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Every third inhabitant of the planet is a carrier of the bacterium that causes tuberculosis. Approximately 10% of carriers of the disease become ill. Tuberculosis is the second leading cause of death after AIDS.

Tuberculosis: what is it?

The name of the disease was given by the Latin word for tubercle - tuberculum. Painful granulomas - sites of lung damage - look like tubercles.
The disease is caused by numerous bacteria of the species Mycobacterium tuberculosis complex.

In more than 90% of cases, the bacterium affects the lungs. Rare 8-9% are affected by the organs of the lymphatic, nervous and genitourinary systems, bones, skin or the whole body (miliary form of the disease).

When the pathogen enters the body, a small granuloma forms in the lungs. A healthy body with good immunity copes with the disease itself, the granuloma heals after symptoms similar to SARS and overwork. It is possible to detect a healed granuloma only later - through an X-ray examination.

The body, weakened by disease, stress, diet or overwork, is not able to give an adequate immune response to the invasion of Mycobacterium tuberculosis.

The granuloma begins to grow, forming a cavity inside itself - a cavity - filled with blood. From the cavity, blood inhabited by pathogenic bacteria enters the general circulation and creates new granulomas. The body can still cope with one granuloma, but as soon as there are several of them, without medical help, the person will soon die.

Cavities grow in the lungs, close cavities merge and form large cavities filled with disease-causing fluids. In the chest cavity, fluid appears between the lungs and the sternum. A patient with active tuberculosis is highly contagious.

Patients who fall ill with active tuberculosis for the second time die in 30% of cases, despite treatment.

Tuberculosis: when did it appear

The ill-fated disease has haunted mankind almost from the appearance of the species. Archaeologists have unearthed 3,000-year-old skeletons containing bone lesions consistent with tuberculosis.

Fatal consumption in Russia - what kind of disease? This was the name of pulmonary tuberculosis, which for many centuries was a death sentence for the patient. They tried to treat consumption in Russia back in the 11th century by cutting out and cauterizing tuberculous cavities in the lungs.

In ancient Greece, the disease was called phtisis - exhaustion. From the Greek name of the disease comes the name "phthisiology" - a branch of medicine that deals with the treatment and prevention of tuberculosis.

Even ancient healers, including Hippocrates and Avicenna, tried to fight the disease. We can say that the struggle of doctors with tuberculosis lasted for thousands of years. Tuberculosis was defeated only in the 20th century, when antibiotics came to the aid of doctors - the only drugs that can fight Mycobacterium tuberculosis.

Tuberculosis: how does infection occur

98% of infections occur by airborne droplets.

A patient with an active form of tuberculosis, when coughing, sneezing, releases bacteria and can infect up to 15 people a year. Also, the causative agents of the disease are excreted with sweat, urine, saliva and other physiological fluids of the patient.

Science has more than 70 types of mycobacteria - the causative agents of tuberculosis. Mycobacteria live everywhere: in soil, water, air, in the bodies of birds, animals and people.
In addition, the tubercle bacillus can break into tiny particles or cling to a huge octopus, while retaining its dangerous properties.

Mycobacteria are amazingly viable in all conditions. They live in street dust for 10 days, on the pages of books - 3 months, in water - 5 months.

The dried bacteria caused disease in a guinea pig six months later. Frozen bacteria are dangerous even after 30 years!

The most favorable environment for mycobacteria: moist warm environment with a temperature of 29-42 °C. At a temperature of 37-38 ° C, mycobacteria multiply intensively, so the human body is an ideal habitat for tubercle bacillus.

Tuberculosis bacillus is constantly evolving and adapting to environmental conditions. Mycobacteria also adapt to drugs, so new, stronger drugs have to be developed to fight the disease.

There are cases when the patient abandoned the treatment he had begun - in this case, the tubercle bacillus in the body became resistant to drugs, and it became impossible to cure the patient.

Tuberculosis: the first symptoms

Tuberculosis is easily diagnosed with simple medical tests. Regular examination has saved the lives of millions of people, because the earlier treatment is started, the more favorable the prognosis.

How does tuberculosis manifest itself?

• Dry cough - more than 2 weeks.
• Weight loss.
• Sweating during sleep. In addition, sleep becomes restless.
• Loss of appetite.
• Constant subfebrile temperature 37-37.5 °C.
• Chronic weakness, fatigue.

As the disease progresses, secondary symptoms of the disease appear.

• The cough becomes excruciating, with the release of a large amount of sputum. After an attack, the patient feels a temporary improvement. One of the tell-tale signs of TB is bloody sputum, or just the discharge of blood from the throat when coughing.
• There is pain in the chest, especially when taking a deep breath.
• Under the skin, more in the region of the legs, nodules of a reddish-brown hue appear, painful when touched.

Tuberculosis: diagnosis

There are simple medical tests to diagnose TB.

Mantoux test

Tuberculin solution inoculation is injected under the skin of a child older than 1 year or a teenager. After 3 days, a reddish spot appears at the vaccination site, which is used to judge the adequacy of the body's immune response to the pathogen. With a normal reaction of the body, the spot takes on sizes of 5-15 mm.

Fluorography

Under weak x-rays, a chest x-ray is taken. It clearly reflects all tuberculous granulomas.

