The open form of tuberculosis is dangerous. About risk groups. There are such forms of extrapulmonary tuberculosis

The disease tuberculosis has been known to mankind under the name consumption since ancient times. The disease was first described by the physician Hippocrates, who believed that it was genetic disease. Another ancient doctor, Avicenna, found that the disease can be transmitted from one person to another. In the 19th century, the German scientist Robert Koch proved the infectious nature of the disease by discovering a mycobacterium that caused the disease. The causative agent of the disease, Koch's bacillus, is named after its discoverer. For his discovery the scientist received Nobel Prize.

Tuberculosis in our time is still one of the most common diseases in all countries of the world. According to WHO, many cases of tuberculosis infection are registered annually in the world - about 9 million. In Russia, 120,000 people become ill with tuberculosis every year. The mortality rate from infection in Russia is higher than in European countries.

So what is tuberculosis? How does a person become infected with tuberculosis, and is this disease always dangerous? What treatment is effective and can tuberculosis be completely cured? Let's look at these questions in detail.

What kind of disease is tuberculosis?

The causative agent of tuberculosis is mycobacterium (Mycobacterium tuberculosis). Tuberculosis is an infectious disease. The most common route of transmission of tuberculosis is airborne. The tuberculosis bacillus is transmitted through contact during talking, sneezing, singing or coughing, as well as through household items. The immune system of a healthy person copes with the infection by destroying the Koch bacillus in the respiratory tract. Too massive an infection or frequent contact with a sick person can cause illness even in a healthy person. In people with a weakened immune system, its cells are not able to destroy mycobacteria.

The incubation period of pulmonary tuberculosis is from 3 to 12 weeks. Symptoms of the disease during the incubation period include a mild cough, weakness, and a slight increase in temperature. During this period, the disease is not contagious. However, the absence of pronounced symptoms of the incubation period explains why tuberculosis is dangerous for the infected person. After all, mild symptoms do not attract special attention; they can be mistaken for respiratory disease. If the disease cannot be recognized at this stage, it becomes pulmonary. The main cause of tuberculosis is low level quality of life. Crowding of people contributes to the spread of the disease, especially in prisons. Decreased immunity or concomitant diabetes mellitus contributes to infection and its progression.

The first signs of tuberculosis

Signs of pulmonary tuberculosis in the early stages vary depending on the form, stage and localization of the process. In 88% of cases, the infection takes a pulmonary form.

Symptoms of pulmonary tuberculosis at an early stage of its development:

• cough with phlegm for 2–3 weeks;
• periodically elevated temperature up to 37.3 °C;
• night sweats;
• sudden weight loss;
• presence of blood in sputum;
• general weakness and loss of strength;
• chest pain.

The initial manifestations of tuberculosis infection can be mistaken for any other disease. It is in the initial stage that the patient is dangerous to others. If the patient does not consult a doctor in a timely manner, the tuberculosis infection will progress and spread in the body. That is why it is so important to undergo annual fluorography, which will promptly identify the source of the disease.

Forms of tuberculosis according to clinical course

There are primary and secondary tuberculosis. Primary develops as a result of infection with Koch's bacillus in an uninfected person. The process most often affects children and adolescents. The manifestation of the disease in old age means activation of tuberculosis of the lymph nodes suffered in childhood.

In children, tuberculosis occurs in the form of the primary tuberculosis complex. IN infancy the process affects a lobe or even a segment of the lung. Symptoms of pneumonia include cough, fever up to 40.0 °C and chest pain. In older children, the lesions in the lung are not so extensive. The disease in the lungs is characterized by an increase in cervical and axillary lymph nodes.

The primary complex consists of 4 stages of disease development.

1. Stage I - pneumonic form. X-ray shows a small lesion in the lung, enlarged lymph nodes in the root of the lung.
2. Stage II of resorption. During this period it decreases inflammatory infiltrate in the lung and lymph nodes.
3. Next stage Stage III, it is manifested by compaction of residual foci in the lung tissue and lymph nodes. In these places, the X-ray image shows small pinpoint pockets of lime deposits.
4. In stage IV, calcification of the former infiltrate occurs in the pulmonary and lymphatic tissue. Such calcified areas are called Ghon lesions and are detected by fluorography.

The primary tuberculosis process in children and adults often occurs in a chronic form. In this case, the active process in the lungs and lymph nodes persists for many years. This course of the disease is considered chronic tuberculosis.

Open and closed forms of tuberculosis infection

Open form tuberculosis - what is it and how does it spread? Tuberculosis is considered to be in open form if the patient secretes mycobacteria in saliva, sputum, or secretions from other organs. Isolation of bacteria is detected by culture or microscopy of the patient's secretions. Bacteria spread through the air very quickly. When talking, the infection with saliva particles spreads over a distance of 70 cm, and when coughing it reaches up to 3 meters. The risk of infection is especially high for children and people with reduced immunity. The term “open form” is more often used in relation to patients with the pulmonary form of the disease. But the release of bacteria also occurs during an active tuberculosis process in the lymph nodes, genitourinary system and other organs.

Symptoms of open tuberculosis:

• dry cough for more than 3 weeks;
• pain in the side;
• hemoptysis;
• causeless weight loss;
• enlarged lymph nodes.

A patient in open form is dangerous to everyone around him. Knowing how easily open tuberculosis is transmitted, in case of prolonged and close contact with a patient, you need to undergo examination.

If the bacteriological method does not detect bacteria, this is a closed form of the disease. Closed form of tuberculosis - how dangerous is it? The fact is that laboratory methods Koch's bacillus is not always detected; this is due to the slow growth of mycobacteria in the culture for inoculation. This means that a patient who has no bacteria detected can practically excrete them.

Is it possible to become infected with tuberculosis from a patient with a closed form? With close and constant contact with a sick person, in 30 cases out of 100 you can become infected. In a patient with a closed form, the process in the lungs or any other organ can be activated at any time. The moment the process transitions into an open form is initially asymptomatic and is dangerous for others. In this case, tuberculosis closed form it is transmitted, like open, through direct contact during communication and through household items. Symptoms of the closed form of tuberculosis are practically absent. Patients with a closed form do not even feel unwell.

