What are the first signs of tuberculosis. What are the symptoms of tuberculosis at an early stage in a woman. Hemoptysis - a dangerous symptom of tuberculosis

Pulmonary tuberculosis - infectious pathology, caused by Koch's bacillus, characterized by clinical and morphologically different variants of lung tissue damage.

The variety of forms determines the variability of symptoms. The most typical for pulmonary tuberculosis are respiratory disorders (cough, hemoptysis, shortness of breath) and symptoms of intoxication (prolonged subfebrile condition, sweating, weakness).

Next, we will look at what pulmonary tuberculosis is, what forms of the disease are and how a person becomes infected with them, as well as signs of the disease in the early stages and methods of treatment in adults today.

What is pulmonary tuberculosis?

Pulmonary tuberculosis is an infectious disease. It develops due to the ingestion of the pathogen - tuberculosis mycobacterium. Entering the human body, bacteria cause local inflammation, manifested in the formation of minor epithelial granulomas.

Even if the mycobacterium has penetrated into the human body, it is not a fact that signs of pulmonary tuberculosis can be immediately noticed - the probability of the disease is not one hundred percent. As medical studies have shown, Koch's wand itself is present in the body of many modern people, among them every tenth suffers from an unpleasant disease.

If the immune system is strong enough, it successfully resists the infectious agent, eventually developing strong immunity to it.

Since Koch's wand multiplies rapidly in unsanitary conditions, there is an opinion that the disease occurs only in the poor, but everyone can get sick with tuberculosis, regardless of age and position in society.

Forms of tuberculosis

According to WHO, 1/3 of the world's population is infected with mycobacteria. According to various sources, every year 8-9 million people fall ill with tuberculosis and 2-3 million die from complications of this disease.

You should know that tuberculosis is transmitted exclusively from people who have an open form of the disease. The danger lies in the fact that under some circumstances the patient himself may not know about the transition of the disease from a closed form to an open one.

Depending on the nature of the occurrence, the following types of disease are distinguished:

1. Primary. It develops when the patient makes the first contact with the Koch stick. The human body to which an infection is first transmitted can easily become ill. The disease can take a latent form, remaining in the body for many years, and "waking up" only when the patient's immunity is weakened;
2. Secondary pulmonary tuberculosis develops upon repeated contact with the MBT or as a result of reactivation of the infection in the primary focus. Main clinical forms secondary tuberculosis are focal, infiltrative, disseminated, cavernous (fibrous-cavernous), cirrhotic, tuberculoma.

Open form of pulmonary tuberculosis (contagious)

This form is the most dangerous. The lungs are most commonly affected, but other organs may be involved. Infection occurs by inhalation of the infectious agent. A patient with an open form must be isolated. This term should be understood as the fact that a person is contagious to others, as he releases active mycobacteria into the environment. The presence of an open form can be determined by examining a sputum smear.

Mycobacteria are able to survive even on dust, so it is very easy to become infected with them when using the same items. In addition, the use of public institutions and transport, even for a short time, can lead to the transmission of an open form of tuberculosis from one person to many others.

Closed tuberculosis

The closed form of pulmonary tuberculosis does not imply the release of Koch's sticks into the environment. This form is called TB-, which means that a person who is sick with this disease will not be able to infect others.

Closed tuberculosis is associated with changes in the patient's state of health, which can take physical and internal forms. It should be noted that under the influence of BC on the area of ​​the lungs, the epidermal tuberculin test in infected patients in 80% of cases guarantees positive result. Its confirmation is necessary through testing and instrumental examinations.

Other characteristics boil down to the fact that patients do not feel unwell - they do not form any unpleasant symptoms, indicating a problematic functioning of the lungs or other body systems.

Signs of an early stage of pulmonary tuberculosis

Symptoms of tuberculosis in adults may not appear immediately. The duration of the incubation period (the time from the moment of infection with the virus until the first noticeable symptoms appear) can vary depending on several factors. Very often, signs of pulmonary tuberculosis in the early stages are mistakenly confused with SARS, and real reason diseases can only be detected during routine fluorography.

The first signs of tuberculosis are mild, but then gradually increase. These include:

• cough with expectoration of sputum for 3 weeks;
• hemoptysis;
• constantly high temperature;
• fatigue, lethargy, low performance;
• sudden mood swings, irritability;
• a sharp loss of kilograms;
• loss of appetite.

Symptoms do not necessarily appear immediately: as a rule, one or two appear first (and it is not necessarily a cough) or two, others join it. If, in combination, these symptoms last longer than 3 weeks, there is a serious need to see a doctor.

Pay attention to your appetite, in patients it decreases very quickly. The first feature tuberculosis in children and adults - a sharp weight loss and a prolonged cough.