Radiography

It is carried out to study the existing foci of tuberculosis.

Sputum examination

The patient may require a sputum test for the presence of tuberculous mycobacteria if he has been coughing for a long time.

ELISA blood test

Allows you to determine the presence of the causative agent of the disease in the body. The analysis is relevant for the detection of extrapulmonary forms of tuberculosis.

Tuberculosis: treatment

Tuberculosis treatment is carried out only permanently under the supervision of a phthisiatrician.

The standard course of treatment lasts six months - during this period, the body, supported by intensive treatment, completely gets rid of the disease.

For the period of treatment, a person completely drops out of active life, since the treatment is very intensive.

The main treatment is antibacterial, aimed at the destruction of tuberculosis mycobacteria that affected the body.

Tuberculosis: extrapulmonary forms

Such forms of tuberculosis are extremely rare, they are treated according to the same schemes as pulmonary tuberculosis.

Damage to the urinary organs

Diagnosed by urinalysis. The main symptom is the cloudy color of urine and the presence of blood in it. Urination is frequent and painful. Women have bleeding, aching pain in the lower abdomen. In men, painful swelling in the scrotum.

Damage to joints and bones

This form of the disease is characteristic of HIV-infected people. Tuberculosis bacillus affects the knees, spine and hip joints. The result is lameness, sometimes a hump.

Damage to the central nervous system

It occurs in HIV-infected and infants with a congenital form of tuberculosis. Mycobacterium infects the lining of the brain. Symptoms: severe headaches, fainting, convulsions, impaired hearing and vision. The disease is practically incurable.

miliary lesion

Microgranulomas - up to 2 mm in diameter - are scattered throughout the body. The inflammatory process occurs in addition to the lungs in the kidneys, liver and spleen and requires long-term treatment.

Digestive tract injury

This form of tuberculosis is typical for HIV-infected people. The abdomen swells, pain, diarrhea and constipation appear, blood is released with feces. In addition to conventional treatment, surgery is often required.

Skin lesion

The entire body of the patient is covered with subcutaneous dense painful nodules. They break through when pressed, white curdled contents are released from them.

A simple medical examination can detect tuberculosis in the early stages of lung damage, when it can be cured relatively easily. This is especially important for children, debilitated and elderly people whose body can hardly cope with the disease.

Photo 1. The main symptom of tuberculosis disease at an early stage in humans is a specific cough with sputum.

Symptoms of tuberculosis at an early stage:

• cough with phlegm;
• fast fatiguability;
• loss of appetite;
• weight loss;
• hemoptysis;
• temperature increase to subfebrile value;
• obsessive dry cough at night and in the morning;
• irritability;
• pressure drop;
• dizziness.

Photo 2. The appearance of a cough with blood in a patient with tuberculosis is a sign of the transition of the disease to an open form.

The increase in the above symptoms is characteristic as the pathology progresses.

Photo 4. Persistent chest pain that makes it difficult to breathe may accompany the closed form of tuberculosis disease.

If treatment is started on time, it is possible to prevent intoxication of the body in a short time, which occurs when the first symptoms of tuberculosis appear in adults. As practice shows, the body copes with a dangerous pathology.

Signs of the disease in the early stages

When identifying the symptoms of tuberculosis in the first stages, the following nuances are taken into account:

1. It is important to consult a doctor without delay. As a rule, the district therapist is engaged in the study of the clinical picture and the collection of anamnesis. Based on the results of the tests, which confirm the presence of mycobacteria in the patient's body, he refers the patient to a phthisiatrician who specializes in the development of tuberculosis.

Photo 5. X-ray is one of the most common methods for diagnosing tuberculosis used by TB doctors.

1. If tuberculosis is suspected, limit communication. Being an infectious disease, the closed and open form of pathology poses a direct threat to healthy people.
2. The therapy is carried out in stationary conditions using modern anti-tuberculosis drugs, under the supervision of a phthisiatrician.

The infectious process in children and adults is manifested indifferently to age. The first symptoms of tuberculosis:

• pallor of the skin;
• pointed facial features;
• rapid weight loss against the background of lack of appetite;
• the formation of an unnatural blush on sunken cheeks;
• painful shine of the eyes;
• increased susceptibility of the eyes to daylight.

F oto 6. Photophobia occurs in a person suffering from tuberculosis at an early stage, along with other signs of the disease.

If you have a persistent cough with sputum, see your doctor. Having studied the clinical picture and the results of the medical examination, the phthisiatrician will prescribe adequate therapy.

Signs of tuberculosis by type of disease

The table shows the main types of tuberculosis according to the principle of its localization.

Tuberculosis takes on extrapulmonary forms, affecting the internal organs of a person. The intensity of the development of tuberculosis depends on the localization of the focus of pathology, the individual characteristics of the body, the degree of resistance of the immune system to negative environmental factors. Depending on the localization, closed tuberculosis is classified as:

• bone tuberculosis
• genitourinary system
• lupus
• nervous system
• organs of the gastrointestinal tract
• brain damage
• miliary tuberculosis

Photo 7. Tuberculous disease of the skin is expressed in the form of systemic lupus erythematosus.