Types of pulmonary tuberculosis

Based on the degree of spread of tuberculosis, there are several clinical forms diseases.

Disseminated tuberculosis

Disseminated pulmonary tuberculosis is a manifestation of primary tuberculosis. It is characterized by the development of multiple lesions in the lungs. The infection in this form spreads either through the bloodstream or through the lymphatic vessels and bronchi. Most often, mycobacteria begin to spread hematogenously from the mediastinal lymph nodes to other organs. The infection settles in the spleen, liver, meninges, and bones. In this case, an acute disseminated tuberculosis process develops.

The disease is manifested by high fever, severe weakness, headache, general serious condition. Sometimes disseminated tuberculosis occurs in a chronic form, then sequential damage to other organs occurs.

The spread of infection through the lymphatic tract occurs from the bronchial lymph nodes to the lungs. With a bilateral tuberculosis process in the lungs, shortness of breath, cyanosis, and cough with sputum appear. After a prolonged course, the disease is complicated by pneumosclerosis, bronchiectasis, and pulmonary emphysema.

Generalized tuberculosis

Generalized tuberculosis develops due to the spread of infection through the hematogenous route to all organs simultaneously. The process can occur in acute or chronic form.

The reasons for the spread of infection are different. Some patients do not comply with treatment regimen. In some patients it is not possible to achieve the effect of treatment. In this category of patients, the generalization of the process occurs in waves. Each new wave of the disease is accompanied by the involvement of another organ. Clinically, a new wave of the disease is accompanied by fever, shortness of breath, cyanosis, and sweating.

Focal tuberculosis

Focal pulmonary tuberculosis manifests itself as small foci of inflammation in the lung tissue. The focal type of the disease is a manifestation of secondary tuberculosis and is more often detected in adults who suffered from the disease in childhood. The source of the disease is localized in the apices of the lungs. Symptoms of the disease include loss of strength, sweating, dry cough, and pain in the side. Hemoptysis does not always appear. The temperature during tuberculosis rises periodically to 37.2 °C. A fresh focal process is easily cured completely, but with inadequate treatment the disease becomes chronic form. In some cases, the lesions level out on their own with the formation of a capsule.

Infiltrative tuberculosis

Infiltrative pulmonary tuberculosis occurs during primary infection and chronic form in adults. Caseous foci are formed, around which a zone of inflammation forms. The infection can spread to the entire lobe of the lung. If the infection progresses, the caseous contents melt and enter the bronchus, and the vacated cavity becomes a source of formation of new foci. The infiltrate is accompanied by exudate. If the course is favorable, the exudate does not completely dissolve; in its place, dense strands of connective tissue are formed. Complaints from patients with the infiltrative form depend on the extent of the process. The disease can be almost asymptomatic, but can manifest itself acute fever. The early stage of tuberculosis infection is detected by fluorography. In people who have not undergone fluorography, the disease develops into a widespread form. Possible death due to pulmonary hemorrhage.

Fibrous-cavernous tuberculosis

symptom of fibrocavernous tuberculosis - weight loss

Fibrous-cavernous pulmonary tuberculosis is formed as a result of the progression of the cavernous process in the lungs. With this type of disease, the walls of caverns (empty cavities in the lung) are replaced by fibrous tissue. Fibrosis also forms around the cavities. Along with caverns, there are foci of contamination. Cavities can connect with each other to form a large cavity. The lung and bronchi are deformed and blood circulation in them is disrupted.

Symptoms of tuberculosis at the onset of the disease include weakness and weight loss. As the disease progresses, shortness of breath, cough with sputum, and temperature rise. The course of tuberculosis occurs continuously or in periodic outbreaks. It is the fibrous-cavernous form of the disease that causes death. A complication of tuberculosis manifests itself in the formation pulmonary heart With respiratory failure. As the disease progresses, other organs are affected. A complication like pulmonary hemorrhage, pneumothorax can be fatal.

Cirrhotic tuberculosis

Cirrhotic tuberculosis is a manifestation of secondary tuberculosis. Moreover, as a result of the age of the disease, there are extensive formations of fibrous tissue in the lungs and pleura. Along with fibrosis, there are new foci of inflammation in the lung tissue, as well as old cavities. Cirrhosis may be localized or diffuse.

Elderly people suffer from cirrhotic tuberculosis. Symptoms of the disease include cough with sputum and shortness of breath. The temperature rises as the disease worsens. Complications occur in the form of cor pulmonale with shortness of breath and bleeding in the lungs; they cause the death of the disease. Treatment consists of a course of antibiotics with sanitation of the bronchial tree. When the process is localized in the lower lobe, its resection or removal of a segment of the lung is performed.

Extrapulmonary types of tuberculosis

Extrapulmonary tuberculosis develops much less frequently. Suspect tuberculosis infection other organs is possible if the disease cannot be treated for a long time. According to the location of the disease, extrapulmonary forms of tuberculosis are distinguished, such as:

• intestinal;
• osteoarticular;
• genitourinary;
• cutaneous

Tuberculosis of the lymph nodes often develops during primary infection. Secondary tuberculous lymphadenitis can develop when the process is activated in other organs. The infection is especially often localized in the cervical, axillary and inguinal lymph nodes. The disease is manifested by enlarged lymph nodes, fever, sweating, and weakness. The affected lymph nodes are soft, mobile on palpation, painless. In case of complications, caseous degeneration of the nodes occurs, other nodes are involved in the process, and a continuous conglomerate is formed, fused to the skin. In this case, the nodes are painful, the skin over them is inflamed, a fistula is formed, through which the products of specific inflammation of the nodes are discharged. At this stage, the patient is contagious to others. If the course is favorable, the fistulas heal and the size of the lymph nodes decreases.

Tuberculosis of the female genital organs is more susceptible to young women 20–30 years old. The disease is often erased. Its main symptom is infertility. Along with this, patients are concerned about the violation menstrual cycle. The disease is accompanied by an increase in temperature to 37.2 °C and nagging pain in the lower abdomen. To establish a diagnosis, X-ray examination and culture of uterine discharge are used. The x-ray shows displacement of the uterus due to adhesive process, pipes with uneven contours. An overview image reveals calcifications in the ovaries and tubes. Complex treatment includes several anti-tuberculosis drugs and is carried out long time.