The reasons

The causative agents of this disease in humans are bacteria of the genus Mycobacterium, more precisely: Mycobacterium tuberculosis.

The main provoking factor is a decrease in the body's resistance. This can happen under the following circumstances:

• if a person has severe somatic diseases;
• chronic alcoholism;
• depletion of the body.

As it was revealed in the course of research, the infectious agent is characterized by increased resistance to any aggressive influences, it is not afraid of alcohol, acid, alkali. Tuberculosis can survive in the ground, snow, and the destruction methods identified by the German scientist assumed the direct influence of sunlight, heat, antiseptic components containing chlorine.

The main predisposing factors for the development of pulmonary tuberculosis are:

• smoking;
• malnutrition (lack of vitamins and animal proteins);
• physical fatigue;
• neuropsychic overstrain (stress);
• drug use;
• substance abuse;
• hypothermia;
• frequent viral and bacterial infections;
• serving a sentence in places of deprivation of liberty;
• crowding of teams;
• stay in rooms with insufficient ventilation.

Transmission routes

1. The penetration of mycobacteria into our body usually occurs by air, or aerogenic, by. Contact, transplacental and alimentary (alimentary) routes are much less common.
2. Respiratory system healthy person is protected from the penetration of the microbe by special mechanisms, which are significantly weakened in acute or chronic diseases respiratory tract.
3. The alimentary route of infection is possible in chronic bowel diseases that disrupt absorption in it.

Regardless of the route of entry, mycobacteria enter the The lymph nodes. From there on lymphatic vessels they are distributed throughout the body.

Symptoms of pulmonary tuberculosis in adults

Incubation period disease can be from one to three months. The danger lies in the fact that in the early stages of the development of the disease, the symptoms are similar to a simple respiratory infection. As soon as the stick enters the body, it begins to spread with blood to all organs, the first manifestations of infection appear.

With tuberculosis, a person feels weak, as at the beginning. Efficiency decreases, apathy appears, you constantly want to sleep, the patient quickly gets tired. Signs of intoxication do not go away for a long time.

Symptoms of pulmonary tuberculosis:

• persistent cough;
• shortness of breath, which increases gradually after infection with tuberculosis, occurs even with minor physical activities;
• wheezing, noted by the doctor when listening (dry or wet);
• hemoptysis;
• pain chest, appearing at deep breaths or at rest;
• fever body: up to 37 degrees or more;
• painful glint of the eyes, pallor, flush on the cheeks.

The temperature in tuberculosis usually rises at night. There is a fever, the thermometer can show up to 38 degrees.

With greater bacterial activity, patients may complain of:

• sharp jumps in temperature up to 39 ° - especially towards the end of the day;
• girdle pain in the chest and shoulder area;
• spasms under the shoulder blades (if the disease has affected the pleura);
• dry persistent cough;
• heavy sweating during sleep.

Similar symptoms are characteristic of primary tuberculosis - this means that a person has not encountered this disease before.

Coughing up blood and developing acute pain when inhaled - the most dangerous symptoms of pulmonary tuberculosis in adults. It is very difficult to treat the disease at this stage. The patient is recommended hospitalization. The foci of the disease rapidly affect a variety of organ systems, and the musculoskeletal system may also suffer.

AT severe cases The patient has complications such as:

• pulmonary bleeding;
• pulmonary hypertension;
• cardiopulmonary insufficiency;
• edema of the extremities;
• ascites of the abdominal cavity;
• fever;
• sudden weight loss;
• painful sensations in the cell;

To a greater extent, tuberculosis affects the lungs - in almost 90% of cases. However, mycobacteria can be dangerous to other organs as well. The patient may be diagnosed with tuberculosis genitourinary system, bones, central nervous system, digestive organs. Symptoms of the disease in this case are caused by a malfunction of the affected organs.

Stages of development

When the pathogen enters the lungs, the following occurs:

1. Mycobacterium tuberculosis settle in the bronchioles and alveoli, penetrate into lung tissue, cause inflammatory response(focus on specific pneumonia).
2. Then they are surrounded by protectors-macrophages, which, having turned into epithelioid cells, stand around the pathogen in the form of a kind of capsule and form the primary tuberculosis focus.
3. Some mycobacteria manage to penetrate this protection, then they move with the bloodstream to the lymph nodes, where they contact the cells. immune protection and cause a complex of reactions that form specific cellular immunity.
4. Inflammation occurs, it is replaced by a more perfect reaction, in which macrophages are also involved, it is their activity that determines whether the anti-tuberculosis defense of the body will be effective.

Diagnostics

Diagnostics consists of several stages:

• Collection of anamnestic data (what complaints, whether there were contacts with patients with tuberculosis, etc.).
• Clinical examination.
• Radiography.
• Laboratory tests (blood and urine tests).
• Three times microscopic and bacteriological examination sputum.
• If necessary, conduct a series special surveys: bronchoscopy, lung tissue biopsy, molecular biological diagnostics, etc.

