With tuberculosis, the cough is persistent or intermittent. What is the cough for tuberculosis in children

Coughing is a reflex action that clears Airways. Occurs with a closed glottis with a characteristic sound. Is a signal of what is happening in the body pathological change. Its character, duration and intensity speak of probable cause symptoms and help the doctor determine the tactics of examination and treatment of the patient. Cough with tuberculosis does not appear immediately, and for a long time an infected person is unaware of the infection.

Tuberculous bronchoadenitis is characterized by inflammation of the lungs. lymph nodes when infected with Mycobacterium tuberculosis. With an increase in the lymph nodes, filling with necrotic caseous masses, compress the bronchi, which causes coughing attacks and intoxication.

In young children, pressure on the bronchi can cause a two-tone cough. In an adult, the walls of the bronchi are not as elastic as in childhood, and a noticeable squeezing occurs when the lymph nodes already become massive, dense, containing caseosis with calcification elements.

Then a cough appears: dry, paroxysmal, tickling. It is caused by irritation or perforation of the bronchial mucosa. Defeat nerve plexuses sometimes causes bronchospasm. The rapidly growing volume of lymph nodes in children and the accumulation of liquefied masses of caseosis in them can provoke asphyxia.

Prolonged cough with sputum is evidence of the progression of the disease and late sign pulmonary tuberculosis. Blood may appear in the sputum. An advanced form of pulmonary tuberculosis can provoke bleeding with secretions of more than 50 ml of scarlet blood per day. Such bleeding requires urgent intensive care.

Specific inspiratory dyspnea is associated with:

• decrease in lung area;
• deterioration of bronchial patency;
• deterioration of the activity of the centers of the brain responsible for breathing.

Specificity and types of cough

Dry unproductive coughs in primary tuberculosis are paroxysmal in nature. The appearance of a cough with sputum in tuberculosis indicates the beginning of a destructive process in the lungs. Sputum is a homogeneous, colorless, odorless mass. In the event that it acquires purulent, green color and bad smell suspect associated pneumonia or bronchitis. The specificity of the symptom depends on the stage of the disease.

Doctors say "tuberculosis suspected" when the patient has been coughing for more than three weeks. The infection does not specific symptoms. To establish a connection between cough and the disease, sputum is examined for the presence of Mycobacterium tuberculosis.

Cough with and without sputum is common in acute respiratory infections, but in this case it lasts for one to two weeks. An important indicator which makes one suspect tuberculosis is the gradual development of cough symptoms lasting for weeks. When infected, symptoms of intoxication are also observed:

• weight loss;
• poor appetite;
• subfebrile temperature;
• sleep disorders;
• weakness;
• apathy;
• fever.

It is a mistake to assume that tuberculosis causes only bouts of dry obsessive coughing, reminiscent of smoker's bronchitis. It all depends on the form of the disease and the stage at which it is located. The stages of progression of the disease must be distinguished in order to determine which cough in tuberculosis corresponds to one or another of its forms:

Cough at different stages of the disease

The specificity of the cough indicates how much the disease has developed. Unreasonable dry, unproductive expectoration, delivering enough severe pain in the chest, observed with miliary tuberculosis. This is a primary infection, when Mycobacterium tuberculosis enters the bloodstream and spreads throughout the body, localized in places with good blood supply, including the lungs.

The specificity of infection lies in the fact that Mycobacterium tuberculosis does not secrete a substance to which the immune system reacts. Only already actively multiplying, mycobacteria with their accumulation cause a response of the immune system, form primary foci and provoke the formation of tuberculoma. At this time, rare coughs are observed, provoked by irritation of the lung tissues. In this case, the focal form of the disease can occur without a cough symptom.

The beginning of destructive processes: the decay phase, turning into cavernous tuberculosis and appearance fibrotic changes in lung tissues, characterized by a dull cough with a metallic tinge of sound. The appearance of such a specific sound is caused by the formation in the tissues of the lung of pathological capsular cavities, caverns, at the site of rejection of necrotic caseous masses. This symptom is accompanied by increased secretion in the lungs to remove sputum and caseosis.