Diagnostics

How to diagnose tuberculosis at an early stage? The initial and effective diagnostic method is carried out in the clinic during fluorography. It is performed for each patient once a year. Fluorography for tuberculosis reveals fresh and old foci in the form of infiltration, focus or cavity.

If tuberculosis is suspected, a blood test is done. Blood counts are very different when varying degrees severity of infection. With fresh lesions, neutrophilic leukocytosis with a shift to the left is noted. At severe form lymphocytosis and pathological granularity of neutrophils are detected. ESR indicators increased in the acute period of the disease.

An important method examination for the detection of Koch bacillus is sputum culture for tuberculosis. Mycobacteria are almost always detected in culture if a cavity is visible on the x-ray. With infiltration in the lungs, Koch's bacillus is detected by culture only in 2% of cases. A 3-fold sputum culture is more informative.

A test for tuberculosis is a mandatory method for mass diagnostics. The tuberculin test () is based on the skin reaction after intradermal injection of tuberculin in various dilutions. The Mantoux test for tuberculosis is negative if there is no infiltrate on the skin. With an infiltrate of 2–4 mm, the test is doubtful. If the infiltrate is more than 5 mm, then the Mantoux test is considered positive and indicates the presence of mycobacteria in the body or anti-tuberculosis immunity after vaccination.

Treatment

Is it possible to recover from tuberculosis and how long will it take to therapeutic measures? Whether the disease will be cured or not depends not only on the location of the development of the infectious process, but also on the stage of the disease. The body's sensitivity to anti-tuberculosis drugs is of great importance in the success of treatment. These same factors influence how long the disease will take to be treated. If the body is sensitive to anti-tuberculosis drugs, treatment is carried out continuously for 6 months. In case of drug resistance, treatment of tuberculosis continues for up to 24 months.

The modern treatment regimen for tuberculosis infection includes taking a complex of drugs that have an effect only when used simultaneously. For drug sensitivity complete cure open form is achieved in 90% of cases. At improper treatment An easily treatable form of infection turns into difficult-to-treat drug-resistant tuberculosis.

Complex treatment also includes physiotherapeutic methods and breathing exercises. Some patients require surgical treatment. Rehabilitation of patients is carried out in a specialized dispensary.

Drug treatment is carried out according to a 3, 4 and 5 component scheme.

The three-component regimen includes 3 drugs: Streptomycin, Isoniazid and PAS (para-aminosalicylic acid). The emergence of resistant strains of mycobacteria has led to the creation of a four-drug treatment regimen called DOTS. The scheme includes:

• "Isoniazid" or "Ftivazid";
• "Streptomycin" or "Kanamycin";
• "Ethionamide" or "Pyrazinamide";
• "Rifampicin" or "Rifabutin".

This scheme has been in use since 1980 and is used in 120 countries.

The five-component regimen consists of the same drugs, but with the addition of the antibiotic Ciprofloxacin. This regimen is more effective for drug-resistant tuberculosis.

Medical nutrition

Nutrition for pulmonary tuberculosis is aimed at restoring body weight and replenishing the lack of vitamins C, B, A and minerals.

The diet for tuberculosis includes the following categories of products.

1. Required increased amount proteins due to their rapid breakdown. Easily digestible proteins found in dairy products, fish, poultry, veal and eggs are preferred. Meat products should be boiled, stewed, but not fried.
2. It is recommended to get healthy fats from olive, butter and vegetable oil.
3. Carbohydrates contained in any foods (cereals, legumes). Honey is recommended flour products. Easily digestible carbohydrates are found in fruits and vegetables.

Food should be high in calories and served freshly prepared. The diet consists of 4 meals a day.

Prevention

The main means of preventing tuberculosis is vaccination. But besides this, doctors recommend:

• lead a healthy and active image life, including walks in the fresh air;
• consume foods containing fats of animal origin (fish, meat, eggs);
• do not eat fast food products;
• eat vegetables and fruits to replenish the body with vitamins and minerals that support the immune system;
• In order to prevent infection, young children and elderly people should not have close contact with the sick. Even short-term contact with a sick person in an open form can cause them to become infected.

Vaccination

Prevention of tuberculosis in children and adolescents comes down to preventing infection and preventing the disease. The most effective method of preventing tuberculosis is vaccination. The first vaccination against tuberculosis is carried out in maternity hospital for newborns on days 3–7. Revaccination is done at 6–7 years of age.

What is the tuberculosis vaccine called? Newborns are given the gentle tuberculosis vaccine BCG-M. Vaccination during revaccination is done with the BCG vaccine.

As a result, we come to the conclusion that tuberculosis is a common infection and poses a danger to everyone around us, especially to children and people with reduced immunity. Even patients with a closed form are potentially dangerous to others. Tuberculosis is dangerous due to its complications and often ends fatal. Treatment of the disease requires a lot of time, patience and money. A severe and debilitating disease deprives a person of their quality of life. The best measure to prevent the disease is vaccination.

Many people are interested in whether tuberculosis can be cured or not. Modern medicine has made a breakthrough in methods and methods for curing this disease. Today they give positive prognoses to patients. The most important thing is to apply for timely medical care. What methods are used in treatment? Can you trust folk recipes? We will try to find answers to these questions in the article.

This terrible word is tuberculosis

When faced with a terrible disease, patients have a question: “Is tuberculosis curable or not?” If in the 90s up to 80% of those sick died from the disease, in our time the percentage has decreased significantly. Modern medications, new treatment methods. Doctors talk about enormous progress in resolving this issue.

Don't forget that positive result largely depends on how timely the patient sought consultation.

Studying the symptoms

Every person should know the symptoms of the disease:

• Elevated temperature that lasts for a long time.
• General malaise: drowsiness, weakness, depression.
• Night sweats.
• Continuous cough.
• Enlarged lymph nodes.
• Chest pain.