For the purposes of a productive diagnosis of tuberculosis, the fact that the pathology of the respiratory organs often occurs with symptoms of acute intoxication of the body, influenza, and pneumonia is taken into account. Drug therapy using modern broad-spectrum antibiotics can improve the patient's condition. However, a complete cure does not occur. The disease passes into a sluggish form, periods of relative well-being are replaced by relapse.

Photo 8. In anti-tuberculosis drug therapy, antibiotics specially designed for this purpose are used.

Extrapulmonary forms of the pathological process are accompanied by local symptoms. For example, tuberculous meningitis is characterized by characteristic migraines, tuberculous tonsillitis is accompanied by pain in the larynx, hoarseness. Tuberculosis of the musculoskeletal system leads to dysfunction of the joints and bones, accompanied by acute pain in the spine, joint.

Photo 9. Tuberculous meningitis is accompanied by bouts of intense headache, often in the frontal and occipital parts.

Women with tuberculosis of the reproductive system complain of aching persistent pain in the uterus, menstrual irregularities. The lumbar spine declares itself with acute pain in the case of a destructive process in the organs of the genitourinary system. Mesenteric lymph nodes are also affected by tuberculosis. In this case, patients are disturbed by the intestines, pain and pain in the abdomen.

Despite the fact that mycobacteria have been studied to date, they mutate, adapting to new environmental conditions, progressive antibiotics and other medicines. Experts are unanimous in their opinion: an unfavorable environmental factor causes the rapid development of the disease.

Difficulties in identifying the disease by symptoms

The development of the pathological process depends on the state of the immune system, the physiological characteristics of the patient. Symptoms of tuberculosis at an early stage in adults are similar to a cold, appearing under the guise of a viral respiratory infection, bronchitis, or chronic prostration.

Photo 10. Fresh air, sun and a healthy lifestyle are used to prevent tuberculosis.

The anamnesis and initial examination allow us to make an assumption about the development of a dangerous pathology. The complete clinical picture is based on the results of numerous tests:

• immunological blood test;
• microbiological research;
• radiation diagnostics;
• endoscopic diagnostics;
• morphological history;
• study of the genetic factor.

In the early stages of development, pathology does not cause any inconvenience. In the later stages, it poses a real threat to human life. In this regard, it is important to undergo a special examination once a year, which helps to diagnose and neutralize the pathological process at an early stage.

Video: Types of tuberculosis: x-ray

Tuberculosis is an infectious disease caused by different types of mycobacteria (the most common is Koch's bacillus). The disease usually affects lung tissue, rarely affecting other organs. Mycobacterium tuberculosis is transmitted by airborne droplets when the patient coughs, sneezes and talks. After infection with tuberculosis, the disease often proceeds in a latent form (tuberculosis), but sometimes it becomes active.

The causative agent is Mycobacterium tuberculosis. Tuberculosis in humans can be caused by Mycobacterium tuberculosis, Mycobacterium bovis, Mycobacterium africanum, Mycobacterium bovis BCG, Mycobacterium microti, Mycobacterium canettii, Mycobacterium caprae, Mycobacterium pinnipedii. There are such ways of transmission of tuberculosis infection:

• Airborne (most common): Bacteria are released into the air when a person with active illness coughs, sneezes, or talks. The infection enters the lungs of a healthy person.
• Alimentary: penetration of bacteria with food.
• Contact: with direct contact. Usually infection occurs through the mucous membrane.
• Intrauterine infection: the possibility of infection of the fetus in utero has been established.

Types of disease: classification of tuberculosis

There are pulmonary and non-pulmonary forms of tuberculosis. Phases of the tuberculous process: infiltration, decay, seeding; resorption, compaction, scarring, calcification.

More than 90% of cases account for the pulmonary form of tuberculosis. Damage to the genitourinary organs, brain, bones, intestines and other organs is also possible.

Depending on whether a person fell ill with tuberculosis for the first time or not, primary and secondary tuberculosis are distinguished.

• primary tuberculosis is an acute form of the disease that begins to manifest itself after the pathogen enters the bloodstream. Often, primary tuberculosis occurs in children under 5 years of age. This is because the immune system is not yet fully formed in children, which is not able to cope with mycobacteria. Despite the fact that the disease in this period is difficult, it is not dangerous to others. At the beginning, with primary tuberculosis, a small granuloma forms in the lungs. This is the primary lesion of the lungs, which, in the event of a favorable outcome, can heal itself. So, the patient may not suspect that he actually had tuberculosis, attributing his well-being to a cold. However, after another x-ray, it turns out that he has a healed granuloma in his lungs. The development of a bad scenario involves an increase in the granuloma with the formation of a cavity in which tubercle bacilli accumulate. Mycobacteria are released into the blood, where they are carried throughout the body.
• secondary tuberculosis. This form of the disease occurs when a person has already had tuberculosis once, but he became infected with another type of mycobacteria. Or secondary tuberculosis can proceed in the form of an exacerbation of the remission of the disease. Secondary tuberculosis is much more severe than primary. New lesions form in the lungs. In some cases, they are located very close to each other, which merge, forming extensive cavities. Approximately 30% of patients with secondary tuberculosis die within 2-3 months after the onset of the disease.

Symptoms of tuberculosis: how the disease manifests itself

At the beginning of the disease, tuberculosis is quite difficult to distinguish from ordinary acute respiratory infections. The patient has constant weakness and "brokenness". In the evening, there is a slight chill, and sleep is accompanied by sweating, and sometimes nightmares.