The collapse of tuberculoma leads to the opening of foci of infection, which makes a coughing person dangerous to others, since mycobacteria are easily transmitted by airborne droplets. This process is called bacterial excretion, and a patient with open (active) tuberculosis is subject to isolation in a hospital.

Everyone who came into contact with him undergoes tuberculin diagnostics and chemoprophylaxis of the disease.

How to recognize an exacerbation?

Characteristic features of cough, depending on the stage of pathology:

The nature of cough in children

A bitonic cough in tuberculosis in children with convulsions appears when large bronchi are squeezed by enlarged lymph nodes. The appearance of asphyxia is caused by the progression of the disease and the accumulation of caseosis. Reduce pressure inflamed lymph node on the respiratory tract, you can turn the child on his stomach.

In this position, the affected lymph node moves forward, freeing the airways. Another difference in children's tuberculosis cough symptom is the inability of young children to consciously clear their throats. Swallowing sputum leads to congestion in the lungs and complicates the diagnosis of the disease.

How to distinguish ordinary cough from tuberculosis?

The main symptomatology of tuberculosis is a long (longer than 20 days) period coughing fits with gradually increasing intensity. Initially dry and rare cough becomes paroxysmal and difficult to stop. There is abundant sputum, possibly with impurities of pus and blood. Hemoptysis is indicative of final stages diseases.

At the same time, there are general weakness, decreased attention and performance, subfebrile temperature. With such a clinical picture, you need to be examined by a phthisiatrician. Properly selected antibacterial chemotherapy is necessary to stop tuberculous cough.

A common cause of coughing is upper respiratory tract infections, which are seasonal because they are caused by viruses:

First, the lesion affects the nasopharynx and larynx, causing:

• weakness;
• runny nose;
• sneezing
• congestion of the nasopharynx;
• tearing;
• sore throat;
• headache;
• heat;
• swelling of the nasal mucosa.

That's why, cold infections different from tuberculosis clinical picture. The symptom appears immediately acute form, does not require specific treatment. They bring tangible benefits plentiful drink and antiviral agents. Fast dynamics turns a dry cough into a productive one in a few days. The intensity decreases during the week.

Methods of diagnosis and treatment

In order to start the treatment of cough in tuberculosis in a timely manner, it is necessary to diagnose the disease in time and differentiate the tuberculosis symptom.

Modern methods for diagnosing infection with Mycobacterium tuberculosis:

• x-ray examination, the result is known after 30 minutes;
• fluorographic diagnostic method;
• laboratory analyzes of sputum using microscopy;
• sowing sputum on a nutrient medium;
• tuberculin diagnostics (Mantoux test), the result is evaluated after 3 days.

Drug treatment in the intensive phase takes at least two months. Are used combination therapy. The first-line chemotherapy drugs are used daily:

The patient becomes safe for others when the bacterial excretion stops. There is healing of lung tissues, closing of foci of infection. The patient's condition is stabilizing.

Then maintenance therapy is prescribed for up to six months. Apply every other day:

1. Rifampicin;
2. Isoniazid.

It is mandatory to fulfill the following rules treatment:

• compliance exact dosages medicines;
• do not skip medications;
• the duration of the course is at least six months.

In addition to the main treatment, to facilitate coughing, they use folk methods. They are used after consultation with a doctor and in the absence of contraindications.

• garlic (a couple of cloves during meals);
• in any form;
• badger fat.

Possible complications and prognosis

In the destructive stages of tuberculosis, hemoptysis may appear. It manifests itself as the excretion of red blood in a volume of less than 50 ml per day and coughing up blood clots. There are no feverish conditions, but there is a danger of blood entering the lungs and the appearance of aspiration pneumonia at which the temperature rises.

The reason most often lies in the violation of lung tissues due to the rejection of necrotic caseous masses. There are cases of false hemoptysis when blood appears from the trachea, stomach, nasopharynx, gums.