If you suspect possible presence disease, the Mantoux test is performed. At the same time, the antigen of the causative agent of the disease is injected under the human skin, after a few days the injection site and the body's immune response are studied. If an infection has occurred, then the reaction will be quite pronounced: the stain is large.

According to the results of the diagnosis, pulmonary tuberculosis is differentiated from:

• sarcoidosis of the lungs
• peripheral lung cancer,
• benign and metastatic tumors,
• pneumomycosis,
• lung cysts, abscess, silicosis, anomalies in the development of the lungs and blood vessels.

Additional Methods diagnostic search may include bronchoscopy, pleural puncture, lung biopsy.

combination of tuberculosis and recent times is not at all rare. Latest Research prove that in people who have had tuberculosis, lung cancer occurs 10 times more often.

Treatment of pulmonary tuberculosis

Tuberculosis treatment is a very long and systemic process. To get rid of the disease completely, you need to make a lot of effort and patience. It is almost impossible to recover at home on your own, since Koch's wand eventually gets used to many drugs and loses sensitivity.

Doctors prescribe to patients:

• physiotherapy procedures;
• breathing exercises at home;
• drugs to increase immunity;
• special nutrition for illness at home;
• surgical intervention.

Surgical intervention for the treatment of adults is used if it is necessary to remove part of the lung due to its serious damage during the illness.

Treatment of tuberculosis in the early stages in an adult

• rifampicin;
• streptomycin;
• isoniazid;
• ethionamide and their analogues.

Pharmacotherapy takes place in two stages. At the initial assigned intensive treatment to suppress bacteria with a high metabolism, and finally - blocking the remaining microorganisms of low metabolic activity. The main group of anti-tuberculosis drugs used includes:

• Isoniazid
• Rifampicin
• Pyrazinamide
• Ethambutol
• Streptomycin

With resistance of bacteria to drugs of the main group, reserve drugs are prescribed:

• Kanamycin
• Amikacin
• Cycloserine
• Prothionamide
• Ethionamide.

Treatment of pulmonary tuberculosis should begin with first-line drugs, if they are ineffective, then others are prescribed. The best solution is the use of several groups of drugs.

If the patient's condition allows, then he receives treatment on an outpatient basis, with a weekly appearance at an appointment with a phthisiatrician.

Should be considered, what ambulatory treatment possible only if a non-contagious form of pulmonary tuberculosis is diagnosed, in which it will not infect others.

The effectiveness of therapy is not judged by how long pulmonary tuberculosis is treated, but by the following criteria:

1. bacterial excretion stops, which is confirmed microscopic studies and sputum culture (some foreign researchers believe that this criterion alone is sufficient to ascertain cured tuberculosis);
2. signs of tuberculous inflammation disappear, both clinical and laboratory;
3. the foci of the process, visible on the radiograph, regress, forming residual inactive changes;
4. the patient is recovering functionality and work capacity.

Spa treatment

This type indicated for focal, infiltrative, disseminated form of tuberculosis at the stage of scarring lung tissue, resorption and compaction changes in it, after surgical operations. Spa treatment includes:

• pharmacotherapy;
• diet food;
• beneficial effects of the climate;
• physiotherapy;
• physiotherapy exercises.

Operation

Tuberculosis of the lungs requires surgical treatment if destructive processes - cavities or large caseous formations - in the lungs do not decrease after 3-9 months of complex chemotherapy.

Also surgical methods treatment of tuberculosis are indicated in the development of complications:

• stenosis and deformation of the bronchi,
• chronic empyema (extensive purulent lesion),
• atelectasis (areas of falling lung tissue) and abscesses.

Prevention

1. Social prevention (carried out at the state level) - a set of measures to improve the life and health of people, educational work on tuberculosis, etc.
2. Sanitary prevention is a variety of activities in the foci of tuberculosis infection.
3. Specific - vaccination and revaccination of BCG.
4. Chemoprophylaxis is the appointment of an anti-tuberculosis drug not for the purpose of treatment, but for the purpose of prevention, to people who have been in contact with a patient with tuberculosis.

Tuberculosis of the lungs is dangerous disease, which must be treated under the supervision of a specialist and preferably at the earliest stages. Monitor your health, undergo diagnostics 1-2 times a year and follow preventive measures.

The diagnosis sounds like a sentence for a prosperous person - the disease is considered to be social, common among people living in adverse conditions. Unfortunately, neither an adult nor a child is insured against cases of infection. The disease, detected at the initial stage, is cured, but you need to know its symptoms.