Body temperature in the initial stage of tuberculosis is kept at 37.5 - 38 degrees. The patient has a dry cough that worsens in the morning. Note that all of the above symptoms may appear simultaneously or all together.

And now let's take a closer look at the main symptoms of tuberculosis:

• Change in appearance. In tuberculosis, the face becomes pale and haggard. The cheeks seem to sink, and the facial features are sharpened. The patient is rapidly losing weight. At the initial stage of the disease, these symptoms are not very noticeable, however, in the chronic form of tuberculosis, the change in appearance is so pronounced that the doctor, with a high degree of probability, can make a preliminary diagnosis only by appearance.
• Heat. Subfebrile temperature (37-38 degrees), which does not subside within a month, is a characteristic sign of tuberculosis. In the evening, body temperature may rise slightly - up to 38.3 - 38.5 degrees. Despite the fact that the patient sweats all the time, the body temperature does not subside, since the infection constantly provokes the development of a feverish state. In the later stages of tuberculosis, a febrile temperature may appear, reaching 39-40 degrees and above.
• Cough. With tuberculosis, the patient coughs almost constantly. At the beginning of the disease, the cough is usually dry and intermittent. However, with the progression of the disease, when cavities form in the lungs, the cough intensifies and is accompanied by copious sputum production. If a person is worried about coughing for more than three weeks, then this is a reason to contact a phthisiatrician!
• Hemoptysis. This is a rather dangerous symptom, indicating an infiltrative form of the disease. In this case, the diagnosis must be differentiated from a lung tumor and acute heart failure, since hemoptysis is also characteristic of these diseases. In severe cases, blood may spurt, indicating a rupture of the cavity. In this case, the patient requires urgent surgical intervention.
• Chest pain. As a rule, pain in the chest and in the area of ​​​​the shoulder blades disturbs patients with both acute and chronic forms of tuberculosis. If pains are observed at the beginning of the disease, then they are mild and look like discomfort. The pain gets worse when you take a deep breath.

Patient's actions in case of tuberculosis

At the slightest suspicion of illness, you should contact your family doctor. Protracted cough, which is not stopped by conventional antitussive drugs, should alert a person. You should consult a doctor and undergo all the necessary examinations for the presence / absence of tuberculosis.

Diagnosis of tuberculosis

To detect tuberculosis, fluorography (or computed tomography) is performed. With a productive cough, a sputum sample is taken for examination to determine the pathogen, as well as its sensitivity to antibiotics. Sometimes a bronchoscopy is done. If you suspect the presence of non-pulmonary forms of tuberculosis, tissue samples of these organs are examined.

Children under 18 years of age undergo the Mantoux reaction annually. A positive Mantoux test indicates infection with tuberculosis bacilli.

The basis of tuberculosis therapy is multicomponent anti-tuberculosis chemotherapy. There are several treatment regimens:

The three-component scheme of therapy includes the use of isoniazid, streptomycin, para-aminosalicylic acid (PAS). This classical scheme, however, is not currently used due to the high toxicity of PAS, the impossibility of prolonged use of streptomycin.

Quadruple regimen: isoniazid, rifampicin (or rifabutin), ethambutol, pyrazinamide.

Five-component scheme: A fluoroquinolone derivative (ciprofloxacin) is added to the four-component scheme. In the treatment of drug-resistant forms of tuberculosis, drugs of the second, third and next generations of this group are included.

With insufficient effectiveness of 4-5-component chemotherapy regimens, second-line (reserve) chemotherapy drugs (capreomycin, cycloserine), which are quite toxic to humans, are used.

Much attention is paid to the quality, varied nutrition of patients, correction of hypovitaminosis, leukopenia, anemia. TB patients suffering from alcohol or drug addiction undergo detoxification before starting chemotherapy.

In the presence of HIV infection in combination with tuberculosis, specific anti-HIV therapy is used in parallel with anti-tuberculosis therapy, and the use of rifampicin is also contraindicated in such patients.

In some cases, glucocorticoids may be prescribed. The main indications for their appointment are severe inflammation, severe intoxication. Glucocorticoid preparations are prescribed for a short period of time and in minimal doses, which is associated with their immunosuppressive effect.

An important role in the treatment of tuberculosis is played by sanatorium treatment. Improving the oxygenation of the lungs when inhaling the rarefied air of mountain resorts helps to reduce the reproduction and growth of mycobacteria. For the same purpose, hyperbaric oxygen therapy is used.

In advanced cases, surgical methods of treatment are used: the imposition of an artificial pneumothorax, drainage of a cavity or empyema of the pleura, removal of the affected lung or its lobe, and others.

Complications of tuberculosis

Complications of tuberculosis include hemoptysis or pulmonary bleeding, pulmonary heart failure, spontaneous pneumothorax, atelectasis, renal failure, bronchial, thoracic fistulas.

The main prevention of tuberculosis is the BCG vaccine (Bacillus Calmette-Guerin). Vaccination is carried out in accordance with the calendar of preventive vaccinations. The first vaccination is carried out in the hospital in the first 3-7 days of a newborn's life. At 7 and 14 years old, in the absence of contraindications, a negative Mantoux reaction, revaccination is carried out.

