How to identify tuberculosis in humans. How to determine tuberculosis at home by symptoms? Extrapulmonary tuberculosis

Tuberculosis has been the leading cause of death for many centuries, claiming millions of lives every year. Today, thanks to active methods all possible prevention of this disease, managed to stop the pandemic and turn it into an epidemic. Thanks to the development of science and pharmaceuticals this disease treated quite successfully. However, the duration of therapy and the amount residual effects directly affects its timely detection.

The importance of early detection of tuberculosis

Early detection of tuberculosis important point during its therapy, since the causative agent of the MBT disease (mycobacterium tuberculosis) is extremely resistant to almost any influence, and also has resistance to many antimycotic drugs and quickly develops addiction to new drugs.

Few people know that it is possible to kill a bacillus only during division, which occurs only once a day, and at the resting stage it is practically invulnerable. That is why the shortest course of treatment takes as long as six months, and in the presence of a large focus or a large number of MBT, this period increases significantly and the likelihood of relapse increases. In addition, the longer Mycobacterium tuberculosis is inside the body, the more harm they give him:

1. By themselves, mycobacteria are extremely allergens, and therefore cause a strong allergic or hyperergic reaction of a delayed type in patients.
2. Their secretions are extremely toxic and adversely affect nervous system the patient, and for the whole organism as a whole, because of which, even in the early stages, immunity falls, develops bad feeling and general oppression.
3. Affecting lung tissue, MBT in best case cause inflammation and cell death lung tissue, instead of which pathological voids or scars are formed from connective cells which permanently reduce the efficiency of work respiratory system patient with consequences. When advanced disease the patient can not only get an acute respiratory failure, but also to lose part of the organ, sometimes more.
4. They also hit lymphatic system.
5. During periods of exacerbations, there is a possibility of developing sepsis or damage to other tissues of a sick person, including the membranes of the brain, which is fraught with a fatal outcome.

If the detection of tuberculosis occurred in the early stages after infection, and even better during the period latent form when only dormant bacilli are present in the body, in addition to preventing negative consequences it is possible to use drugs that are more gentle on the body or even just immunostimulating therapy in the form of an improvement living conditions, nutrition and general condition sick.

How to detect tuberculosis at home?

The vast majority of new cases of the disease are detected during the mandatory preventive examination, which is carried out without exception from the very beginning. early age. However, there are cases when, for some reason, a person does not pass the diagnosis, which does not reduce the likelihood of infection with the ubiquitous bacilli.

The only answer to the question of how to find out at home that you have tuberculosis is no way, since this is a difficult to diagnose disease, even for experienced doctors. That is why a mandatory clinical examination is required in preventive purposes. However, there are still some ways to determine tuberculosis at home, although they are unreliable:

The first way to check for tuberculosis at home is to examine your surroundings for sick people or animals, especially cattle, through whose dairy products it is very easy to get infected. If a person lives in an epidemiologically dangerous area, does not have immunity to mycobacteria, communicates closely with the patient or uses common things, the likelihood of at least a latent form of MBT being present inside his body is very high.

The second way to check tuberculosis at home is to carefully look at your well-being. This method is extremely unreliable, since the symptoms of the disease do not manifest themselves in the early stages or are very vague:

• apathy, Bad mood, prostration;
• chronic fatigue and rapid fatigue;
• pallor;
• loss of appetite;
• a decrease in immunity, which is more likely a cause, rather than a consequence of infection;
• gradual slight deterioration in well-being;
• sometimes small fluctuations in temperature within subfebrile or a feeling of chills are possible at its normal rates;
• weight loss or extremely rare weight gain;
• children may have a slight developmental delay from their peers or slow weight gain.

Many do not pay attention to these signs or begin to remember them only when interviewed by a phthisiatrician, when the diagnosis has already been made. More obvious symptoms, such as cough, sputum, shortness of breath, and even more so pain, appear only with damage to the lung tissue, and hemoptysis only on final stages or during periods of exacerbation. That is why medicine is still actively working, inventing more and more new ways to diagnose tuberculosis.