It is not necessary that all the symptoms “come out” at once. The first thing that should alert you is a cough that does not go away after taking the appropriate syrups and mixtures. In this case, you must consult a doctor and undergo a special examination (fluorography or x-ray). If the diagnosis is confirmed, only a doctor can answer the question of how to treat tuberculosis. It all depends on individual characteristics body.

Can tuberculosis be cured?

At the first suspicion of tuberculosis, you should immediately consult a doctor. The result of treatment depends on how quickly this is done. Unfortunately, many people put off visiting medical Center until the last minute, thereby only aggravating the situation. Doctors are often asked the question: “Is tuberculosis curable?” Experts give a positive answer to this.

First of all, it is necessary to confirm the diagnosis. This can be done using a special device - a fluorograph. Treatment in the future will depend on the form of tuberculosis. In cases with open outbreaks, it is planned to carry out special measures in tuberculosis dispensaries.

When answering the question about how long tuberculosis is treated, doctors do not give exact dates. This process is quite lengthy, on average it takes from 12 to 18 months. Treatment is carried out comprehensively. In addition to drugs that have an anti-tuberculosis effect, it is necessary to take drugs that increase the body’s immune qualities. Doctors prescribe appropriate dosages: they start with minimal ones, eventually reaching maximum quantity. It is important that treatment is carried out under the constant supervision of a pulmonologist and physiotherapist.

Open form - is there a chance of recovery?

“How long does it take to treat tuberculosis?” - perhaps this is one of the most popular questions from patients. It all depends on the form of the disease. If it is open, the patient will have to longer time carried out in a hospital to prevent infection of people nearby. First of all, the doctor is faced with the task of converting the disease into a closed form. In this case, the outbreaks become safe for others. This can be done with the help of special drugs. They are quite expensive, but you can’t do without their help.

Answering the question whether it is treated open tuberculosis, experts give a positive prognosis. The only thing is that it will take more time and effort. Do not forget about drugs that are responsible for increasing the body’s immunity. During this period, it is important that all resources are used and the organs work at full capacity.

Features of treatment in children

The child can also become infected with tuberculosis. This happens if the parents did not immunize on time. In order to protect the baby, he is given a BCG vaccination while still in the maternity hospital. Then vaccination takes place according to a specific schedule approved by WHO.

Many parents are interested in: “Is there treatment for children?” The recovery process is complicated by the fact that most drugs are prohibited for children. They can cause serious disorders in the body, reduce immunity, change hormonal balance and much more. In this case, doctors offer the following treatment regimens:

1. Use medications that remove foci of tuberculosis.
2. Use immunostimulating tablets.
3. Don’t forget about additional techniques: breathing exercises, physiotherapy, acupuncture.

In cases where the above methods do not help, specialists have to resort to a drastic measure - surgical intervention. The lung is cleaned, lesions are treated, and removed excess mucus and accumulated fluid. After this, in 80% of cases, children have a chance of recovery.

Tuberculosis in old age. Is it treatable?

The situation is different for people over 55 years of age. It's all about the changes that occur in the body. In this case, doctors need to make every effort to cure the patient. not enough. The general condition of the patient is actively maintained. Vitamins and drugs that enhance immunity are prescribed.

As a rule, doctors do not give comforting prognoses. It is not possible to completely get rid of the disease. Specialists can only improve the patient’s general condition and remove acute form tuberculosis. In any case, older people are under the constant supervision of a pulmonologist.

Physiotherapy is a method that brings benefits

Many doctors, in addition to drug treatment, offer physical therapy. It can take different forms: ultrasound, infrared radiation, laser, application of a magnetic field and much more. It all depends on the severity of the disease. Basic goals this method are as follows:

Death of microorganisms and bacteria that cause tuberculosis.

Removal of phlegm and fluid from the bronchi and lungs.

Termination and relief of inflammatory processes.

Feeding the body with pure oxygen.

Restoration of lung tissue.

It is impossible to cure tuberculosis with physiotherapy alone. This method is only an addition to the main treatment. It helps speed up the healing process, improving the general condition of the patient.

Is there any point in breathing exercises?

Many experts have a positive attitude towards breathing exercises. They need to be performed daily, while monitoring the general condition of the patient. Gymnastics performs the following functions:

• Strengthens muscles, lungs, bronchi.
• Helps improve gas exchange. Oxygen reaches the lungs faster.
• Restores correct breathing rhythm.

There are quite a lot of exercises; only a doctor has the right to decide which of them to use in a particular case. In this case, constant monitoring of the patient’s condition is necessary. It is advisable that the first procedures take place in the presence of a doctor or visiting nurse.

Many people ask: “Is tuberculosis curable or not with the help of breathing exercises?. Doctors assure that without intensive drugs that will destroy bacteria, it will not be possible to cope with the disease. Additional techniques can and should be used, but they are not fundamental in the treatment process.

Traditional treatment

Unfortunately, tuberculosis is a fairly common disease. To deal with it, many use folk recipes. Medvedka helps to overcome the disease. The fact is that leukocytes are present in sufficient quantities in the insect’s body. They are able to break down and remove it with sputum. It is necessary to dry the mole cricket, grind it into a pulp and take it for at least 3 days. After this, there is copious discharge of sputum and coughing.

Regular badger fat will help boost your immunity. It can be purchased at a pharmacy. It is available in the form of tablets or capsules. To improve the effect, you need to eat a spoonful of honey at the same time.

Garlic and horseradish can help in the fight against the disease. They will not only strengthen the immune system, but will also promote the removal of sputum. Garlic can be consumed up to 5 heads per day. And the horseradish root is grated, placed in a three-liter jar, filled with whey and placed in a warm place for 4 days. After the expiration date, drink half a glass of the product per day.

Patients often ask the question: “Is tuberculosis treated or not using traditional methods?” Doctors are sure that you cannot self-medicate, this will only aggravate the situation and precious time will be lost. At the first signs of illness, you need to contact a specialist and have fluorography done.

When asked whether tuberculosis is curable or not, doctors give a positive answer. Thanks to modern medicine, strong drugs, and new developed techniques, it is possible to cope with the disease. To do this, you just need to promptly seek advice from specialists and follow all their instructions and recommendations.

