacterial growth and spread) and have no tuberculosis bacteria in the sputum. People with latent tuberculosis generally can not transfer Mycobacterium tuberculosis bacteria to others unless the immune system; The defect causes reactivation (more suppressed bacterial growth) resulting in active tuberculosis so that the person becomes contagious. Latent tuberculosis infection resembles chickenpox remains dormant and can re-activate years later.

There are many other types of tuberculosis in active or latent form. These types are named by the signs and bodily systems infected with Mycobacterium tuberculosis preferably, and these types of infection vary from one person to another. Therefore, pulmonary tuberculosis mainly infects the pulmonary system, cutaneous tuberculosis presents skin symptoms, while miliary tuberculosis describes the small infected sites (lesions or granulomas of about 1 mm-5 mm) found in the organs of the skin body. It is not uncommon for some people to develop more than one type of active tuberculosis. More types appear in the Symptoms and Signs section

What causes tuberculosis?

The cause of tuberculosis is an infection of human tissue (s) by Mycobacterium tuberculosis bacteria (Mycobacterium tuberculosis). These bacteria are slow growth, aerobic and can develop in the cells of the body (parasitica intracellular bacteria). Its unique cell wall helps protect the body's defenses and gives mycobacteria the ability to retain certain dyes as fuschine (red dye) after acid rinsing that rarely occurs with other bacterial, fungal or fungal parasites.

Mycobacteria escape destruction by the body's defenses can spread through the blood or lymph to most organ pathways, preferably to oxygenate well (lungs, kidneys and bones, for example). Typical TB lesions, called granulomas, usually consist of a central necrotic zone, followed by an area with macrophages, giant cells, and Langerhans cells that surround immature macrophages, plasma cells, and lymphocytes. These granulomas also contain mycobacteria. In latent infections, a fibrous capsule usually surrounds granulomas, and in some people, granulomas calcify, but if the immune defenses initially or later (reactivating) bacteria continue to spread and disrupt the physiological functions

What are the risk factors for tuberculosis?

There are many risk factors for the development of tuberculosis. Some groups of people are at high risk, such as people who work in hospitals and other places where people may be infected with tuberculosis (prisons, nursing homes, group homes for HIV patients, shelters for the homeless ). Close association with drug users or people with known tuberculosis infections is also at increased risk. Others at high risk:

• Visitors and immigrants from regions affected by the high incidence of tuberculosis
• Children and the elderly with weakened immune systems (especially those with a positive skin test for tuberculosis, see below)
• Patients infected with HIV
• Drug addicts, particularly intravenous drug abuse
• Patients with head and neck cancer
• Transplant patients
• diabetics
• Patients with kidney disease
• People who undergo immunosuppressive therapy
• silicosis

What are the symptoms and signs of tuberculosis?

Although there are a number of types of tuberculosis, pulmonary tuberculosis is responsible for the majority (about 85%) of tuberculosis infections. Therefore, symptoms and signs of pulmonary tuberculosis can occur with or even before other types of tuberculosis are diagnosed. Typical clinical symptoms and signs of pulmonary tuberculosis may include the following:

• fever
• night sweats
• Against cough (often chronic)
• Hemoptysis (bloody sputum)
• Decreased or decreased appetite
• Loss and / or muscle loss weight (involuntary)
• Fatigue and / or discomfort
• Thoracic pain (breathing pain)
• Difficulty breathing
• Swollen lymph nodes
• Pneumonitis (may be the only symptom in the elderly).

Other types are roughly like extrapulmonary and often have symptoms that are non-specific, but are often located on the site concerned. Here are the signs and symptoms of other types of tuberculosis include:

• TB Skeletal (also called Pott's disease): spinal pain, stiff back, paralysis is possible
• Tuberculous meningitis: headache (variable but persistent length), mental changes, coma
• TB arthritis: usually a single joint pain (most common hips and knees)
• Genitourinary TB: dysuria, flank pain, increased frequency, masses or lumps (granulomas)
• TB Gastrointestinal: difficulty swallowing, ulcers that do not heal, abdominal pain, malabsorption, diarrhea (sometimes bloody)
• Miliary TB: many small nodules scattered in organs resembling millet seeds (hence its name)
• Tuberculosis purulent pleurisy and pleural effusion
• MDR TB: tuberculosis patients infected with multidrug-resistant bacteria
• Patients with tuberculosis XDR infected with tuberculosis who are resistant to some of the most effective anti-tuberculosis drugs; Highly resistant XDR media

Is tuberculosis contagious and the duration of the incubation period and the contagious period?

Tuberculosis is very contagious and can spread to others by droplets in suspension during sneezing, coughing and contact with sputum, so that you can catch the disease by close contact with infected people; Hatching occurs in overcrowded conditions. The incubation period may vary from about two to 12 weeks. A person may remain contagious for a long time (as long as viable tuberculosis bacteria are present in the sputum) and may remain contagious until it has been in the appropriate therapy for several weeks. However, some people may be infected, but compress the infection and develop symptoms years later; Some do develop symptoms or become contagious.


How Do Physicians Diagnose Tuberculosis?