The best way to find out if you have TB is to have a preventive examination just once a year, which does not take much time, is very effective, and is almost always completely free, and not rely on chance. Even experienced phthisiatricians cannot always recognize tuberculosis, how then can a person who does not have medical knowledge and is subjective about his condition do it?

What is tuberculosis

Tuberculosis (TB) is an airborne infection that primarily affects the lungs.

Who is at risk

Although TB ​​is less common now, some children are more at risk than others.

At risk are:

• children living in a family with an adult open form tuberculosis or having high risk TB infection due to low immunity;
• children infected with HIV or suffering from other diseases that significantly weaken the immune system;
• children born in a country where TB is widespread;
• children who have visited countries for which tuberculosis is endemic, or who have had long-term contact with people who live permanently in such countries;
• children from places where medical care is at a low level;
• children living in a boarding school or in a family, one of whose members previously served a sentence in prison.

Ways of spreading tuberculosis

The usual route of this infection is airborne: an ill adult coughs and the bacteria enters the air. The child inhales them along with the air and thus becomes infected. Children under the age of ten who have pulmonary tuberculosis rarely infect other people because they tend to be very a large number of bacteria in secreted mucus and relatively unproductive cough.

Fortunately, most children who have been exposed to TB germs do not get sick. When the bacteria reach the baby's lungs, the immune system body destroys the "enemy" and prevents further spread of the infection. These children develop an asymptomatic infection that is detected only positive reaction for a skin test. However, children with asymptomatic TB still need to be treated to prevent further progression of the disease.

Symptoms

From time to time at a small amount children left without proper treatment, the infection begins to develop actively, causing fever, fatigue, irritability, persistent cough weakness, heavy and/or rapid breathing, night sweats, inflammation of the lymph nodes, weight loss and growth retardation.

In some children (mostly under the age of four), TB germs can spread through the bloodstream, affecting almost any organ. In this case, the disease will require much more difficult treatment and the sooner it is started, the better the result will be. These children are more likely to develop tuberculous meningitis - most dangerous form this disease that affects the brain and central nervous system.

Diagnostics

Children who are at constant risk of contracting TB should be regularly skin tested for TB.

Your child may need a skin test if you answer yes to at least to one of the questions:

• Did any of the family members or people your child came into contact with have TB?
• Has anyone in the family had a positive tuberculin skin test?
• Was your child born in a country with high level TB risk (all countries except USA, Canada, Australia, New Zealand and countries Western Europe)?
• Has your child traveled to high-risk countries for TB for more than one week and had contact with local residents?

The test is carried out in the pediatrician's office (or in the manipulation room of the clinic) by injecting tuberculin (a mixture of organic substances varying degrees complexity derived from Mycobacterium tuberculosis) into the skin of the forearm. If an infection occurs, your child's skin will swell and turn red at the injection site. Your pediatrician will check the injection site within 48-72 hours after the test and measure the diameter of the redness and swelling. This skin test will show if the infection was caused by bacteria, even if the child has no symptoms and has successfully fought off the disease.

Treatment

• If your child's skin test is positive, a chest x-ray will be taken to determine the presence/absence of active or past infection in the lungs. If the X-ray examination of the lungs indicates possible presence active infection, the pediatrician will refer your child for testing for Mycobacterium tuberculosis in cough secretions or in the stomach. This is done in order to determine further treatment.
• If your child's skin test is positive, but they don't have symptoms or signs of active TB infection, the child is still infected and needs treatment. To prevent the process from becoming active, your pediatrician will prescribe isoniazid (INH). This drug should be taken by mouth - once a day, tablet daily for at least nine months.
• For an active TB infection, the pediatrician will prescribe three or four medications. You will need to give them to your child for 6-12 months. Sometimes on initial stage treatment the child is in the hospital, although in fact most of the treatment activities can be carried out at home.