The cause of the appearance of blood in the sputum may be pulmonary bleeding with the release of more than 50 ml of blood during the day. This condition is considered an emergency and may result in hemorrhagic shock.

Interruption of chemotherapy causes an aggravation of the disease in 80% of cases within six months. In this case, the tactics of the previous treatment will no longer be effective. Follow-up therapy will take much longer (about 3 years), be more expensive and possible complications. Timely and proper treatment significantly increases the chances of a full recovery.

1. Tuberculosis of intrathoracic lymph nodes- dry cough of varying intensity;
2. Damage to the lung parenchyma– slight cough or quiet cough;
3. Tuberculosis of the bronchi- hacking ringing cough;
4. Pleura lesion- dry painful, scratching cough.
5. Tuberculosis of the larynx- dry cough, accompanied by hoarseness and pain when swallowing.

How does cough change depending on the stage of tuberculosis?

1. The initial stage of tuberculosis- (in children, the lymph nodes are most often affected) - dry occasional cough with a slight discharge of white frothy sputum;
2. Progressive stage- wet persistent cough with separation of mucous or whitish sputum, sometimes streaked with blood;
3. Lung collapse- (for this stage pathological process cavities are characteristic, that is, cavities in the lung) - deaf moist cough with the release of a large amount of yellow-green sputum due to the addition of a bacterial infection.

In children of the first three years of life with tuberculosis of the bronchopulmonary lymph nodes, an obsessive ringing cough appears, similar to that of whooping cough. The child begins to cough, while exhaling, but not inhaling air. Children of the first year of life turn blue. Such an attack is called a reprise. It is dangerous for young patients because hypoxia (lack of oxygen) adversely affects the development of the brain. Sometimes the cough ends in vomiting.

If a child has a cough that is not associated with acute respiratory infections, lasting more than a month, in combination with weakness, lack of appetite, night sweats chills, you need to contact your pediatrician. Mantoux reaction or Diaskin test will help confirm or refute the diagnosis of tuberculosis.

When does cough occur in children with mycobacterial infection?

Cough most often occurs in the morning. This is due to the fact that sputum accumulates during the night. When the child gets up, she flows into lower divisions lungs, irritating the cough receptors of the bronchi. Cough has no seasonality, that is, it is present in winter and summer. He worries the children for many months.

How to treat cough with tuberculosis in children?

Cough- it's just a symptom of a terrible disease. No sickness, no cough. On the present stage development medical technologies Tuberculosis is a curable disease.

1. When coughing with tuberculosis accompanied by copious sputum, you can not take antitussive drugs. This is fraught
2. With a dry, painful cough in case of damage to the pleura or larynx, mucolytic agents are indicated - Ambroxol, Lazolvan, Mukaltin.

How to cure cough with tuberculosis?

Instruction

The first symptoms of tuberculosis are most often manifested by low-grade fever and cough. The patient often thinks that this is a common cold and is treated accordingly, without seeking help from specialists. In the first stage of pulmonary tuberculosis, cough can stop even after self-treatment anti-inflammatory drugs and antibiotics. But soon the feeling of discomfort in the chest returns, and then new progressive coughing fits begin.

Coughing fits are wet in nature, while the patient feels the appearance of a lump in the chest and cannot cough it up. The cough reflex is caused by a large accumulation of mucus in the lumen of the bronchi, which is formed due to inflammatory processes. Mucus in the bronchi interferes with the passage of air, and its accumulation in lung lobes hinders the process of ventilation of the lungs, gas exchange is disturbed in the alveoli. In response to violation respiratory function the body activates defensive reflex- cough, which should help clear the lumen of the respiratory organs from mucus. But since mucus continues to be produced in large quantities, the cough does not decrease.

The cough is also protracted because the patient, when coughing, strains the pleural wall and diaphragm, they compress the lungs, their ventilation worsens. These processes lead to more inflammatory response. With tuberculous inflammation, it becomes more and more difficult for a person to breathe, so coughing attacks intensify.