Symptoms of tuberculosis at an early stage

The causative agent of the infection is Koch's wand. The bacterium is transmitted by airborne droplets, strikes great amount of people. Not everyone gets infected: the reason for this is a well-functioning immune barrier that stops the infection, preventing it from developing. Initially, Koch's wand penetrates the respiratory system, then spreads through the body with blood, infects internal organs.

The peculiarity of an infectious disease is that if the immune system does not immediately destroy it, the pathogen lives for many years. The incubation period at closed form lasts for several years. Provoke the disease:

• poor home conditions;
• weakened immunity;
• drug use;
• poor nutrition;
• stress;
• smoking;
• depression;
• lack of fresh air;
• chronic diseases internal organs.

The infection is difficult to diagnose in the initial stages - there are no pronounced symptoms. When does it start acute form, they are easily confused with the features of other diseases. You need to know how tuberculosis manifests itself - the symptoms, the first signs, in order to start treatment in a timely manner. Bacteria enter the lungs through the bronchi. They begin to multiply, causing inflammation. During the incubation period, it is difficult to suspect an infection - there is no cough. Early symptoms of tuberculosis appear:

• loss of strength;
• sharp decline weight;
• sweating during night sleep.

Signs of pulmonary tuberculosis in the early stages

When bacteria have all the conditions for reproduction, they initially infect lung tissue. Gradually enter the bloodstream and begin infection of the internal organs. The incubation period lasts up to two years, while the patient does not infect others. With provoking factors, the process is activated in the lungs, goes into an open form. What signs of tuberculosis appear during this period, what are their manifestations?

The main symptoms of pulmonary tuberculosis at this stage are the appearance of a painful cough with sputum. It intensifies in morning time, has blood impurities. The following symptoms are expressed:

• the appearance of pain behind the sternum, in the shoulders;
• fast fatiguability;
• irritability;
• decrease in working capacity;
• elevated temperature;
• change of mood;
• sweating during sleep;
• dyspnea.

The first signs of tuberculosis of the gastrointestinal tract

tuberculosis infection it often enters the digestive tract through household items, with food. The causative agent can provoke a disease of the liver, intestines or stomach. There are frequent situations when a patient suffers, having a pulmonary form and swallowing his own mucus. What symptoms of tuberculosis of the gastrointestinal tract indicate infection? They are similar to other diseases, so people with a pulmonary form are subject to mandatory examination. The first signs of infection of the digestive system:

• bouts of pain;
• constipation;
• blood in the stool;
• nausea;
• fever;
• sweating;
• vomit;
• weakness;
• fatigue;
• exhaustion.

How tuberculosis of the central nervous system manifests itself

Koch sticks fall into nervous system due to violations of the vascular barrier that protects it from harmful substances that are in the blood. The infection develops in the membranes of the brain, affects spinal cord. Diseases affect adults and children. The first signs are easily confused with other diseases, because of this, inflammation is often neglected, which leads to a tragic outcome.

What are the most pronounced symptoms of CNS tuberculosis? The first signs of the disease include severe headaches. With development inflammatory process observed:

• violations of coordination;
• stiffness of the neck muscles;
• seizures;
• sleep disturbance;
• disorientation in space;
• blurred vision;
• stool retention;
• temperature rise;
• photophobia.

The first symptoms of tuberculosis of bones and joints

This disease is predominantly found in adults. The spine, knees are affected, hip joints. Bacteria through the vessels, lymphatic pathways enter the tissues of the bones, causing an inflammatory process. Provoke infection:

• excessive loads on the joints;
• trauma;
• poor nutrition;
• unfavourable conditions life;
• frequent infections;
• hypothermia;
• contacts with infected patients;
• difficult working conditions.

On the initial stage tuberculosis of the bones shows little symptoms. There is a disease with pain in the spine, joints, characteristic of arthrosis, osteochondrosis. The child has a fever, fatigue, loss of appetite. When infection develops, its first signs are:

• increased pain;
• constrained movements;
• lameness;
• clubfoot;
• change in gait;
• amyotrophy.

Symptoms of skin tuberculosis

This variant of the development of infection is rare - the skin creates a defense against bacteria. The disease affects women, children and adolescents. Infection occurs through wounds on the skin during contact with the patient, through blood poisoning. Often there are relapses of the disease. The first signs appear on the face, the region of the lymph nodes, on the buttocks. Distinguish skin tuberculosis symptoms:

• cyanosis of integument;
• tubercles, dense knots;
• hard papules;
• abscesses;
• non-healing ulcers;
• warty growths.

What are the signs of eye tuberculosis

This infection is very difficult to diagnose. Only a specialist can identify the first signs of eye tuberculosis disease. Incorrect and untimely diagnosis leads to loss of vision. First signs:

• eye redness;
• decreased visual acuity;
• sharp pain;
• increase intracranial pressure;
• the appearance of a veil before the eyes.

