Tuberculosis usually affects the lungs (pulmonary TB) but can also attack the central nervous system, lymphatic system, blood vessels, bone, genitourinary system and skin. So how in the world is fixed pervasive epidemic of tuberculosis, everyone should know how to recognize the first symptoms of the disease and carry out an effective treatment.
What it is?
Tuberculosis - a widespread infectious disease caused by various species of mycobacteria from the group of Mycobacterium tuberculosis complex (M. tuberculosis and other closely related species) or otherwise tubercle bacillus.
In humans, tuberculosis usually affects the lungs, sometimes affecting other organs and systems. Mycobacterium tuberculosis is transmitted by airborne droplets during talking, coughing and sneezing patient. Most often, after infection with mycobacterium disease is asymptomatic, latent form (Tubinfitsirovannost), but approximately one in ten cases of latent infection, in the end, becomes active form.
Classic symptoms of pulmonary tuberculosis - a long cough, sometimes with hemoptysis, appearing in the later stages, fever, fatigue, night sweats and a significant weight loss.
How do you get TB?
Unfortunately, you can become infected with TB, and make it easier than we think. According to statistics, every second in the world someone gets in his body the unwanted guest - Office. Tubercle bacilli can pick up in any public place, and the more often you spend time in a human crush in public transport and hospitals, the higher the risk. One patient with chronic active TB per year throws up in the air for about seven and a half billion bacteria and infects about 15 people. The World Health Organization says that one-third of the world's population (around 2 billion people) are infected with tuberculosis. Then why are we still not extinct?
From human to human tuberculosis is transmitted by airborne droplets, that is, you can catch even without direct contact with the patient, and just being with him in the same room. In some cases, infection occurs through food and other items that are infected with Koch's bacillus. If the TB germs are in the diet, then tuberculosis in children and adults it affects the gastrointestinal tract, and are not easy, as it happens through inhalation of contaminated air. Extreme caution should be observed for people who have frequent contact with patients and have an increased susceptibility to the action of pathogens.
The fact that the immune system of a healthy person - is an impassable barrier for millions of germs and bacteria, daily bombarding our body. Tubercle bacillus is also not let take root, and carriage will likely never go into disease. But if the body is weakened and vulnerable, tenacious mycobacterium will not fail to seize the opportunity for a better future. Colds, stress, malnutrition, vitamin deficiency and other factors are favorable to the ILO could provoke active tuberculosis.
Primary and secondary form
Depending on whether a person ill with tuberculosis for the first time or not, distinguish between primary and secondary tuberculosis.
- Primary tuberculosis is a severe form of the disease which begins to appear after hitting the pathogen in blood. Often primary tuberculosis observed in children under 5 years. This is because children are not yet fully formed by the immune system, which is unable to cope with the mycobacteria. Despite the fact that the disease in this period was difficult, it is not dangerous to others. At the beginning of primary tuberculosis in the lung granuloma formed small. This is the primary lesion of the lungs, which can independently scar in the case of a favorable outcome. Thus, the patient may be unaware that in fact had been ill with tuberculosis, writing off their well-being in the cold. However, after the next radiography it appears that the lungs had scarred granuloma. The development of bad scenario would increase the granulomas to form a cavity in which the TB bacillus and accumulate. Mycobacteria go into the blood, where spread throughout the body.
- Secondary tuberculosis. This form of the disease occurs when a person has once been ill with tuberculosis, but he was infected with another type of mycobacteria. Alternatively, the secondary tuberculosis may occur as exacerbation remission. Secondary tuberculosis is considerably heavier than the primary. In mild form new foci. In some cases, they are very close to each other, which merge to form large cavities. Approximately 30% of cases of secondary tuberculosis die within 2-3 months after the onset of the disease.
Also distinguish between pulmonary and non-pulmonary tuberculosis. Phase tuberculous process: infiltration, disintegration of contamination; resorption seal scarring calcifications. More than 90% of cases occur in the form of pulmonary tuberculosis. Also, it may result in urinary organs, brain, bones, intestines and other organs.
The first signs
The earliest signs of pulmonary tuberculosis varies depending on the form and stage of the localization process. In 88% of cases of pulmonary infection takes shape.
Symptoms of pulmonary tuberculosis in the initial stages of its development:
- sudden weight loss;
- the presence of blood in the sputum;
- cough for 2-3 weeks;
- periodically raising the temperature to 37,3 ° C;
- night sweats;
- weakness and fatigue;
- chest pain.
The initial manifestations of tuberculosis infection can be mistaken for any other disease. If the patient does not go to the doctor in a timely manner, TB infection will progress and spread in the body. That is why it is important to periodically undergo chest X-rays, which quickly identify the disease site.
tubercular symptoms
In adults, pulmonary tuberculosis may be asymptomatic for a long time or with a small amount symptoms and discovered by accident during fluoroscopy or X-ray chest cells. The fact of colonization of the organism Mycobacterium tuberculosis and the formation of specific immunological hyperreactivity can also be found in the formulation tuberculin tests.
In cases where tuberculosis is manifested clinically, usually the first signs appear nonspecific symptoms intoxication: fatigue, pallor, fatigue, weakness, apathy, subfebrile temperature (about 37 ° C, seldom higher 38°), sweatingEspecially worrisome at night, weight loss. Often revealed generalized or limited to any one group of lymph nodes lymphadenopathy - lymphadenopathy sizes. Sometimes it manages to identify the specific lymph nodes - a "cold" inflammation.