Tuberculous cough is accompanied by sputum - a mixture of inflammatory mucus and pus. In the sputum there is a greater number of causative agents of tuberculosis - mycobacteria. At the beginning of the disease, the color of the expectorated mucus is light, often transparent. With the development of the tuberculous process, sputum turns yellow due to the addition of purulent discharge. In the last stages of pulmonary tuberculosis, due to strong inflammatory processes, the walls become thinner and burst blood vessels respiratory organs. First, streaks of blood appear in the sputum, with the progression of tuberculosis, the patient has practically only blood, which has impurities of pus and a specific unpleasant odor.

The cough in tuberculosis is aggravated by lying down, especially at night. This is due to the fact that in the affected foci of the lungs, a large number of mucus and when the patient takes lying position, it stagnates and puts pressure on neighboring tissues. The patient experiences painful feeling in the chest and incessant urge to cough. Such patients are recommended to sleep on several high pillows, that is, in a half-sitting position.

Cough with tuberculosis is a fairly common occurrence and with timely handling doctor can significantly reduce the risk further development diseases.

Pulmonary tuberculosis is one of the most dangerous infections respiratory organs, which until the end of the 9th century was considered incurable. Her causative agent - Koch's wand - was isolated in 1882 in one of the German clinics.

Therapist: Azaliya Solntseva ✓ Article checked by Dr.

Types of cough reflex

The nature of the cough during the disease is affected by the location of the focus of infection, and the stage in which the disease occurs.

The main route of transmission of the infection is airborne, so any coughing, and even loudly talking person is potentially dangerous to others.

However, not all forms of the disease are contagious; in order to infect others, the concentration of bacteria in the patient's body must be such that it is excreted with saliva and sputum when coughing.

Characteristics cough reflex at various forms tuberculosis:

With the initial form of pathology

After a bacterium enters the body, the disease does not appear immediately, sometimes the microbe does not make itself felt for years, and its owner becomes the owner of a latent form of the disease. With tuberculosis for early stage infection of others does not yet occur, but it is important to start treatment on time, since the disease with a weakened immune system can progress rapidly.

cure the pathology this stage possible completely and without consequences, so the annual x-ray examination, which helps to identify the disease of the organs, is mandatory for everyone.

Cough with tuberculosis at this stage has a peculiar character - a person coughs all the time, as if he has a tickle in his throat. As a rule, it is dry, but with the development of the disease, sputum begins to form and cough up.

Attacks usually worsen at night and in the morning, which is explained by large quantity mucus accumulated during sleep. According to this feature, it is already possible to suspect something was wrong, and contact a phthisiatrician for further diagnosis.

How it manifests itself in children

Children most often present with systemic lesion lung tissue, and tuberculous bronchoadenitis.

The lung tissue in this form of the disease changes minimally, but inflammation of the thoracic lymph nodes occurs at the root of the lung, causing:

• unproductive obsessive cough;
• wheezing in the chest due to the pressure of the lymph nodes on the bronchi;
• absence high temperature pointing to another infection.

Particular attention should be paid to the duration of the child's cough. If it is present for more than three weeks, then this may indicate the development of pathology.

Additional Features

Coughing and sputum are not the only signs of the disease.

In the tuberculous process, there are a number of symptoms, paying attention to which pathology can be suspected:

1. Constantly present subfebrile temperature, kept within 37 degrees. At first, it rises only in the evenings by 1-2 degrees, but with the development of the disease, such thermometer readings become constant.
2. A bright blush on the cheeks, unnaturally shiny eyes.
3. Rapid weight loss regardless of appetite.
4. Excessive sweating during sleep.
5. Pain in chest arising from both the front and the back. Possible when inhaling stabbing pain in the lungs.
6. Fatigue and weakness with minimal physical exertion.
7. Shortness of breath, heavy breathing.