Diagnosis of tuberculosis

The doctor at the reception collects an anamnesis of the disease. The doctor must find out the likelihood of contact with carriers of the disease. An infection is detected by the first sign - coughing up blood. Help to clarify the diagnosis modern methods examinations. How is tuberculosis diagnosed? childhood? A child, starting from a year to seven years old, is given a Mantoux test - the antigen of the pathogen is injected subcutaneously. How to recognize tuberculosis? Diagnosis of infection is carried out visually: a reaction appears - swelling at the injection site.

How to detect tuberculosis? Mass primary diagnosis– regular checks of the population using fluorography. The definition of the disease occurs by darkening in the pictures. If tuberculosis is suspected:

• sputum analysis under a microscope;
• examination of blood, urine;
• radiography of the respiratory system;
• bronchial endoscopy;
• spiral tomography of the lungs.

Video: signs of tuberculosis in a child

Tuberculosis is an important medical and social problem our time. According to medical indicators, annually from this disease 3 million people die, and the incidence rate among the population is 8 million patients a year. The insidiousness of this disease lies in the fact that from the moment of infection with the causative agent of the disease, to the acute period of its development, a lot of time can pass, up to several years.

The reason for the increased incidence of tuberculosis among the population is considered to be a decrease in the body's immune forces, poor quality and unbalanced diet, poor social and living conditions, difficult working conditions and other factors that significantly worsen the quality of human life. All people are at risk for development age categories, from infants and children, to adults and the elderly. Despite the high mortality from this disease, it is still treatable, especially in the initial stages of its development. Therefore, it is very important to identify tuberculosis - symptoms and first signs. Only then will there be a chance for a successful recovery, preventing the development chronic form and complications that can be life-threatening.

Tuberculosis - what kind of disease?

It is an infectious disease caused by bacteria that can infect both respiratory system and other internal organs and systems of a person. The causative agent of tuberculosis is the bacterium Mycobacterium (Koch's bacillus), which is most often transmitted by airborne droplets, less often by contact with an infected person or by the transplacental route.

The Koch bacterium is resistant to the external environment, as well as to high temperature conditions. For example, in water, this microorganism can survive for 60 days, and on the surface of household items for about four weeks. In a cold environment or in a frozen state, the stick can live for decades. Entrance gates for the penetration of the pathogen are Airways. After the initial penetration into the mucous membranes of the bronchi, the microorganism enters the alveoli, then penetrates into the blood stream and spreads throughout the body. If a person has had close contact with someone who has tuberculosis, this does not mean at all that he will definitely become infected with it.

Once in the human body, the tuberculosis bacillus encounters multiple barriers of the immune system that can protect us from the effects of a foreign organism. In cases where a person's immunity is weakened, there is a risk of getting sick or becoming a carrier of Koch's sticks. After the penetration of microorganisms into the human body, they can be in an inactive form for a long time. In addition, it is not so easy to suspect the signs, because this disease refers to those that often resemble completely different diseases. According to medical indicators, one third of tuberculosis patients on early stages do not experience any symptoms, which in turn complicates the course and treatment of the disease. Therefore, it is very important to recognize the first sign, this will significantly increase the chance of curing a person and preventing a transition to a more severe stages which often lead to death.

Tuberculosis: causes

The main cause of the development of the disease is Koch's microbacterium, which, after penetrating the human body, may not manifest itself for a long time. The activation of bacteria occurs when the human immune system does not have enough resources to destroy the pathogen. It does not belong to highly contagious diseases, but as shown modern research, 1 bacillus excretor can infect about 15 people. It is important to note that getting infected does not mean getting sick. It all depends on the state of the human immune system, concomitant diseases as well as lifestyle. There are several predisposing factors for development:

• drug use;
• smoking;
• alcohol abuse;
• predisposition to diseases of the respiratory system;
• diabetes;
• malnutrition;
• frequent depression and stress;
• internal chronic diseases;
• unfavorable living conditions.

Based on the above factors, we can conclude that all of them in one way or another are associated with a violation and a decrease in immunity.

Signs of tuberculosis

After the penetration of the stick into the body, it is introduced into the lung tissue, where it begins to actively multiply, causing an inflammatory process. At the beginning of the development of the disease, an infected person does not feel severe symptoms.

In the early stages of development, a person may feel a breakdown, sudden loss in weight night sweats. Temperature rise in early stages not noted, also there is no cough. Cough and fever are noted only when the pathogen has entered the bloodstream and extensively affected the lung tissue. The erased picture of tuberculosis at the beginning of its development, as a rule, does not arouse suspicion in a person, and the disease, in turn, progresses, acquires new stages of development, which force one to see a doctor.