Tuberculosis- a severe infectious disease that most often begins in the lungs and can cause complications in other organs. It quickly spreads from a sick person to others.

Tuberculosis has affected people since ancient times; until the 20th century, it was incurable and claimed many lives. However, even today this problem relevant in modern society. Each year, 8 million people become ill and 3 million die. The disease is so common that in 1993 the WHO designated tuberculosis as a problem great danger. Despite effective treatment and diagnosis, the disease progresses every year.

Doctors have identified 3 main groups of clinical forms of tuberculosis:

• Group 1 - tuberculosis in children and adolescents;
• Group 2 - respiratory tuberculosis of various stages and forms;
• Group 3 - tuberculosis of other organs and systems (meninges and central nervous system, tuberculosis of bones and joints, reproductive system, tuberculosis of the skin, intestines, tuberculosis of the kidneys and other organs of the excretory system).

The most severe form of the disease is disseminated pulmonary tuberculosis, in which multiple foci of tissue damage are formed. It can arise from prolonged and improper treatment of the disease. For disseminated pulmonary tuberculosis, long-term therapy is prescribed, including surgery to remove part of the organ.

Causes of tuberculosis

The causative agent of tuberculosis is tuberculosis bacteria or Koch's bacillus, transmitted from person to person through the air and household objects. You can also become infected from a sick animal, through its waste products. Almost every person has been infected with tuberculosis bacilli, but not all people get the disease. Tuberculosis bacteria are resistant to heat, cold, moisture and light. They die only at extremely high temperatures and when exposed to chlorine.

How is tuberculosis transmitted?

Ways of infection with tuberculosis:

• Airborne - when inhaling air with the presence of bacteria, when a sick person sneezes and coughs, in dusty rooms where a person with tuberculosis was located;
• Food route - when eating contaminated foods and water;
• The contact route is through the patient’s belongings and personal items, in rare cases through the conjunctiva of the eyes of children and adults.

The bacteria enters the respiratory tract and a mild lung infection occurs. If a person has high immunity, he will quickly defeat the infection. A healthy person does not develop the disease. Some tuberculosis bacteria remain in the lung tissues in a latent state; the disease can begin after a time when immunity is reduced. Tuberculosis bacilli can enter the blood and penetrate other systems of the body. In some cases, tuberculosis affects other tissues and organs.

The cause of tuberculosis may be a weakened human defense system. People with HIV are most susceptible to this disease. diabetes mellitus taking medications to maintain immunity. This includes people with chronic lung diseases, people who have poor nutrition and live in overcrowded, unsanitary, damp rooms. Children and the elderly are most susceptible to tuberculosis, as their defense mechanism is weakened.

Symptoms of tuberculosis

Symptoms of pulmonary tuberculosis are associated with many factors: the state of the person’s immune system and the form of tuberculosis. The first signs of pulmonary tuberculosis can be expressed in different ways. Thus, a sick person may either remain unaware of the illness for several months or go to bed, and his condition will look like or spicy . The first signs of pulmonary tuberculosis are similar to the symptoms of other diseases, so making a correct diagnosis is often difficult.

Symptoms of pulmonary tuberculosis practically do not appear when the following stages of pulmonary tuberculosis are observed: infiltrative limited pulmonary tuberculosis, pulmonary tuberculoma, focal pulmonary tuberculosis. In this case, minor signs of pulmonary tuberculosis may appear:

• weight loss;
• loss of appetite;
• weakness;
• increase in body temperature to 37 degrees.

The incubation period for tuberculosis lasts from 2 to 6 weeks, after which more severe symptoms occur. Symptoms of tuberculosis in adults and children may be as follows:

• persistent, severe cough with yellow or green sputum, sometimes with blood in it;
• sharp chest pain and behind in the shoulder area during deep inhalation and exhalation;
• hard breath;
• pale skin color;
• high temperature and fever;
• loss of appetite and significant weight loss;
• severe sweating at night;
• fatigue, pain in joints and muscles.

If pulmonary tuberculosis is not treated, it can spread to the heart tissue. Bacteria can be carried throughout the body through the blood and enter the tissues of the brain, bones, joints and other organs. Non-pulmonary forms of the disease progress for a long time, accompanied by the appearance nonspecific signs and may be similar to other diseases, so they are difficult to detect through diagnostics.

Forms of tuberculosis

Identify the main forms of tuberculosis

• pulmonary tuberculosis;
• extrapulmonary tuberculosis.

Tuberculosis infection mainly affects organs respiratory system- lungs and bronchi; in rare cases, damage may affect the larynx, pleura and trachea. This form of tuberculosis, known as extrapulmonary tuberculosis, can be localized in any human organ.

There are such forms of respiratory tuberculosis

• miliary pulmonary tuberculosis;
• tuberculosis of intrathoracic lymph nodes;
• disseminated pulmonary tuberculosis;
• primary tuberculosis complex;
• caseous pneumonia;
• infiltrative pulmonary tuberculosis;
• focal pulmonary tuberculosis;
• pulmonary tuberculoma;
• fibrous-cavernous pulmonary tuberculosis;
• tuberculosis of the trachea, bronchi, upper respiratory tract;
• cirrhotic pulmonary tuberculosis;
• tuberculous pleurisy (including empyema);
• tuberculosis of the respiratory system, combined with occupational dust diseases of the lungs (coniotuberculosis);
• cavernous pulmonary tuberculosis.

Tuberculosis in children is usually isolated into a separate form - tuberculosis intoxication in children and adolescents, which is a form of primary active tuberculosis. Its specificity is that specific local lesions are not detected by X-ray and other research methods.

There are such forms of extrapulmonary tuberculosis

• tuberculosis of the meninges and the central nervous system - damage to the brain and spinal cord, dura mater of the brain;
• tuberculosis of the digestive system - most often affected distal section small intestine and cecum;
• tuberculosis of the genitourinary system - urinary tract, affects the kidneys, genitals;
• lupus;
• tuberculosis of bones and joints - most often the bones of the spine are affected;
• eye tuberculosis.

In organs affected by tuberculosis infection, a specific lesion of the lymph nodes develops - “cold” inflammation. Such inflammation is characterized by the formation of nodules, which can lead to the appearance of multiple tubercles that are prone to decay.