The entire adult population, in order to detect tuberculosis in the early stages, must undergo a fluorographic examination at least once a year.

Tuberculosis is a worldwide infectious disease of bacterial etiology that affects various organs: skin, kidneys, eyes, intestines. Most often, tuberculosis affects the lungs. Every year, approximately 3 million people in the world die from this disease, and about the same number get sick again.

Epidemiology

There is an opinion that about a third of the world's population has an infection. The number of people who have this disease is not decreasing, but due to population growth, on the contrary, continues to increase. In 2007, the number of people with active chronic TB was 13.7 million. At the same time, 1.8 million deaths were recorded. That is, there is a risk of dying from the disease. It should be noted that we are talking mainly about developing countries.

The spread of the disease is not uniform throughout the world. According to WHO statistics, approximately 80 percent of the population of Asian and African countries are infected with tuberculosis. In the United States, only 5-10 percent of the population has the disease. In Russia, the incidence of tuberculosis in the period from 2008 to 2018 was reduced by 43 percent.

Pathogen and mechanism of development

The causative agent of tuberculosis is acid-resistant mycobacteria (Koch's bacillus), which spread in soil, among people and animals. Today there are 74 species of these bacteria.

The main route of entry into the body of Koch's sticks is airborne. But infection can also occur through the use of food, and through contact with objects that a person with tuberculosis has come into contact with.

The greatest probability of contracting tuberculosis is where there are a large number of people. Penetrating into the human body, the tubercle bacillus enters the cells of the immune system. In certain cases, Koch's wand can spread throughout the body.

It should be understood that the infection can affect absolutely all organs and tissues of the human body, except for nails and hair. For this reason, the development of extrapulmonary tuberculosis is possible. Pulmonary tuberculosis is the most common, but the disease can also affect the bones, liver, kidneys, larynx, and even the eyes.

Tuberculosis classification

Tuberculosis is classified according to clinical forms, according to the characteristics of the process, according to residual effects after treatment. Types and forms are grouped according to various principles.

infiltrative

Infiltrative tuberculosis means the presence of inflammatory changes in the lungs. The manifestations of this disease depend on the prevalence and type of changes in the lungs. In most cases, infiltrative tuberculosis is recognized by X-ray examination. Basically, the disease occurs under the guise of other diseases. These include pneumonia, bronchitis. One of them is hemoptysis (in the general normal condition of the patient).

Disseminated

Disseminated tuberculosis is characterized by the presence of multiple foci in the lungs. At the same time, the patient has a general malaise, hyperthermia, wet and hemoptysis. To suspect the disease allow characteristic changes on radiographs.

Miliary

This is a disease that occurs with the formation of tuberculous tubercles in the lungs or other organs. In patients, miliary tuberculosis is observed in acute and chronic forms. The acute form is a severe disease of the whole organism. In the chronic form, there are periods of exacerbations and "calm".

Tuberculous pleurisy

Tuberculous pleurisy is an inflammation of the pleura that occurs against the background of tuberculosis of the lungs and other organs. This disease has three forms: acute, subacute and chronic.

In newly diagnosed patients with tuberculosis of the respiratory system, tuberculous pleurisy is diagnosed in 3-6 percent of cases. Pleurisy is diagnosed in 2-3 percent of patients. Most often, this disease is detected in children, adolescents and young people.

Cavernous

Cavernous pulmonary tuberculosis is a stage in the development of pulmonary tuberculosis, which proceeds with the formation of a thin-walled cavity - a cavity. Mostly adults are affected by this. In children, the formation of cavities is much less common. Cavernous tuberculosis develops approximately in the third or fourth month of ineffective tuberculosis treatment. Symptoms of the disease are a wet cough and hemoptysis.

Fibrous-cavernous

Fibrous-cavernous tuberculosis occurs as a result of the development of one of the forms of pulmonary tuberculosis. If the cavity does not have a tendency to scarring, then connective tissue grows around the cavity. Because of this, the deformation of the thin-walled cavity occurs, the cavity ages and the fibrous-cavernous stage of tuberculosis develops. In general, the process takes 1.5-3 years. Patients suffering from fibro-cavernous tuberculosis complain of poor health in the body, wet cough and shortness of breath. The state of health of patients is generally satisfactory. Body temperature before treatment is usually elevated. The disease is accompanied by sweating and pallor of the skin.

cirrhotic

With cirrhotic pulmonary tuberculosis, patients experience gross cicatricial changes in the lung parenchyma and pleura, which are combined with minimal inflammation activity.

The disease develops after other forms of tuberculosis. This variety is quite rare. In order for cirrhotic tuberculosis to form, a long period of untreated inflammation is necessary. It is important to understand that with advanced cases of this form of the disease, a fatal outcome is possible. The severity of manifestations of cirrhotic tuberculosis depends on the extent and localization of changes in the lungs. Symptoms are generally mild. Outside of exacerbation, there may be slight shortness of breath and occasional dry cough.

Focal

Focal pulmonary tuberculosis is a specific tuberculous lesion, which is characterized by the presence of small foci of inflammation in the lungs. Focal tuberculosis is often a secondary tuberculosis infection, and occurs several years after the primary disease has been cured. For this reason, most of the sick are just adults. Distinctive features of this lung disease are latency, limited area of ​​damage, non-destructive nature of inflammation.