Stages of tuberculosis

This disease, like any other, has its own stages of development:

• The primary form is the period of development when the pathogen is in the lungs;
• Latent infection is a latent period that does not allow infected person infect other people;
• An active disease or an open form is contagious to others;
• The secondary stage of the disease - the microorganism is aggressive and spreads throughout the body.

Based on the practice of TB doctors, most people have latent form tuberculosis, when Koch's wand is in the body, but does not cause any discomfort to a person. Quite a part of the primary type goes into an open form. For this, the bacteria will need up to 2 years of habitation in the human body. In addition, in order for the wand to begin to actively multiply and go through new stages, there must be provoking factors. With strong immunity and healthy body, the tuberculosis bacillus is unable to reproduce, and dies a few days or weeks after settling in the respiratory system.

Tuberculosis symptoms

Clinical signs do not appear immediately, but only when the causative agent of the disease has entered the bloodstream or struck most lungs. At first, the symptoms of tuberculosis are mild, but as the disease progresses, they become more pronounced. The main features in acute period The following symptoms are considered:

• cough with sputum production that lasts more than 3 weeks;
• an admixture in the blood in the sputum;
• temperature rise to subfebrile;
• weight loss;
• fatigue;
• lack of appetite;
• abrupt mood swings;
• increased irritability;
• decrease in performance.

The cough in tuberculosis is usually loose and frequent, especially in the morning. People who smoke often think of this cough as "smoker's cough" but should not be taken for granted. If at least 1-2 symptoms appear, it is better to consult a doctor and make sure that you do not suffer from this disease.

In cases where the disease develops more aggressively, the following symptoms may be present:

• increase in body temperature up to 38-39°C;
• pain under the sternum;
• pain in the shoulder area;
• painful, dry and hard cough;
• sweating during sleep.

The above symptoms may be present in other diseases, so it is unnecessary to worry prematurely, it is better to seek help from a doctor who, after examining the patient and collecting anamnesis, will be able to diagnose and prescribe appropriate treatment.

Symptoms of extrapulmonary tuberculosis

The causative agent can affect not only the lungs, but also other internal organs of a person. In such cases, we will talk about the extrapulmonary type. The defeat of any internal organ or system with Koch's wand is difficult to recognize, therefore, the diagnosis of internal organs is most often made after the exclusion of other pathologies. Symptoms extrapulmonary tuberculosis depend on the localization of the disease and the affected organ.

• Tuberculosis of the brain - develops slowly, more often in children or people who are ill diabetes or HIV infection. This form of the disease is characterized by an increase in body temperature, sleep disturbance, nervousness, an increase in the occipital muscles of the neck, back pain when stretching the legs or tilting the head forward. This form can appear all sorts of violations in the functioning of the central nervous system.
• Tuberculosis of the digestive system - characterized by periodic violation of the stool, bloating, pain in the intestines, blood in the feces, high temperature body up to 40 degrees.
• Tuberculosis of bones and joints is rare and is manifested by pain in the affected areas of the body, limited joint mobility. This form difficult to distinguish from other diseases of the musculoskeletal system.
• Tuberculosis of the genitourinary system - affects the kidneys and pelvic organs. It is characterized by back pain, fever, frequent and painful urination the presence of blood in the urine.
• Tuberculosis of the skin - manifests itself in the form of rashes on the skin, which quickly spread throughout the body, forming dense nodules that eventually burst.

The microorganism can affect other organs and systems, but it is difficult and almost impossible to determine it by clinical signs. Extrapulmonary tuberculosis develops when the pathogen enters the bloodstream and spreads through the bloodstream throughout the whole body, invading one of the internal organs or systems of the human body. The prognosis after treatment of extrapulmonary tuberculosis depends on many factors: the localization of the pathogen, the degree and stage of the affected organ, as well as general condition health and other factors. Therefore, it is difficult to answer the question, what is the prognosis after treatment.

How to recognize tuberculosis

It is impossible to determine the pathogen without the results of examinations, therefore, if this disease is suspected, the doctor prescribes a series of tests that will help identify the pathogen and determine the stage of the disease. Diagnosis consists of the collected patient history, study of the medical history, as well as the results of examinations such as:

1. The Mantoux reaction is an easy way to detect tuberculosis bacillus. If a person is sick, then the reaction of the sample will appear after 72 hours. A mantoux test will show if an infection is present in the human body, but many phthisiatricians believe this method research is very inaccurate.
2. Polymerase chain reaction(PCR) - informative method diagnostics, which allows in 98% to detect tuberculosis bacillus. AT this case the patient's sputum is examined.
3. X-ray of the chest - allows you to identify the focus of inflammation of the infection in the lungs.

The results of the examination allow the doctor to make complete picture disease, identify the pathogen, determine the degree and stage of the disease, and prescribe treatment. It is important to note that at the initial stages of development, it responds well to treatment, which cannot be said about chronic forms.