By these signs alone, it is impossible to diagnose pathology; with pulmonary tuberculosis, the symptoms are often similar to other diseases. Correct Diagnosis based on laboratory research outgoing sputum to determine the degree of concentration of bacteria. The analysis is carried out by the method of polymer chain reaction.

After illness

Normally, after treatment, cough should not bother the patient. But if it is present, a natural question arises whether this is a sign of an undertreated pathology.

The point is that therapy this disease should be carefully selected and considered in order not only to stop the reproduction of bacteria, but also to completely destroy them. As a rule, tuberculosis treatment lasts at least 6 months.

But often there are such drug-resistant forms of the disease that are difficult to treat. traditional therapy, and require individually tailored dosage regimens. Forecast similar shape diseases can be completely unpredictable, therefore, to eliminate all doubts, the analysis for tuberculosis is given again.

With sputum

Normally, sputum (tracheobronchial secretion) performs bactericidal and protective function. When a bacterial infection occurs, cells of the immune system try to kill the infection, which affects the number and qualitative composition secret. That's why laboratory analysis sputum is one of the main methods for diagnosing tuberculosis.

On the various stages disease and in its various forms, sputum looks different:

• vitreous, white color clears his throat for initial stage diseases, sputum can be excreted more than 1 liter per day;
• greenish purulent sputum indicates tuberculous pleurisy, focal or infiltrative form of the disease;
• mucopurulent profuse sputum is a consequence of cirrhotic tuberculosis.

The streaks of blood present in the sputum indicate the beginning of a destructive process in the lungs caused by the pathogenic action of bacteria. At this stage, the sputum is viscous, thick, with great content dead leukocytes.

The appearance of dry cough

In the early stages, the disease may not manifest itself. special symptoms, or "masquerade" as various diseases respiratory system (bronchitis, pneumonia). The cough reflex is rare at first, it is dry and obsessive.


In the future, attacks occur more often due to impaired ventilation and gas exchange of the lungs due to mucus accumulated in the bronchi. Seizures are aggravated if a person is in a smoky or dusty room, with physical activity when breathing quickens.

With bleeding

Hemoptysis is a sign of infiltrative tuberculosis, when the infection affects small vessels circulatory system in the lungs. There may be small blood streaks or copious blood scarlet color, excreted with sputum.

Infection large vessels respiratory system can lead to pulmonary hemorrhage - an extremely dangerous condition that requires immediate medical attention.

On the other hand, with tuberculosis, the walls of the vessels become thinner, and a slight effort or cough is enough for the vessel to burst. As a result, blood fills the trachea and bronchi to such an extent that a person cannot breathe normally. Such bleeding threatens with death from suffocation, so the patient should be given timely assistance.

Bitonal view

In some cases, attacks of the cough reflex in tuberculosis have the character of convulsions, there are metallic notes in the sound. This is usually observed in children with tuberculous bronchoadenitis.

In medicine, such a cough is called bitonal. This sound occurs due to a violation of gas exchange in the lungs due to the increased pressure on them from enlarged lymph nodes. At first, a low sound of the timbre is heard, which gradually turns into a whistle. The cough itself is deep, hysterical, which causes severe pain in the sternum.

Self-medication for any kind of cough reflex is unacceptable. It may not be just a cold, but more serious infection. Therefore, the first thing that is recommended to be done is to consult a doctor so as not to miss the time and start treatment in a timely manner.

Tuberculosis is an infectious disease with an inflammatory course in the lungs, a lesion bronchial tree Koch stick. As inflammation develops, pathological changes are subject to cell structures bronchi, as it develops, it collapses and begins to function incorrectly respiratory system generally.

Tuberculin bacillus transmission route: airborne. Infection can occur through contact with infected person when talking, sneezing, coughing. Many patients are wondering what kind of cough with tuberculosis? After all, it is important to identify the disease on initial stage while the chances of recovery and a favorable prognosis are much greater.

What is the cough with tuberculosis?