Influence medical supplies on mycobacteria can lead to their acquisition of drug resistance. Over time, the number of strains of mycobacteria resistant to anti-tuberculosis drugs is rapidly increasing.

Acquired drug resistance is considered a consequence of unsuccessful treatment - in other words, during treatment there were factors that led to a decrease in the concentration of chemotherapy drugs in the blood, as a result of which their effectiveness also “triggered” protective mechanisms in mycobacterial cells.

Primary drug resistance is the result of a person becoming infected with an already drug-resistant form of infection.

Secondary tuberculosis

This is a form of tuberculosis that occurs in a person who has already had a primary infection in the past, which is why he has anti-tuberculosis immunity, albeit weakly expressed. The disease develops as a mild allergy and is chronic.

Disseminated pulmonary tuberculosis

Disseminated pulmonary tuberculosis is characterized by the presence of multiple various symptoms. These may be signs of various infectious diseases, prolonged chronic bronchitis or the consequences of the flu. Chronic diseases of the upper respiratory tract can even manifest as bloody expectoration. Less commonly, disseminated pulmonary tuberculosis can manifest itself through pain in the mouth - as the disease affects the larynx, palate and tonsils. Moreover, the disease can manifest itself in the form of painful joints, bones and especially kidneys.

Since the disease largely relates to diseases of the respiratory tract, disseminated tuberculosis can manifest itself as a consequence of pneumonia. However, in most cases, the disease is latent and does not make itself felt. This factor has a very negative impact on the possibility early diagnosis tuberculosis and preventing its negative development and consequences. Therefore, it is very important not to refuse or postpone scheduled checks, since in many cases you can find out about lung disease purely by chance, during an x-ray examination.

Another negative consequence of disseminated pulmonary tuberculosis is the patient’s easy tolerance to fairly high body temperatures - up to 38 ºC. There is also a very strong cough, which produces very large amounts of mucopurulent sputum. However, with the latent course of the disease, it is not even possible to listen to wheezing in the lungs. The erythrocyte sedimentation rate does not increase significantly, and a tuberculous skin reaction does not occur.

Extrapulmonary forms of tuberculosis

Kidney tuberculosis

Kidney tuberculosis does not have its own pathognomonic signs that could clearly diagnose this disease. Most often, the symptoms of kidney tuberculosis at the onset of the disease are characterized by a latent course, manifested only in bad general health- severe malaise, fatigue, fever up to 37-37.9, constant decrease in body weight.

Negative neoplasms in the kidneys that arise as a consequence of the disease can cause painless appearance of blood in the urine. The reason for this is vascular erosion, which, in turn, causes ulceration of the papillae.

Also, signs of infectious intoxication may occur (if the kidney cavities become tricky). Pain impulses occur in lumbar region, which manifest themselves moderately and achingly. If there are disturbances in the urination process, colic may also bother you. As a consequence of urination disorders, the development of renal failure (even chronic) is also possible.

Tuberculosis of the genital organs

Tuberculosis of the genital organs develops due to mycobacteria - aerobic organisms, which do not form a dispute. This form of tuberculosis today ranks first among extrapulmonary forms of this disease. This disease develops by entering the internal genital organs through the blood or from a primarily infected organ of mycobacteria.

Reveal this disease It's not so easy for a person. Symptoms of genital tuberculosis do not always indicate this particular disease. Doctors include these symptoms:

• menstrual irregularities;
• changes in hormonal levels;
• the appearance of adhesions;
• inflammation of the fallopian tubes.

Patients also often complain of nagging pain that occurs in the lower abdomen and fever. However, in addition to the indicated symptoms, which can be attributed to most diseases to which the genitourinary system is susceptible, genital tuberculosis has “its own” symptoms, including:

• fever;
• at night the patient breaks into a sweat;
• weakness;
• poor appetite;
• weight loss.

The presence of all (or most) of the above symptoms indicates that a person is developing genital tuberculosis. This disease is sometimes confused with ovarian apoplexy, acute appendicitis or an ectopic pregnancy.

Tuberculosis Bladder

The enormous danger that tuberculosis of the genitourinary system poses is also due to the fact that for quite a long time the overwhelming majority of patients do not experience any symptoms at all that could be paid attention to. Are there any painful sensations and obvious disturbances in the functioning of the body, which is why the diagnosis of the disease is based on early stages development is a rather rare case.

Experts divide the symptoms of the disease into local and general. The former, in turn, can be subjective and objective.

If we talk about general symptoms, then tuberculosis of the bladder manifests itself due to the general condition of the person, which undergoes changes and arterial hypertension. In addition, there is an increase in body temperature for no apparent reason.

Subjective local symptoms include possible pain sensations various levels, accompanying the process of urination and disorders associated with it. Objective symptoms are changes in urine.

An important fact is that in almost forty percent of patients, the course of the disease is associated with the absolute absence of general and local subjective symptoms.

Even when it comes to complex stages and global organ damage, the state of health of most patients is quite satisfactory. Intoxication is expressed extremely weakly and is practically not felt. If we take into account generally accepted statistics and research results, we can clearly conclude that no more than five percent of patients feel ailments and pain.

That is why even rare pain in the lower back, which can be sharp and sharp, or aching and dull, cannot be ignored. An increase in temperature is also one of the possible symptoms that should be taken into account.

Tuberculosis of the eye

This form is dangerous and unpleasant because it has a long process, which can often return. In addition, the patient loses the ability to see, and at the same time the ability to function normally and perform professional duties.

The occurrence of this disease occurs through the tuberculosis bacillus, which is the cause of eye tuberculosis. Infection occurs as a result of contact with the eyes of a pathogenic pill, which, in turn, is the dried sputum of a person suffering from tuberculosis. In addition to the eyes, dust along with the tuberculosis bacillus can enter the respiratory tract, causing pulmonary tuberculosis, and as a consequence and concomitant disease - eye disease.
There is no doubt that the most significant role in whether a person gets sick or not, and how the disease itself will proceed, depends on the strength of the immune system.