How to treat tuberculosis?

As practice shows, it is possible to recover, but the most important thing is to detect it in time and strictly follow the doctor's recommendations, take the medicines prescribed by him throughout the course of treatment. Tuberculosis treatment should be complex and lengthy, from several months to several years. The reception is considered important in therapy. antibacterial drugs, the action of which is aimed at the destruction of a pathogenic pathogen. Usually the doctor prescribes several antibiotics that need to be taken for several months, as well as anti-tuberculosis drugs, probiotics, vitamin therapy and immunostimulants. In addition to receiving medicines patients need special diet and physical therapy.

Drug treatment lasts up to 6 months or more. During this period, a sick person is in a tuberculosis dispensary. This isolation of the patient allows you to avoid infecting other people. After the treatment, a person periodically visits a doctor, takes necessary tests and makes examinations, and is also registered in the dispensary. If the doctor prescribed a course of treatment for 6 months, then it must be completed in its entirety, otherwise the termination medical therapy can lead to relapse of the disease and its progression.

It is important to note that wrong treatment, as well as an incompletely completed course of medical therapy, lead to the transformation of the disease, which in turn leads to a relapse of the disease and its transition to severe and incurable forms, ending in death.

If a tuberculosis symptoms detected early, the disease responds well to treatment. late discovered, advanced tuberculosis- often already incurable. What are the symptoms of tuberculosis? The peculiarity and, to a certain extent, insidiousness of this disease lies in the fact that, as a rule, it begins and proceeds imperceptibly at first. Most often, the amount of the causative agent of tuberculosis is too small for the body to react in any noticeable way and it would be possible to determine the symptoms of tuberculosis. The only sign of infection is a tuberculin reaction. At further development diseases, the body copes with the pathogen so easily that, fortunately, in very rare cases defensive forces organisms show themselves clearly.

The first manifestations of the disease are usually mild at first, and then gradually increase. Tuberculosis symptoms are cough with sputum production for more than 3 weeks, hemoptysis, prolonged temperature rise to small numbers, weight loss, increased fatigue, loss of appetite. There are mood swings, irritability, decreased performance. Not all symptoms of tuberculosis may appear immediately, but only 1-2, and it will not necessarily be a cough.

Any of these TB symptoms lasting more than 3 weeks and not explained by other reasons, and especially a combination of several of them, should be a reason to see a doctor and be tested for TB.

However, there are cases when the symptoms of tuberculosis manifest themselves more actively: the temperature rises to 38-39 ° C and the patient feels pain under the sternum and behind in the shoulder area; there is a hard dry cough; sweating at night. Fever usually occurs in the evening heavy sweating, the temperature rises slightly (from 37.5 to 38 ° C), the cough is constant, but not very strong, which in some cases can be assessed as characteristic symptom tuberculosis.

Often the patient also complains of pain under the shoulder blades (with the spread of the tuberculous process to the pleura); he feels tired, pale, easily excited, loses his appetite and suffers from indigestion. Joint pain is also common.

The above tuberculosis symptoms could be typical of the disease, but in reality everything is not so simple. Most different types influenza and simple inflammation of the lower respiratory tract have exactly the same symptoms. On the contrary, in many cases, the symptoms of tuberculosis are so mild that the initial stage of tuberculosis, in which the patient is easily treatable, is not detected.

Sometimes undercurrent the disease continues for a long time, before the development of a common process. In order to identify such imperceptibly flowing forms, a fluorographic examination of the population is carried out. At the same time, and in the interval between fluoro examinations, tuberculosis can go quite far. Therefore, if you suspect symptoms of tuberculosis, you need to pay attention to your health.

Tuberculosis is called infectious process, the beginning of which is provoked different kinds mycobacteria. If the disease is detected in the initial stage of development, the chances of successful treatment much higher than when diagnosing pathology on late stages. The lung tissue is most often affected, but other organs are also affected.

Mycobacterium tuberculosis is extremely resistant to various factors environment and can stay in soil or water for a long time, which explains the wide spread of the disease between people.

Ways of infection with tuberculosis

In most cases, infection with tuberculosis is provoked by Koch's wand. There are several ways of transmission of the disease:

1. Through the air - when talking with a sick person or a carrier, in the process of communication and inhalation of microparticles of saliva released when coughing or sneezing;
2. Through the digestive tract - when a person consumes food infected with mycobacteria. This type of transmission of tuberculosis is extremely rare;
3. By the placental route - from a sick mother to the fetus or during the passage of the child through the birth canal.

When infected with mycobacteria, tuberculosis develops by airborne droplets, however, if Koch's bacillus was transmitted to a person in some other way, then tuberculosis of other organs most likely develops, in particular:

• Skin;
• organs of vision;
• musculoskeletal system;
• CNS or meninges;
• Digestive organs;
• Organs of the urinary system.