Cough with tuberculosis does not appear immediately. At the first stage, at an early stage, it is practically absent. By nature it happens:

• dry, paroxysmal, causes: swollen lymph nodes, compression of the bronchial tree, outpouring of pathological fluid into the lumen of the bronchi or pleural cavity;
• enhanced, productive against the background of the progression of the disease, the addition of nonspecific bronchitis, severe destruction of the lungs.

Cough begins to clog the bronchi, bother with seizures when congested pathogenic bacteria leading to irritation of the respiratory receptors.

The symptoms and urge to cough can be quite prolonged until the accumulated mucus is completely expelled. As you accumulate serous fluid paroxysmal cough may occur with a duration of 3-10 minutes, especially in the morning when taking horizontal position After sleep. Mucus stagnates overnight, in the morning it spills over the bronchial cavity again, leading to disruption of normal breathing, the urge to wet expectoration due to the body's quick reaction to the situation.

Appearance of cough after sleep, taking vertical position — clear sign disease development. During the night, mucus accumulates in the pleural cavity, splashes out in the morning, causing a prolonged cough (up to several hours), until the lungs are completely cleared.

Children often have a dry cough with tuberculosis. It can be compared with a metallic sound at the moments of oxygen entering the respiratory organs. In case of damage to the larynx, the glottis begins to close incompletely. There is a feeling of congestion, a coma in the throat. Cough becomes hoarse, muffled.

Can there be tuberculosis without a cough?

When answering the question: is there tuberculosis without a cough, it is worth saying that it can at the initial stage. The latent form of the disease often leads to the fact that the patient learns about his diagnosis too late, when the infection of the lungs is already at the stage of complications.

The main cases when tuberculosis can occur without coughing, temperature:

• weakness immune system;
• closed, chronic form diseases with slow progression;
• the development of a focus of inflammation outside the lungs: in the liver, brain, bones, intestines, genitals.

Danger extrapulmonary tuberculosis- the spread of infection to the brain, the development of meningitis with a fatal outcome. In particular, cough is absent at the initial stage of development of 2 forms of tuberculosis: focal and tuberculoma. In addition, the disease is clinically similar to the common cold, flu, especially in children. Parents should be vigilant if the child coughs for too long.

Symptom - dry, hysterical, convulsive, paroxysmal cough, accompanied by shortness of breath, similar in sound to a metallic rattle in the morning (night) hours.

Cough is absent at the initial stage of the development of the disease. This makes it difficult to recognize. Tuberculosis should not be confused with colds, in which children begin to cough almost immediately.

Symptoms of cough in tuberculosis

Tuberculosis has a relapsing course. Inflammatory process either escalating or slowly declining. As intoxication fills the lungs and pleura, the infection begins to show many signs, symptoms in adults, along with cough and fever:

• fever with an increase in temperature up to 37 degrees;
• a sharp decline weight, up to 20 kg in 2 months;
• increased sweating at night;
• fast fatiguability;
• weakness;
• irritability.

Not always the inflammatory course in the lungs is accompanied by a cough. Doctors have noted cases when the pathology begins to develop immediately with acute stage. A destructive form with a disseminated course or miliary pulmonary tuberculosis is diagnosed.

At the initial stage distinctive features pathologies: a short cough, a quick transition from dry to wet, fever (37, 37.5 g) at night.

Additional Features:

• slight discomfort in the chest with increased inhalation, at the moments of contraction, reduction of lung tissue in volume;
• squeezing pain with intensification on inspiration;
• enlarged lymph nodes under the armpits, collarbone;
• dry unobtrusive cough at night, quickly turning into a wet one;
• discharge of blood particles;
• weakness;
• decreased concentration;
• lacrimation;
• photophobia;
• eye conjunctivitis;
• pallor of the skin;
• the appearance of an unnatural blush on the cheeks, glitter in the eyes;
• apathy;
• dizziness;
• wheezing of varying intensity;
• tachycardia;
• feeling short of breath.