In addition, with this disease there are no symptoms, so the disease can be detected mainly with preventive fluorography. Signs of the disease are fever, sleep disturbance, sweating. In some cases, there are also signs of hyperthyroidism: tachycardia, irritability appear. In women, there may be a change in the menstrual cycle.

Chronic

Chronic tuberculosis is observed in patients with a long course of the disease in the case when complex treatment does not give the expected results. With this disease, foci of infection appear in the lungs of a person. Patients are concerned about cough with sputum, subfebrile condition, night sweats, weakness. The danger of the disease lies in the fact that other human organs are also affected. Anemia develops, skin manifestations, inflammation in the urinary system are possible.

Extrapulmonary tuberculosis

Extrapulmonary tuberculosis is most often a secondary disease that occurs due to tuberculosis infection of the lungs. Extrapulmonary tuberculosis affects a variety of organs: the intestines, the central nervous system, the meninges, lymph nodes, bones, joints, the genitourinary system, the skin, and the eyes.

Tuberculosis of the central nervous system

Tuberculosis of the central nervous system begins slowly, the symptoms increase gradually. A person has a periodic headache, weakness in the body, drowsiness and reduced appetite. All this is observed several months before the main symptoms of the disease. The disease itself is characterized by severe headache, which is aggravated by noise, bright light. It is also accompanied by a mental disorder. There may be confusion or agitation.

Pupil dilatation, strabismus, facial asymmetry, and deterioration in visual acuity are noted. There may be a violation of swallowing, choking, hearing loss.

Infection of the gastrointestinal tract and abdominal organs

The development of tuberculosis of the gastrointestinal tract is facilitated by various chronic diseases, as well as a decrease in immunity. Patients have weakness, fatigue, sweating, fever. In addition, there are severe pains in the abdomen, or. Complications can be intestinal obstruction, and internal bleeding.

Osteoarticular tuberculosis

The most commonly affected are the hip and knee joints, as well as the spine. If the inflammatory process in tuberculosis has not gone beyond the bones, then a person may feel slight pain in the damaged areas. If the disease spreads to the joints and tissues nearby, then the pain intensifies, mobility is limited and even the affected joint or spine is deformed.

Inflammation of the urinary organs

Tuberculosis of the genitourinary organs is the most common extrapulmonary lesion. These include: damage to the kidneys, urinary tract (ureter, bladder, urethra), male (prostate, testicles) and female (ovaries, endometrium) genital organs.

eye disease

Tuberculosis of the eye is one of the most severe forms of extrapulmonary tuberculosis. This disease is found in approximately 10 percent of cases of diagnosed extrapulmonary forms. Most often, the tuberculous process is localized in the vascular system of the eye. A complication may be a cataract or. Also, Koch's wand can affect the skin, lymph nodes, spleen, heart muscle. But all these cases are extremely rare.

Main symptoms

The main symptoms are:

• prolonged cough with sputum;
• hemoptysis;
• increased sweating;
• noticeable weight loss;
• causeless fatigue and weakness;
• decrease or lack of appetite;
• deterioration in performance.

In addition, pain is felt in the chest and upper limbs, body temperature rises, and hard breathing appears. It is important to understand that the symptoms of tuberculosis are very similar to other clinical manifestations of lung diseases. Therefore, only a specialist can make an accurate and correct diagnosis. The symptoms also depend on the affected area. If this is tuberculosis of the gastrointestinal tract, then the patient will be disturbed by pain in the abdominal cavity, nausea, and digestion will be disturbed.

If we are talking about the central nervous system, then headaches, dizziness and other similar and unpleasant symptoms will mainly bother.

Stages and types of flow

Tuberculosis is characterized by certain stages and periods of the infectious process.

Incubation period

From the time Koch's wand entered the human body, and until the moment when the first symptoms of the disease appeared in a person, a certain period of time passes, which is called incubation. This period can be from 7 to 12 weeks, in some cases up to several years.

During the incubation period, all mycobacteria that have entered the respiratory system are attacked by the immune system. If the immune system copes with its functions, then all bacteria die. If the immune system fails, then mycobacterium causes an inflammatory process in the lungs. In this case, the first symptoms of the disease will appear. It is worth noting that all this time a person is not contagious and dangerous to other people. And it does not even show the presence of the disease, which complicates the situation at an early stage.

Latent and active

Latent tuberculosis is a latent form of the disease in which an infected person does not have any symptoms, and the tuberculin test is positive. At the same time, radiography does not reveal pathologies, and the person is not contagious to other people.

In the active form, the patient feels a general malaise, he has almost all the symptoms of tuberculosis. Specific tests are positive, and the person is contagious to others.

closed and open

Tuberculosis is an infectious disease, but patients may or may not be contagious. At the same time, the status of the patient may vary depending on the stage of development of the disease and the effectiveness of the prescribed treatment. With an open form of tuberculosis, the patient releases the causative agent of the disease into the environment. This mainly concerns pulmonary tuberculosis, since the release of these microbes occurs during coughing and expectoration. With the closed form of tuberculosis, mycobacterium is not excreted from the patient's body.