Because tuberculosis can occur in a latent or active form, the definitive diagnosis of active tuberculosis depends on the culture of sputum mycobacteria or tissue biopsy. However, it may take weeks for these slow growing growth bacteria in specialized media. Because patients with latent tuberculosis do not require isolation or immediate drug therapy, is helpful in determining if a person is not infected, if you have a latent or active infection is infected with transmissible bacteria. Therefore, physicians needed presumptive evidence that could reasonably ensure that the person was infected or not, so treatment can begin. After obtaining the history and data from the physical examination of the patient, the next test is the usual skin test (skin test called Mantoux TB or tuberculin test or TST). The test involves injecting tuberculin (an extract made from killed mycobacteria) into the skin. In about 48-72 hours, the skin is examined for induration (swelling) by a qualified person; A positive (hardening) strongly suggests that the patient has been exposed to live mycobacteria or is actively infected (or has been vaccinated); No hardening suggests that the person is negative for tuberculosis. Another test, IGRA (interferon-gamma release assay) is used to measure the immune response to Mycobacterium tuberculosis. Other rapid tests are useful; Pulmonary x-rays may show signs of pulmonary infection, while smears stained with certain dyes that are predominantly (but not exclusively) retained by mycobacteria may show the presence of bacteria. These tests, when examined by a physician, are useful for establishing a diagnosis of latent or active tuberculosis, and most physicians begin treatment based on their judgment on these tests. In addition, some of these tests are useful in the US and elsewhere than in people who are not vaccinated with a TB vaccine (see below), but are less useful in vaccinated individuals. For some patients, culture studies are still needed to determine the drug susceptibility of an infectious tuberculosis strain.

Other tests have been developed. For example, you can use a PCR test (polymerase chain reaction) to detect tuberculosis antigens and microscopic LED-FM technique to identify TB microscopy organisms. Two other TB analyzes (also called interferon-gamma release test or IGRA) have been approved by the FDA and measure the strength with which the body's immune system reacts to tuberculosis bacteria. TLIG is recommended in patients who have been vaccinated against tuberculosis (see Prevention section below).

People with positive symptoms, blood testing are considered positive, smear or positive culture infected with tuberculosis and contagious. Doctors diagnose and treat people with latent tuberculosis (LTBI) infection according to the following criteria: CDC 2013:

• No symptoms or physical signs suggestive of tuberculosis disease
• TCT or TLIG mostly positive result
• Chest x-ray is usually normal
• If this is done, the respiratory samples are negative from the smears and the culture
• You can not spread TB bacteria to others
• You should consider a treatment of ITL to prevent tuberculosis disease (strongly recommended by CDC)

What is the treatment of tuberculosis?

The treatment of tuberculosis depends on the type of tuberculosis infection and the drug sensitivity of mycobacteria. For latent tuberculosis three anti-tuberculosis drugs are used in four different programs. The drugs are isoniazid (INH), rifampin (RIF, Rifadin®) and rifapentine (RPT, Priftin) and the four diets recommended by the CDC are listed below and are chosen by the attending physician depending on general health and type Likely exposure of TB patients.

The treatment of current guidelines should be reviewed and correlated with the condition and circumstances before beginning any treatment of the patient.

Treatment of drug-resistant tuberculosis can be difficult. Patients with these infections are recommended by the CDC to involve infectious disease specialists because there are several approaches involving other anti-tuberculosis drugs and treatment programs of the variables that can be used. In addition, there are new drugs and treatment programs under development and approved by the FDA. Infectious disease consultant may be aware of these new treatments that may benefit specific patients. For example, Bedaquiline (Sirturo) has been approved for the treatment of multidrug-resistant tuberculosis.

Some side effects of treatment may include the following:

• Loss of appetite
• Nausea and / or vomiting
• jaundice
• paresthesia
• Hematoma, Bleeding
• Changes in Vision
• Patients are encouraged to consult their physician if side effects occur.

In some patients, lung destruction may be severe and the only treatment may be surgical resection of diseased lung tissue.

Medicines are needed to treat tuberculosis; At best, home remedies can help reduce symptoms but do not treat tuberculosis. Home remedies can include milk, pineapple, Indian currant, bananas, and many others. Patients should discuss these remedies with their physician before using them

What types of doctors treat tuberculosis?

Although the patient's primary care physician can monitor and coordinate treatment, other specialists such as infectious diseases, pulmonary medicine, internal medicine, intensive care and public health doctors may also be involved in the treatment .

What are the complications of tuberculosis?

Although some people may not have complications, other complications ranging from mild to severe, including death. Some of the most serious complications include lung function, bone pain (spine, ribs and joints), meningitis, renal dysfunction and / or liver, cardiac tamponade and visual disturbances.

What is the prognosis of tuberculosis?

For most people who live in areas where diagnosis and treatment is available, the prognosis is good if they complement the treatment protocols for tuberculosis. The rate of recurrence of TB is low (0% -14%) and some may be due to reinfection. Drug-resistant tuberculosis is more difficult to treat and the prognosis is not so good. The same prognosis occurs in immunocompromised patients, the elderly and in patients already having a tuberculosis infection and treatment.

How can TB be prevented?

A vaccine against tuberculosis is commercially available; BCG or the vaccine called Bacille Calmette-Guérin. However, the vaccine is recommended for use in the United States because of the low risk of TB infection. In addition, the vaccine is highly variable in its ability to prevent lung disease in adults. Another problem is that the vaccine may interfere with the interpretation of the tuberculin skin test. However, several countries still use to reduce infantile and miliary infections. Therefore, the CDC makes this recommendation: "The BCG vaccine should be considered only for highly selected individuals who meet specific criteria and consult a TB specialist. "

Currently, it is suggested that people with active TB should be treated using isolation techniques as well as anti-tuberculosis drugs to prevent CDC spread. The CDC suggests that patients with active TB are likely to be isolated in a private room with negative pressure (air sucked outdoors or through a high efficiency air particle filter). In addition, the staff that care should wear disposable masks sufficiently filter high-efficiency mycobacteria in the air. Continuous insulation is suggested that sputum smears are negative for three consecutive measurements (usually after about two to four weeks of treatment). Sanatoriums (also called the hospital or sanatorium) are those where people with long-term illness, especially those with tuberculosis, used to treat before there is good antibiotic therapy.