The first signs and symptoms of pulmonary tuberculosis, photo

Symptoms of tuberculosis in adults are somewhat different from the clinic of the disease in pediatric practice. On the early stage any long time Clinical signs there are no diseases, so it is important for the patient to be attentive to his health and apply for medical care at slightest symptoms ailments.

The following symptoms should alert and become a reason for contacting the clinic:

1. Weakness and lethargy;
2. Fast fatiguability;
3. Constant causeless dizziness;
4. Increased sweating, especially during night sleep;
5. Paleness of the skin of the face against the background of a pronounced blush of the cheeks;
6. Loss of appetite, rapid weight loss;
7. An increase in body temperature to subfebrile levels (not higher than 37.5) against the background of the absence of other signs of a viral infection.

The symptoms often listed are early symptoms tuberculosis, so the patient should consult a general practitioner for an examination and complex diagnostics(see photo).

As the disease spreads and more and more lung damage is added, other symptoms of tuberculosis are added:

1. Appearance chronic cough, dry or with productive sputum;
2. Shortness of breath, which first appears with physical activity, and as the pathology progresses - at rest;
3. Various rales in the lungs, which are detected by the doctor during auscultation of the patient;
4. Subfebrile condition (increase in body temperature up to 37.5 degrees against the background of relative health);
5. Rapid weight loss and lack of appetite, while organ diseases digestive tract are not detected;
6. Discomfort and pain in the chest during deep breath – this symptom turebculosis is present if the pleura is involved in the pathological process.

Particular attention, if tuberculosis is suspected, is paid to the nature of the cough and the presence of various impurities (pus, blood) in the sputum. One of the symptoms of tuberculosis at an early stage is the appearance of a cough.

With the development of an inflammatory process in the lung tissue, the respiratory organs cannot work fully, as a result of which the patient feels a lump in the chest and constantly tries to cough it up.

With frequent coughing, tension of the diaphragm and pleural sheets occurs, which provokes the appearance of new coughing fits and the involvement of these organs in the pathological process.

With pulmonary tuberculosis, the patient produces sputum, often mixed with blood and pus. In that biological material there is a huge amount of Mycobacterium tuberculosis, therefore, to confirm the correct diagnosis, patients are prescribed bacteriological analysis sputum.

There are several stages of the pulmonary form of tuberculosis:

Stage of primary infection- the pathological process develops in the place where it directly hit infectious agent. Most often, tuberculosis of the lymph nodes develops at this stage, the first signs and symptoms appear as the disease progresses and the infection spreads to nearby organs.

Stage of latent infection- with weakened immunity of the patient, mycobacteria from primary focus infections with blood or lymph flow spread to other organs and tissues, forming new foci of the disease there.

Adult relapse stage- the resulting tuberculous foci affect the internal organs, in particular the lung tissue. If the cavity of the formed infiltrate breaks into the respiratory tract, then the patient becomes contagious to others and then they speak of an open form of tuberculosis.

Symptoms of other forms of tuberculosis

Depending on location pathological process, symptoms of other forms of tuberculosis are:

• Diarrhea, nausea, vomiting, fever, spastic pains in the lower abdomen and blood in feces- during the formation of foci of infection in the organs of the digestive canal;
• Headaches, dizziness, vomiting of central genesis (irritation of the vomiting center in the brain), muscle rigidity, as a result of which normal body movements of a person are disturbed - with the localization of foci of tuberculosis in the central nervous system;
• Pain in the joints, back, stiffness in movement - tuberculosis of the bone;
• Cystitis, pain during urination, cramps - tuberculosis of the urinary organs;
• The formation of seals on the surface of the skin, which subsequently break through and pus is released from them - skin tuberculosis.

Listed clinical symptoms may be signs of others serious illnesses which can only be diagnosed in a clinical setting.

How to recognize tuberculosis?

All people are shown for prevention once a year to undergo diagnostic study- fluorography. FG is X-ray chest, on which blackouts are clearly visible if the patient suffers from a pulmonary form of tuberculosis.

Every year, children undergo a diagnostic Mantoux test, the indicators of which make it possible to judge the presence of immunity to tuberculosis. A child is injected intradermally with 0.1 ml of tuberculin, an incomplete antigen of Mycobacterium tuberculosis. On the 3rd day after the test, the diameter of the papule is estimated.

Normally, the diameter of the papule should not exceed 5 mm, if it is larger or does not appear at all after the test, the patient should be shown to the doctor and additional diagnostic methods should be carried out.

Bacterial culture of sputum can detect the presence of mycobacteria or atypical cells in the secretions, this study administered to patients with suspected tuberculosis.

Non-pulmonary forms of tuberculosis can be diagnosed by additional methods research -, CT.