Tuberculosis damage to the organs of vision is observed mainly either in young or adulthood. Most often, women and residents of large populated areas become such patients, where the bacterium has more opportunities to settle on a person.

It should also be noted that often, when diagnosing general infection tuberculosis, doctors may miss the presence of an infection in the eyes. Thus, ocular tuberculosis is a rather dangerous disease, since it can enter the eye from any infected area own body, and through infection from the external environment.

The complexity of the disease is the reason for the multiplicity of symptoms of ocular tuberculosis. These manifestations depend both on the stage of progression and, again, on the human body itself, its stamina and strength. In general, symptoms of ocular tuberculosis can be as follows:

• inflammation that occurs and occurs in posterior section membranes of the eye. Often, it spreads to the retina of the eye, which negatively affects vision;
• inflammatory damage to the iris of the eye, feels like a veil or fog before the eyes;
• inflammatory processes that arise and occur in the cornea of ​​the eye. Feels like cloudiness, pain in the eyes, redness;
• inflammation of the deepest layers of the clera of the eye. It is destructive in nature and threatens the ability to see. Feels like irritation and pain.

In addition to the main symptoms of eye tuberculosis, many minor ones may occur, manifesting as simple conjunctivitis. It is important to note that such manifestations may be allergic.

Tuberculosis in children

In what forms can this dangerous disease manifest itself in children? Most often, this is tuberculosis of the bronchial glands, which are especially numerous at the very root of the lungs. And tuberculosis bacilli can get there through the bloodstream, forming large inflammatory foci.

It is not always immediately possible to understand that we are dealing with tuberculosis, because the symptoms are very similar to the common flu with fever, cough and similar signs. What should be alarming is that they all drag on for a very long time. That is why, in case of persistent cough and high temperature It is very important to contact your doctor and carry out the appropriate examination. However, the pitfall here is that tuberculosis most often does not always develop acutely, sometimes manifesting itself as a chronic process.

Children suffer from the pulmonary form of tuberculosis much less often than the bronchial form, but it is also the most difficult to treat. But there is no need to despair - with proper treatment, very rarely this form leads to the disintegration of lung tissue and the transfer of lesions to other organs (alas, the younger the patient is, the more likely this is to occur).

Diagnosis of tuberculosis in children is capable of identifying and lymphatic inflammation, which is characterized by enlarged lymph nodes. However, the process does not end there: pus can leak out, forming fistulas and even skin lesions. That is why the slightest swelling in these places should be a serious reason to consult a doctor.

If a child complains of pain when moving, this may be caused by tuberculosis of the bones and joints. Such patients, even at the very beginning of the disease, complain of pain when walking, and then this leads to a change in gait and even lameness. One more serious consequences Such a disease can become a growing hump.

The main signs of tuberculosis in adolescents are precisely intoxication of the body. Most often, children suffer from this particular form of this dangerous disease. Timely treatment of tuberculosis in children will help the child’s body cope with this disease. In any case, it must be fast and comprehensive in order to stop those possible Negative consequences that may occur as the disease progresses. The basis of any treatment must necessarily include adherence to the regime, work, sleep and rest, as well as walks in the fresh air and possible physical therapy training.

Diagnostics

Diagnosis of the disease is carried out in medical institutions. First, the patient is shown to his general practitioner; if tuberculosis is suspected, the patient is sent to a specialized institution that diagnoses and treats this disease. A general examination of the patient is carried out, the doctor checks whether he has lost a lot of weight, whether the lymph nodes have enlarged, checks breathing and the condition of the lungs.

This type of diagnosis does not provide full picture Therefore, tuberculosis is checked using tests and fluorography. To confirm the diagnosis, sputum is examined for the presence of bacteria that cause the disease. The patient is being examined chest using x-rays. If tuberculosis pathogens are found in the sputum, and the x-ray shows the presence of emerging foci of inflammation, the patient is sent for re-diagnosis to confirm the presence of the disease. The doctor determines the form and stage of tuberculosis, the sensitivity of tuberculosis microorganisms to antibiotics. After this, complex treatment is prescribed.

Sputum test for tuberculosis

If a person is infected with Koch's bacillus, then a small amount of sputum is produced, which is usually mucopurulent in nature, sometimes with small streaks of blood. Usually, in the early stages, sputum from tuberculosis does not contain blood. Bleeding can only occur as a result of the cavernous form of tuberculosis. This occurs as a result of the disruption of blood vessels that conduct blood. In the presence of cavities, the sputum may contain Koch lenses or, as they are otherwise called, rice bodies. In addition, sputum analysis for tuberculosis in this form can reveal a variety of crystals and elastic fibers in the sputum. If we compare sputum from tuberculosis with sputum from other diseases, such as chronic bronchitis, it should be noted that sputum from tuberculosis has a large amount of protein.

At lung collapse in case of tuberculosis, tubercle bacilli, cholesterol crystals, calcium salts, and elastic fibers are determined in the sputum.
Sputum is also analyzed for tuberculosis using bacteriological analysis. This test involves examining a specially stained smear. If the result for tuberculosis is negative, then bacteriological analysis is carried out repeatedly. In such cases, it is best to use the flotation method. To test sputum for tuberculosis, a patient is cultured on Lowenstein-Jensen nutrient media, and tests are also carried out on experimental animals that are infected with tuberculosis.

Blood test for tuberculosis

If you have bad reaction Mantoux or FG of the lungs, you will be sent to a specialized tuberculosis clinic, where they will take it from you. Also, a blood test for tuberculosis may be needed for people who have come for permanent residence from another country or are getting a job in an institution with special requirements to sanitary standards: hospitals, kindergartens, schools, catering. In any case, a blood test for tuberculosis is always needed when the results of routine fluorography are poor.

You can donate blood for tuberculosis at a tuberculosis clinic. It is also carried out by many. The most sensitive analysis is considered to be carried out PCR method. Change allergy test Mantoux is not a very reliable method, its accuracy is low, so it is used mainly for economic reasons. Blood is donated for tuberculosis if a mass diagnosis of the immune response is not required, but the establishment or refutation of the diagnosis on an individual basis.