Fight against the spread of tuberculosis

If your child has been infected with TB (whether they develop symptoms or not), it is important to try to find out who they may have contracted. To do this, it is necessary to find out if everyone who has been in close contact with a sick child has symptoms of TB. Skin testing for TB should be performed and all family members, nannies, housekeepers, preschool and school institutions. The most common symptom of tuberculosis in adults is a persistent cough, especially one that is accompanied by hemoptysis. Anyone who has a positive skin test should be seen by a doctor and thoroughly evaluated, including a chest x-ray, sputum examination, etc. If necessary, such a person should be treated with certain drugs.

With active infection found in adult, he will be isolated as much as possible (especially from young children) until graduation full course treatment.

All family members who have been in contact with this person, as a rule, also undergo preventive medical measures are taking isoniazid regardless of the results of their own skin tests. Anyone who becomes ill or has characteristic changes on a chest x-ray should be considered a carrier of active TB.

Tuberculosis is very common among antisocial populations who are more susceptible to disease due to adverse conditions life, malnutrition and lack of proper medical care. Patients with AIDS are also at greater risk of contracting tuberculosis due to their reduced resistance. various infections.

In the absence of treatment causative agents of tuberculosis in the child's body can be dormant for many years and will only become active during special periods - in adolescence, during pregnancy or during periods of stress during adulthood.

Main danger tuberculosis is that a person not only becomes seriously ill himself, but can also spread the infection to others. That is why it is so important that your child be screened for TB in a timely manner if he is in close contact with any adult with a positive result skin test or who have had tuberculosis, even if he received timely and adequate treatment.

Volgograd doctors talk with horror about some of their patients who have been diagnosed with tuberculosis. The point is that, even though terrible diagnosis, these people categorically refuse treatment.

In doing so, they risk not only their lives, but also the health of everyone who is nearby. Why is it sometimes possible to send an infected person to a hospital only through a court?

Reporting by Elena Peach.

The doctors at the entrance of the high-rise building are not an ambulance. Although medical assistance is simply needed here, and the most urgent one at that... In the apartment where the doctors are so persistently trying to get through, there lives a family in which there is a patient with an infectious form of tuberculosis.

Alexandra Burkina, district nurse: "I said - you have a child. Infect both yourself and the child. I took x-rays twice - I didn’t come. I started calling. Once she answered me, the second time she began to hang up."

TB doctors bypass those who should have been on treatment for a long time. In one of the dormitories, a TB patient shares the same kitchen and bathroom with his neighbors. Doctors cannot warn them about the danger. Medical secrecy. However, even those who know that they can become infected are not in a hurry to be examined.

You understand, if God forbid you get infected, then the sooner you pass the examination, the more early stage we will be able to identify the disease, the more successful the prognosis of your recovery will be.

Persuasion is the only medicine that doctors regularly dispense at home without a prescription and dosage restrictions. Alexander has been persuaded to be treated for several years. He agrees, but still does not go to the hospital. When asked about relatives and neighbors with small children, he only dismisses them.

Many, like him, are in the grip of deadly delusions: the first is that tuberculosis cannot be cured, the second is that if certain measures are followed, infection can be avoided.

On the x-ray- barely noticeable light cloud. This means that the person has TB and can infect others. The owner of the picture was placed in the regional TB dispensary for treatment by court order, but after a few weeks, feeling better, he simply left the hospital.

To recover from tuberculosis, you need to spend seven to eight months on hospital bed strictly following all doctor's prescriptions. Not all patients can withstand such treatment. And if it was difficult to leave the clinic before, he acted special treatment, now there is not even a watchman at the gates of the dispensary. Because doctors have no right to keep patients against their will.

Dmitry, a patient of the Volgograd Regional TB Dispensary: ​​"This patient is a time bomb. He can infect a large number of people without knowing it. The disease is not visible. It does not hurt."

It is because of such people, Dmitry admits, that his life turned upside down overnight. He accidentally found out that he had contracted tuberculosis when he was undergoing a medical examination. He still doesn't know from whom. In order not to endanger loved ones, he has not seen them for almost a year. But he is very worried - next to his family there may well be someone who, unlike him, simply does not want to fight the disease.