Disease outcomes

The outcomes of tuberculosis can be recovery with adequate timely therapy or progression of the disease with the development of a fatal outcome. It is obvious that tuberculosis is a dangerous disease, and even more so at the last stage of development. In the absence of proper treatment, responsibility on the part of the patient and attention from the doctors, all this can turn into dangerous and undesirable consequences.

Diagnostics

For the diagnosis of tuberculosis, allergic tests with tuberculin are carried out, sputum examination for mycobacterium by PCR, blood and urine tests are carried out for a general analysis, if necessary, a CT scan of the lungs.

Recently, to confirm the diagnosis, blood is examined for T-POTS, the determination of lymphocytes sensitized to Mycobacterium tuberculosis.

Mantoux test

The Mantoux test is the main method of examining children for the presence of tuberculosis. The test is a skin test that detects the presence of a specific immune response to the introduction of tuberculin. According to the Mantoux reaction, it is possible to determine whether there is a tuberculosis infection in the body. With this test, you can determine the presence of the disease in advance.

T-spot

T-POS is an immunological method for determining the disease. Diagnosis takes approximately 3-4 days. The test requires human blood. The method for determining infection is very sensitive and informative. It can be used to exclude false reactions to the presence of Mycobacterium tuberculosis when most tests are wrong or not entirely accurate.

PCR

Recently, PCR (polymerase chain reaction) has been used for diagnosis. This test has high sensitivity, which allows you to identify cells and DNA fragments in the test material.

PCR can detect various forms of tuberculosis, especially in young children, even with negative results of microbiological studies.

x-ray

Radiography of organs for tuberculosis is a study that is included in the mandatory diagnostic standards. This method is prescribed in order to establish or, conversely, to refute the fact of the disease. It can also be used to determine the nature of lung damage.

Treatment Methods

Tuberculosis can be cured. Treatment consists in the constant and long-term use of medications prescribed by a doctor. A long time is needed in order to completely kill all mycobacteria in the tissues of the human body. At the same time, the patient must lead a healthy lifestyle, follow the treatment regimen and eat right. Mycobacteria are very tenacious, therefore, if the dose of drugs is reduced, then the bacteria become more resistant to drugs. All this makes further treatment more difficult.

How to protect yourself

Prevention of the disease consists of several components. It is extremely important to protect yourself and follow preventive measures in places where TB infection is possible. It is necessary to carry out a whole range of measures that are aimed at preventing the transmission of infection from a sick person to a healthy one.

Specific prophylaxis is a method of fighting an infection, the purpose of which is to create immunity against it. This includes compulsory vaccination of the population. Specific prophylaxis is one of the most effective methods of tuberculosis control.

Non-specific prophylaxis includes drugs that increase the body's defenses.

Tuberculosis is a dangerous and serious disease, which at the very beginning has a hidden character. Often the sick person believes that he just caught a cold and is tired. Therefore, he turns to the doctor after the appearance of more serious symptoms, when complex and lengthy treatment is necessary.

Most people, having heard the diagnosis of "tuberculosis", practically put an end to their lives. But in fact, everything is not so bad.

Naturally, without the necessary treatment, a patient with tuberculosis can live no more than six months. But if you responsibly approach this issue and engage in treatment, then over time you can completely forget about this problem, and life expectancy will depend on the lifestyle of a person. Of course, this can take a long time - from several months to two years. This period depends on the form of the disease and its neglect.

What is contraindicated for patients

Of course, in the fight against tuberculosis, it is necessary to conserve energy and direct it to the main task - the victory over the disease. Patients can and should walk more, walk, do exercises, and do physiotherapy exercises. At the same time, they are strictly forbidden to smoke, observe, starve.

It is enough to follow simple rules to help the body fight the disease.

For a long time it was believed that the sun and its rays have healing effects. But this is far from true. There are diseases in which you can not stay under the sun for a long time and sunbathe, as it adversely affects the human body. Tuberculosis is one of these diseases.

Tuberculosis is a serious disease, but with timely diagnosis and adequate therapy, it is curable.

According to statistics, today about 4 million people worldwide are affected by tuberculosis every year. This disease is caused by a bacterial infection. Infection is possible by airborne droplets or sneezing of an infected person, less often through unboiled milk from a person affected by tuberculosis. This disease is especially aggravated in autumn and spring, during these periods there is the greatest risk of infection.

Tuberculosis may not appear if the human body is able to cope with the infection.

The real risk of this disease is most exposed to people with reduced immunity: their body is not able to resist the infection. There are other factors that lower the body's resistance to tuberculosis infection. This is poor nutrition, physical or nervous exhaustion of the body, hard work, poor sanitary and hygienic conditions.

Tuberculosis spreads more easily in cramped, damp, poorly heated, and sparsely ventilated spaces, including rental apartments, prisons, hospitals, and homeless shelters. Drug treatment of lung diseases, which reduces the vital resistance of the human body and oversaturates it with toxins, also contributes to the development of tuberculosis.

At increased risk are:
- people who often come into contact with patients with active forms of tuberculosis;
- living in overcrowded buildings with poor sanitation (low-income people, prisoners in prisons, migrant workers, homeless people);
- living in countries with a high incidence of tuberculosis among the population (in Latin America, Africa, Asia);
- people with a weakened immune system (especially HIV-infected and being treated for cancer);
- patients with diabetes;
- malnourished and often hypothermic people;
- using drugs intravenously;
- young children.