Next, in the course of disease development join more or less obvious symptoms from the affected organ. When pulmonary tuberculosis are coughing, expectoration of sputum, wheezing in the lungs, a runny nose, and sometimes difficulty breath or chest pain (typically indicate interconnection tuberculous pleurisy) hemoptysis. When intestinal tuberculosis - those or other intestinal problems, constipation, diarrhea, blood in the stool, etc... Usually (but not always), lung damage is primary and the other secondary organs are affected by hematogenous seeding.
However, there are cases of tuberculosis of the internal organs or tubercular meningitis without any current clinical or radiological signs of lung damage, and without such lesions in history.
patient action
At the slightest suspicion of the disease is necessary to address to the family doctor. Lingering cough that is not relieved by conventional antitussives, should alert the person. Should consult a doctor and undergo all the necessary tests to determine the presence / absence of tuberculosis.
diagnosis of tuberculosis
The task of physicians - to identify tuberculosis as early as possible. To do this, children spend an annual tuberculin (Mantoux test), and adults - chest X-rays. If there are any suspicions after these studies, as well as the presence of symptoms, characteristic for tuberculosis, the patient is sent for consultation to the phthisiatrician and examined in greater depth at follows:
- Gathering medical history (any complaint, whether there were contacts with TB patients, etc.).
- Clinical examination.
- Radiography.
- Laboratory tests (blood and urine).
- Three-time microscopic and bacteriological examination of sputum.
If necessary, a number of special examinations: bronchoscopy, lung tissue biopsy, molecular-biological diagnostics, etc.
Effects
Possible complications of pulmonary tuberculosis:
- Generalization process by hematogenous spread to the development of tuberculosis sepsis.
- Pulmonary hemorrhage. Its massiveness and technical difficulties in its stop - are often the cause of death.
- Development of chronic "pulmonary heart" by increasing the pressure in the pulmonary circulation with significant changes in the tissues of the lungs.
- tubercular pleurisy. Exudative form, with a gradual accumulation of fluid in the pleural cavity, as well lead to the progression of respiratory and subsequent heart failure.
- Spontaneous pneumothorax. The penetration of air into the pleural cavity in a significant amount if the cavernous forms can lead to displacement of the mediastinum and reflex cardiac arrest.
Than to treat TB?
In adults, treatment of tuberculosis complicated and long, depending on the type and severity of the disease, it can be extended to two years and includes the following activities:
- chemotherapy;
- Supportive drug therapy;
- Surgical intervention (if necessary);
- Rehabilitation in sanatoria and health resorts.
In modern practice, a TB TB treatment involving multiple types of antibiotics.
At the moment, relevant three treatment regimens:
- three-component;
- a four;
- Five component.
TB treatment consists of two main phases:
- intense;
- Prolonged.
The purpose of the first phase is an intensive stop the inflammatory process, preventing further degradation tissue infiltration and exudate absorption, excretion cessation of tubercle bacilli are excreted into the environment Wednesday. That is, doctors are trying to make sure that the person has ceased to be contagious. It takes, on average, from two to six months.
Prolonged treatment of tuberculosis directed to the full healing of foci of inflammation, scarring of damaged tissue and restoring the patient's immune system strong. Depending on the nature and severity of the disease, therapy can last up to two years, and in the case MDR tuberculosis - and up to three or four years until the X-ray examination can not prove complete attenuation of disease.
Additional tuberculosis therapy includes:
- Vitamins B, glutamic acid and ATP are needed for prevention of peripheral neuropathy, and other undesirable effects from the CNS;
- Immunostimulants (galavit, xymedon, glutoksim) help the body fight tuberculosis mycobacteria;
- Methyluracilum, aloe vera, glyunat, FiBS administered during treatment of tuberculosis to accelerate cellular regeneration processes;
- Sorbents (acetylcysteine and reosorbilakt) is assigned at the time of cancellation of chemotherapy in the case of very severe side effects. After a short rest period of treatment still have to renew;
- Hepatoprotectors needed to protect the liver from the destructive action of antibiotics, they are administered at a constant level of control bilirubin in the blood;
- Glucocorticoids - a last resort, because they have a strong immunosuppressive effect. But sometimes they are still prescribed for a short time, to drown too violent manifestations of the inflammatory process with extensive and severe tuberculosis.
In advanced cases may require surgical treatment of tuberculosis.
How to eat?
Nutrition for pulmonary tuberculosis aimed at restoring body weight and replenishment of shortage of vitamins C, B, A and minerals.
The composition of the diet for tuberculosis includes the following categories of products.
- Healthy fats is recommended to get out of olive oil, butter and vegetable oil.
- Carbohydrates contained in any products (cereals, legumes). Recommended honey, flour products. Easily digestible carbohydrates are found in fruits and vegetables.
- It requires an increased amount of proteins due to their rapid decay. Preference is easily digestible proteins contained in dairy products, fish, poultry, beef and eggs. Meats should be cooked, stew, but not fry.
Calorie food should be freshly prepared and served. The diet consists of 4 times the power.
preventive measures
It provides for prevention of tuberculosis in the first place, protection against contamination of the active form of the disease. For this is not desirable for a long time to be in close quarters with people suffering from active tuberculosis. People who are in places where the sick, as a prevention of tuberculosis should wear protective face masks and comply with all rules of hygiene. We can not allow the transition of latent forms of the disease to an active. Prevention of tuberculosis in children provides protection against infection. To this end, a survey should be carried out regularly all those working in children's institutions.
Prevention of tuberculosis in children provides for mandatory BCG vaccination and chemoprophylaxis disease. In addition, in order to prevent tuberculosis conducted mass screenings through fluoroscopy. Early detection of signs of tuberculosis allows you to begin treatment in the early stages and make it as efficient as possible.
It is equally important to take all measures to strengthen the immune system. In this case, a healthy lifestyle is important, proper and regular meals, a full cessation of smoking, drugs, alcohol abuse.