As the disease progresses, the tuberculous cough begins to recede, accompanied by sputum from pus and mucus. The coughing patient tries to cough periodically. Clusters exit the lungs at first colorless. Then they change in color, begin to depart with blood particles. thinning vascular walls leads to hemorrhage.

Characteristics

With tuberculosis, a cough appears - dry, obsessive, not intractable for 3-4 weeks. Increases at night, clogs the lungs, leads to insomnia, disorders of the nervous system.

Features of cough depend on the form of the course of the disease:

1. Miliary form, cough - hysterical, strong with discharge of white thick sputum;
2. Focal form, cough - and rare weak, when it is difficult to recognize the pathology;
3. Destructive form, cough - muffled, paroxysmal, accompanied by pain in the larynx, but no wheezing;
4. Tumor-like form with the appearance of convulsive cough, discharge of a metallic echo from the larynx;
5. Laryngeal form with the appearance of a silent cough, hoarse voice in case of insufficient covering of the glottis;
6. Infiltrative form - a weak, periodic cough with a gradual change to paroxysmal with discharge of a viscous secretion in small volumes, hemoptysis.

A metallic echo occurs in the destructive form of tuberculosis, when there is a collapse of the lungs, filling with cavities.

Hemoptysis

Hemoptysis is a sign of the development of an infiltrative form of tuberculosis. Sputum with blood particles is observed. it dangerous phenomenon, since there is a high probability of developing bleeding in the lungs.

Tuberculosis is a disease in disguise. Symptoms can be confused with other diseases: lung cancer, heart failure. The danger is hemoptysis in tuberculosis with the appearance paroxysmal cough, flying out of the mouth of sputum with particles of fresh blood. Development pulmonary hemorrhage is a common cause of death.

When similar signs you need to urgently contact a pulmonologist (phthisiatrician), undergo full examination. Pass sputum for analysis and x-rays, for children - a Mantoux test. It is no longer possible to ignore hemoptysis.

Cough treatment

The goal of therapy is to achieve relief of paroxysmal cough, suspension of development inflammatory course. With tuberculosis, such a concept is applicable as to drown out the disease, to achieve a stable remission. Unfortunately, the chronic form of the disease is incurable. In a number advanced cases doctors resort to an operation to remove the affected lung (partially, completely).

Treatment is long, 2-6 months. Patients are required to strictly comply with all prescriptions, instructions of the attending physician. If not fully treated, symptoms may new force flare up again in 6-8 months. On the early stage patients are prescribed symptomatic therapy- anti-tuberculosis drugs in course doses, duration during the intensive phase - 2 months. If the state of health improves, then a transfer to maintenance therapy with the appointment of drugs (Isoniazid, Rifampicin) is possible.

It is important to prevent the resistance of Koch's bacillus to the medications taken, so it can be difficult to treat tuberculosis. This is what makes it difficult to develop a treatment program when antibiotics become powerless. Doctors prescribe drugs in high doses. It is important for patients to comply with doses, not to skip taking medications, not to interrupt treatment for 0.6 years.

Sometimes doctors have to select therapy with inclusion for simultaneous reception 6-7 names of medicines at once. The treatment is comparable to chemotherapy, when immunity is quickly suppressed and complex impact on the pathogenic microflora in the lungs. Additionally, patients are advised to:

• physiotherapy;
• breathing exercises;
• special diet.

Cough is a protective reflex, able to clear the airways from foreign accumulations of mucus. Sputum in nature with tuberculosis is different. Much depends on the provoking factors of its appearance. So cough at bronchial asthma- paroxysmal, unproductive, dry. With inflammation of the lungs - moist with copious discharge of sputum, pus. A cough in a tuberculosis patient without provoking factors has some features: coughing up with the release of clean sputum or, in the case of advanced tuberculosis, with the addition of blood particles.

Tuberculosis is contagious, the symptoms are significantly reducing the quality of life. At the slightest suspicion of an inflammatory-infectious course in the lungs, it is necessary to consult a doctor and undergo an examination.