To protect yourself from the risk of contracting tuberculosis, it is important to strengthen your immunity and lead a healthy lifestyle: eat right, take vitamins, ventilate the room and keep it clean, walk in the fresh air, play some kind of sport, etc. All these measures serve as a good prevention of tuberculosis.

Tuberculosis: symptoms and signs of the disease

Primary TB often has no symptoms, and the infected person may not look sick. The following symptoms may appear later:
- persistent cough, dry or bloody sputum;
- fever, constantly elevated body temperature;
- shortness of breath;
- chest pain;
- weight loss;
- lack of appetite;
- headache;
- increased sweating (especially on);
- fatigue and weakness;
- irritability;
- mood swings;
- Decreased performance.

Periods of exacerbation of the disease can be periodically replaced by periods of calm, but if tuberculosis is not treated, it will progress, disrupting all body functions.

There may be manifestations of only one or two symptoms, and among them there will not necessarily be a cough. Therefore, if at least one of the above symptoms appears, it is advisable not to self-medicate, but to consult a doctor in order to timely diagnose a possible tuberculosis disease and begin its treatment.

Diagnosis of tuberculosis

The simplest test for tuberculosis is the Mantoux test. After 72 hours after the Mantoux test, it is possible to determine whether there is a tuberculosis infection in the human body. However, this method has low accuracy. A study under a microscope of smears also cannot be a standard, because Mycobacterium tuberculosis can be confused with other types of bacteria and an incorrect diagnosis can be made.

Often, sputum culture helps to diagnose this disease, but tuberculosis bacteria do not always “grow”, and therefore in this case there is a risk of a false negative analysis. In most cases, an examination of the patient and an x-ray of the lungs are used to screen for tuberculosis.

In specialized clinics, you can use a more modern method - determining the titer of antibodies to tuberculosis. This method with high reliability (about 75%) allows you to determine whether there is immunity to tuberculosis, as well as to find out whether the vaccination was effective. The most modern method is the polymerase chain reaction (PCR). This is a DNA diagnostic, in which the patient's sputum is taken for analysis. The diagnostic result can be found out after 3 days, its reliability ranges from 95 to 100%.

Tuberculosis: treatment of the disease

It is impossible to cure this disease on your own, because with uncontrolled medication, the microbacterium tuberculosis (Koch's bacillus) develops resistance to drugs. In addition, it will be much more difficult to cure the disease in this case.

Treatment of ordinary tuberculosis takes at least six months, but can take up to 2 years. To suppress the infection, therapy should be carried out systematically, then the disease will not be able to progress. When tuberculosis is detected, the patient is placed in a hospital where he spends about 2 months - during this period, the active isolation of tuberculosis bacteria stops. After the patient ceases to pose a threat to the health of others, his treatment is carried out on an outpatient basis.

Treatment of ordinary tuberculosis is carried out according to a specific scheme, which includes the following drugs: ethambutol, isoniazid, streptomycin, pyrazinamide, rifampicin. The doctor selects a combination of medications that a person suffering from tuberculosis should take for 2-3 months, while the treatment is carried out in a hospital.

If after this time the treatment was not effective, the necessary changes are made to it. In such cases, one / several drugs are replaced or their route of administration is changed (inhalation, intravenous). If a positive effect is observed after 2-3 months of treatment, only rifampicin and isoniazid are prescribed for the next 4 months. After completing the course of this treatment, the patient re-takes tests. If Koch's bacillus is detected, then the disease has passed into a drug-resistant form.

Treatment of a form of tuberculosis resistant to drugs drags on for years. Depending on which drugs the tuberculosis bacterium is resistant to, second-line drugs are added to the main medicines - capriomycin, ofloxacin, cycloserine, ethionamide, pasque. These medicines are much more expensive than conventional TB medicines. Treatment with them can cost about 10 thousand dollars. These drugs should be taken only in combination, otherwise there will be no effect. It is important to remember that uncontrolled treatment with second-line drugs forms the complete resistance of bacteria, which leads to the absolute incurability of this disease.

Surgical intervention in the treatment of tuberculosis is used very rarely, since the effectiveness of this method is very low. Some time ago, sanatorium treatment was considered an important element in the treatment of this disease. Currently, treatment in sanatoriums refers only to additional means of combating the disease. If the patient refuses to be hospitalized when necessary, the medical institution can refer the patient through the courts for compulsory treatment in the TB clinic. This practice is used to treat irresponsible patients and preserve the health of the nation.

Of great importance in the treatment of tuberculosis is a balanced diet. The patient's diet should include fresh, steamed (or baked) fruits and vegetables, calcined milk, whole bread, eggs, butter, nuts, cheese. Meat is best eaten in small quantities. Canned food, white bread, coffee, strong black tea should be excluded from the diet. Since a patient with tuberculosis often loses his appetite, it is recommended to eat foods that stimulate appetite: fish oil, rosehip infusion, yogurt, kefir. Smoking and alcohol are completely contraindicated.

Drug antituberculosis treatment lasts for quite a long time. To get rid of tuberculosis, you can facilitate and supplement this treatment with traditional medicine. In the room where the patient is, there should always be fresh air. An important role is also played by the psychological and mental factor. The patient himself must make efforts on the way to his recovery.