Symptoms of tuberculosis, and the first signs of

GENERAL

This infection is known a long time. Previously, it was called tuberculosis or tuberculosis. The term tuberculosis came from the Latin word from the tuberculum - bump. For the first time an infection was known in 1882, he opened its German scientist Robert Koch, so Mycobacterium tuberculosis is also called Koch's wand.

pathogen characteristics:

• Office are somewhat curved rodsWhose size may vary. The causative agent is acid and stained smears by Ziehl-Nielsen red-pink color. It is aerobic, to the viability and proliferation which necessarily need oxygen.
  
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• for the pathogen characterized polymorphism - the ability to change shape under the influence of adverse factors. Often such a phenomenon occurs when the patient smear microscopy, long receiving anti-TB drugs, while talking about the appearance of L-forms. This type MBT not pathogenic, as typical mycobacteria, and can be long in the body, promoting development of tuberculosis antibodies. The main danger L-forms of MBT is their ability to be transformed under certain conditions into the original pathogenic type. Why so many relapses and latent forms of the course.

The causative agent of tuberculosis is well adapted to the changing conditions of existence and has increased vitality.

The stability of the ILO in the external environment:

• When exposed to low temperatures - up to -23oS - the causative agent remains viable for about 7 years.
• At a temperature of 55 ° C only killed after 12 hours at 70 ° C - after 1 hr.
• Particularly resistant mycobacteria in sputum, dry human patient. Killed pathogen one hour while heating to 95-100oS.
• On Office detrimental effect of ultraviolet rays to inactivate sticks sufficiently 3-5 minutes of irradiation, and under direct sunlight - 4 hr. In a dark room the same mycobacteria in sputum retain their activity to a year.

CAUSES

According to WHO, about one third of the world's population is infected with MBC. This infection is caused by the social and affects, first of all, sectors of the population with a low level of life and culture. But lately, marked rise in the incidence of tuberculosis even among people living in satisfactory social conditions.

Annually from tuberculosis in the world kills more than 1.5 million people with active forms of the disease, even 8 million patients detected each year.

The absolute amount of pace among adults than among children, due to reduction of preventive measures and the weakening of immunity after vaccination old adult population compared with kids.

The main source of infection is a sick person with active TB, released into the environment mycobacteria. the risk of infection from a sick person is 10 times higher than the risk of infection by other means.

transmission path:

• aerogenic (Airborne and airborne dust) - the most common route of infection. In this way about 95% ill patients. Infection occurs during contact with a sick person, secrete M. tuberculosis into the environment, together with saliva and phlegm when talking, coughing and sneezing. The slurry was infected biological material in the air can be up to 2 hours and extended to a distance of about 2 meters. At its settling on the floor or ground, and includes an air-drying the dust transfer path tuberculosis. This is especially true for areas with high concentration of people - public transport, railway stations and so on..
• alimentary - infection is carried out with the use of food products from animals infected with tuberculosis. Most often the source of infection is a sick cow milk and products derived from it, without adequate heat treatment. It is also possible to become infected by human tuberculosis patient with poor personal hygiene.
• intrauterine - infections transmitted from mother to child. This mode of transmission is rare enough.

tuberculosis fostered by the impact of adverse external circumstances and reduced resistance.

Reasons contributing to infection:

• Contact with MbT Office.
• Decreased immunity.
• Frequent respiratory infections, diseases of respiratory system.
• Stress, poor diet, lack of proper sleep.
• The use of domestic dairy products, held insufficient heat treatment.
• Refusal of a routine vaccination.

CLASSIFICATION

The disease is classified on the basis of etiological and clinical symptoms.

Tuberculosis is divided on the etiological basis on:

• primary type - new-onset disease tuberculosis is more prevalent in children and adolescents. Usually develops in the background bend tuberculin test and overreaction of the body is different mycobacterial antigens. In this type of the disease most often affects the lymph nodes of the chest followed by formation of calcifications in them - cicatricial tissue seal with the deposition of salts (Gon foci). The disease responds well to treatment, perhaps a full recovery.
• Secondary type - it is more common in adults and elderly people after earlier suffering a disease or activation of latent tuberculosis flow. Advantageously, the pulmonary system affects the formation of large lesions, for the process difficult, malignant, often involving both lungs.

Clinical classification is quite extensive and complicated. It is based on the localization of the pathological process, severity, radiographic signs of injury, the presence of bacteria, etc.

According to clinical forms of TB infection are divided:

• Tuberculosis of children and adolescents. Infection can occur at any age. But the peak of the disease is considered an interval of 10-14 years, during this time reduced immune defense against routine vaccination and significantly expanding the social circle of children. Hormonal changes the body in adolescence also helps to reduce the overall resistance to mycobacteria.
• Tuberculosis of the respiratory system. This category includes many clinical variations depending on the severity, breadth and presence of histological changes in lesions bronchopulmonary system.
• Tuberculosis of other organs. In this case, all affected organs and systems. For example, the skin, intestine, reproductive system, joints and so on. D.

Criteria for assessing the course of tuberculosis:

• Location of defeat and its prevalence.
• Phase inflammatory activity.
• Bacterial excretion.
• Complications of the disease.
• Residual effects after complete cure.

Classification by categories of TB patients:

• Patients with primary pulmonary tuberculosis, as well as the involvement of other organs. Bacterial excretion may occur or be absent.
• Patients in the acute stage of an existing tuberculosis, as well as those of the first group, the last course of treatment, but did not get a positive result.
• Patients diagnosed with primary infection without pulmonary manifestations, bacteriological and tissue destruction. Also, this group includes patients with indolent forms.
• Patients with resistant TB, are not amenable to treatment with medicines, with a chronic process and its progression.