Dmitry, a patient of the Volgograd Regional TB Dispensary: ​​"If he does not take care of himself and kills others, he is socially dangerous. Such people should be caught and forcibly treated."

In Russia, there is a law on the mandatory sending of such "evaders" for treatment in a hospital. The chief physician of the regional TB dispensary, Professor Alexander Borzenko, sent over a hundred lawsuits to the court this year alone.

Alexander Borzenko, chief physician Volgograd regional anti-tuberculosis

dispensary: ​​"Hospitalization seems to be forced, but compulsory treatment no. And there are no specialized institutions of a closed type, where these patients should be placed.

In the Volgograd region, the court ruled against 70 patients. But only half of them underwent examination and therapy. The rest, referring to the violation of their constitutional rights, refused compulsory treatment, thereby violating the constitutional right healthy people not be infected with a dangerous disease.

Guest in the studio - doctor medical sciences, Professor, Department of Phthisiopulmonology, Moscow medical academy named after Sechenov Irina Bogadelnikova.

Presenter: How can one get infected with tuberculosis?

Guest: It is very easy to get infected with tuberculosis. Mycobacterium tuberculosis is the causative agent of the disease, it spreads with the air, from a sick person to a healthy one, just like the flu virus, for example.

Host: What incubation period this disease?

Guest: Some people get sick almost immediately after being infected, and some people can remain outwardly healthy for many years.

Host: What are the first symptoms? How to understand that this disease already resembles tuberculosis?

Guest: Weakness, malaise, decreased performance. But there is also objective symptom- increase in body temperature. True, the increase is small, up to 37.2 degrees usually after 14:00 and lasts somewhere until 18:00 in the evening. But this does not happen every day, the temperature rises periodically, once every two days, once every three days.

Host: Such classic symptom like coughing with spotting- does this happen often?

Guest: That's right, but coughing is not early symptom, it usually appears two months after the onset of the disease. The most reliable way to detect the presence of infection in the body today is still tuberculin test Mantu. It is required to carry out this test at least once a year.

In our country, this is done in relation to children and adolescents. As far as adults are concerned, early detection tuberculosis is associated with x-ray studies which, in general, is recommended to be carried out once a year.

Presenter: Who is at risk, who is primarily susceptible to this disease?

Guest: First of all, people with a weakened immune system are at risk, so any disease that negatively affects the immune system, in fact, creates a predisposition to tuberculosis in a person, unless, of course, this person becomes infected.

Presenter: How should the relatives of the person who was diagnosed with tuberculosis behave?

Guest: First of all, do not panic, because today tuberculosis is a curable disease. Patients undergo preventive courses of treatment, the so-called preventive therapy, and with the careful implementation of all these appointments that the doctor will make to family members, the risk of getting TB is not so great.

Presenter: What is the prevention of this disease?

Guest: yes specific prophylaxis associated with the use of anti-tuberculosis vaccine, as well as anti-tuberculosis chemotherapy drugs. Is there non-specific prophylaxis associated with the fact that people are encouraged to eat a balanced diet, limit themselves in all bad habits primarily in smoking, of course. healthy image life creates conditions when the probability of disease becomes minimal.

The incubation period for tuberculosis depends on your immunity. If the body is strong, then after infection it may take several years before the first symptoms appear.

In the early stages of the development of tuberculosis can talk great weakness and an increase in temperature at certain hours. But the cough appears already when the disease is in full swing.

You can check if you are infected with tuberculosis using the Mantoux test and x-rays. Therefore, doctors advise doing fluorography at least once a year.

People who are sick with this terrible disease need not only medical, but also psychological help. So, if trouble happened to one of your loved ones, try to convince him that tuberculosis is not a sentence and proper treatment he can be defeated.

By the way, if a person has tuberculosis, his relatives also need to be examined. Moreover, in order to prevent the relatives of the patient, it is often also necessary to drink medicines and vitamins.