SYMPTOMS

The incubation period for TB takes several months to six months, more often 1.5-2 months. Depending on the input gate of infection and the affected organ will occur or that manifestation.

For tuberculosis is characterized by specific inflammation - inflammatory reactions that are unique to this type of disease. In the initial stages of the disease process it has similar characteristics with typical inflammation. With the progression of the infection appear specific inflammation of the tissues - lumps (granulomas), complicated by the destruction (necrosis).

Granuloma formation is productive in nature while preserving the morphology of the affected tissue. At the onset of necrosis irreversible changes, cell death occurs.

Tuberculosis in Adults

Diverse manifestations of tuberculosis, as infection may be affected virtually any organ. Symptoms most frequent pulmonary tuberculosis:

• The dramatic weight loss, fatigue, lack of appetite.
• Periodic or continuous fever to subfebrile marks - 37,5oS.
• Sweating at night or morning time.
• Cough for several weeks or months, not amenable to treatment.
• Expectoration of sputum, coughing up blood, shortness of breath, cough, exhausting in the later stages.
• Pain in the chest.

When the X-ray study revealed inflammation of the lung, foci of necrosis and scarring.

With the progression of TB there is a serious cardio-pulmonary insufficiency and bleeding from the lungs.

Tuberculosis in Children

Symptoms in children are similar to those mentioned above. Are more prone to infections, children with intrauterine infection, the presence of congenital diseases, premature. Most often in childhood tuberculosis occurs in the following clinical forms:

• The disease manifests itself in a period of turn tuberculin reaction or during the following year.
• There have been changes in the child's behavior: fatigue, irritability, drowsiness, loss of appetite, pale skin, intermittent fever, sweating, cough.
• On examination: an increase in peripheral lymph nodes, auscultation signs of bronchitis, the presence of noise on the apex of the heart.
• On X-ray film can detect signs of lung lesions in the active stage and cicatrices after treatment, as well as portions of calcification in the thoracic lymph nodes.

DIAGNOSTICS

For the diagnosis of tuberculosis should be differentiated from other diseases, have a systemic nature and bronchopulmonary manifestations.

The main sign that confirms the infection is to identify Mycobacterium tuberculosis in a patient.

Diagnostic methods:

• Chest X-ray.
• Sputum smear Ziehl-Nielsen. If necessary, a lung biopsy.
• Microbiological identification of the pathogen from sputum or biopsy in the culture media.
• Immunological research: PCR, ELISA.
• General and biochemical blood tests. Such studies are not specific, but they can be used to control the level of inflammation activity and condition of internal organs.

Of great importance for the diagnosis of a sanitary-epidemiological situation in the family of the patient, as well as the identification of contacts with TB patients.

For the diagnosis of tuberculosis in children used tuberculin test (Mantoux test), which indicates the presence of a specific reaction to the antigens of mycobacteria. A positive reaction indicates a turn and possible infection of the body.

TREATMENT

Tuberculosis treatment is carried out permanently and exclusively in the specialized TB dispensaries. Clinical management and the level of restriction of social contacts determined by the physician based on the severity of the disease. In the period of remission and the lack of bacteria possible treatment at home. The average treatment duration is 1-1.5 years.

Conservative treatment:

• For the treatment of tuberculosis use different schemes of several antibacterial drugs. Mycobacterium tuberculosis often are multiresistant to many groups of antibiotics. Then regimen is adjusted. For selection of a suitable preparation method used for determining the sensitivity of a particular type Mycobacterium antibiotic via bacteriological examination.
• Detoxification therapy is used in conjunction with high toxic activity of anti-tuberculosis drugs.
• Immunomodulators to enhance resistance to infection.
• Hepatoprotectors to protect liver cells from the pill burden.
• Corticosteroids are used with caution due to their immunosuppressive effect.
• Intensive vitamin.

In addition to drug treatment, recommended high-calorie diet with a predominance of high-calorie food for a set of lost body weight, proper rest, sunbathing. In remission and healing must sanatorium treatment corresponding profile.

operative therapy

In case of longer chronic course of the disease, the formation of massive areas of necrosis, hemorrhage recommended surgery. Displacement of operation depends on the severity of lung lesions: bleeding vessels by suturing to removal of part or all of the lung.

COMPLICATIONS

At an advanced stage, you may experience severe complications:

• Atelectasis - full spadenie lung alveoli to the inability of the respiratory movements.
• Fistulas of lung tissue in the adjacent connective tissue formation.
• Scarring of the lung tissue with a decrease of respiratory excursions up to fibrosis and cirrhosis of the lungs.

In addition to these complications can arise acute conditions that threaten the life of the patient:

• pulmonary hemorrhage;
• lung empyema and septicemia;
• acute cardio-pulmonary insufficiency.

PREVENTION

Timely prophylaxis effectively prevents tuberculosis.

Measures taken:

• Routine vaccination of children, conducting Mantoux test.
• The timely passage of medical examination, in particular, 1 x-rays once a year.
• Restricting potentially infected people contacts.
• Compliance with the rules of personal hygiene.
• Nutrition, normalization of work and rest.
• In case of confirmation of contact with TB patients to TB specialist treatment and prophylactic antibiotics.

FORECAST FOR RECOVERY

The forecast for recovery and life depends on many factors: localization, the process spread, severity of the condition, the sensitivity of the pathogen to antibiotic therapy, concomitant disease, age. Given the severity of the disease, often arbitrarily poor prognosis.

Ability to work due to illness is lost for a period of treatment. Even after complete recovery there are a number of restrictions on the professional activities due to illness.

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