The Mantoux test is widely used in the diagnosis of tuberculosis. Most often it is used to determine the disease in children. Antigens of the tuberculosis pathogen are introduced into human skin, causing a characteristic reaction of the body. The size and structure of inflammation allows us to determine the level of protective state against tuberculosis. In case of infection with tuberculosis bacteria, the mantoux reaction becomes large and often inflamed.

What is the Mantoux test?

The first thing you need to know about Mantoux vaccinations is that the tuberculin test has nothing to do with vaccination, does not cause the development of anti-tuberculosis immunity and does not replace the BCG vaccine. It is performed on the hand - the inner surface of the forearm. This is the most common and reliable way of early diagnosis of tuberculosis, with the help of which a doctor can assess whether a person has been in contact with Koch’s bacillus (the causative agent of tuberculosis), whether he has immunity to the disease or whether he needs to be revaccinated. The purpose of the Mantoux test is not to develop immunity against tuberculosis, but to determine whether there are mycobacteria in the body that cause the disease.

The results of the Mantoux reaction can only be reliably assessed if the study is carried out over time. Tuberculin test They do it annually from the first year of life, and after graduation - once every few years. If the child is not vaccinated, has HIV status or chronic diseases gastrointestinal tract, receives radiation, corticosteroid, cytostatic therapy or has not experienced local reaction after BCG vaccination, the Mantoux test is performed more often - 2 times a year.

The main tasks of the Mantoux reaction:

• early detection of tuberculosis in children and adolescents
• identification of children who should undergo vaccination and revaccination

For adults, a tuberculosis test is carried out only in certain cases - when issuing a medical book, if there is a suspicion that a group of people has been infected or active form, before re-vaccination with BCG. An “adult” preventive alternative to the Mantoux reaction is fluorography, a laboratory test of blood or pulmonary sputum.

Treatment of tuberculosis

At an early stage, tuberculosis is highly treatable. Treatment is continuous and includes several drugs that destroy the tuberculosis bacillus. Each of the drugs has a different effect on bacteria; only complex treatment can help to finally get rid of them. Treatment of tuberculosis lasts half a year and, as a rule, takes place in a complex. The patient is prescribed courses of physiotherapy, breathing exercises, exercises and drugs to improve immunity. In special dispensaries, patients eat foods with increased energy value, vitamins, since fighting tuberculosis requires a lot of effort and time.

How to treat tuberculosis late stage? Late assistance or wrong therapy lead to tuberculosis developing into a more severe chronic form. In this case, complex treatment of tuberculosis is used. At focal lesion lungs or other organs the patient is prescribed surgical intervention to remove part of an organ or the entire organ. Activities are being carried out aimed at strengthening the body’s defense system: gymnastics, physiotherapy and others.

If tuberculosis is not treated, a person dies within two to three years from the time the disease progresses in half of the cases. In other cases, the disease develops and becomes chronic. A patient with this form of tuberculosis spreads the bacteria and infects other people. If diagnosed untimely or treated incorrectly, the patient may become disabled and then die.

The prognosis of the disease depends on the stage, location of the lesion, how resistant the mycobacteria are to drugs, and whether treatment began on time. In general, tuberculosis treatment ends positive outcome. A disease without nutritious food and vitamins, proper social and hygienic standards of housing, is poorly treated with chemotherapy, especially tuberculosis with increased resistance to drugs. Timely treatment can achieve complete recovery, but there is no guarantee that a relapse will not occur.

Prevention of tuberculosis

It is necessary to carry out measures to prevent tuberculosis everywhere and regularly. It includes specific and non-specific methods. Specific methods include vaccination and revaccination. BCG vaccination is an original live but weakened strain of tuberculosis bacteria, harmless and allows a person to develop immunity against the disease. It is given to newborn children in the first four days of birth. BCG revaccination is carried out for healthy children with a negative Mantoux reaction at 6-7 years of age. Chemoprophylaxis is given to children to prevent progression of the disease when positive reaction for tuberculosis bacilli.

What does the BCG vaccine consist of?

Since the discovery of mycobacteria in 1882 by Robert Koch, he and other scientists have been actively working to find an effective cure for this disease. In 1890, Koch developed tuberculin, which is used today for the Mantoux test. According to his assumptions, tuberculin should have helped the body cope with the disease, but his hopes were not justified.

39 years after Koch's discovery, the first vaccine against tuberculosis was obtained by two French scientists, Calmette and Guerin. For 13 years, doctors subcultured cells containing various subtypes of Mycobacterium tuberculosis until they obtained a weakened type of the pathogen, which they called by their name - Bacillus Calmette-Guerin, known to us as BCG.

A modern vaccination against tuberculosis consists of a mixture of weakened and killed mycobacteria of one of four strains: the French “Pasteur”, Danish, Tokyo and “Glasco” strain. They all have the same effectiveness and are equally safe.

One ampoule of BCG vaccine contains 10 or 20 doses of the drug. Along with regular BCG, a gentle version of the vaccine is produced - BCG-M. Its difference is that it contains half the dose of the vaccine.

This type of vaccine is recommended for administration to children with premature birth weight, children who were not vaccinated in the maternity hospital due to health conditions, and in developed countries where there is a low prevalence of tuberculosis - for vaccination of all newborns.

How does the BCG vaccine work?

Contrary to the popular belief that the BCG vaccination protects against, in fact it does not! Vaccination against tuberculosis is a way to prevent severe forms of the disease, which are deadly and cannot be cured. These forms of the disease include tuberculous meningitis, disseminated and miliary tuberculosis.

The question arises: why cannot the BCG vaccine protect against infection with Mycobacterium tuberculosis? This is because Mycobacterium tuberculosis is immune to specific antibodies produced by our immune system, and only cellular immunity can provide protection against it.

But, nevertheless, these antibodies play an important role in the fight against tuberculosis, as they prevent the development of fatal dangerous forms diseases to which children are especially susceptible. Their effectiveness in this regard is 90%.

On this moment Scientists are working to develop a vaccine against tuberculosis, which could completely eliminate the likelihood of developing this disease. According to the latest data, two vaccines are in development that should cope with this task, but they are all in preclinical and clinical trials.

In this regard, in the prevention of tuberculosis, not only vaccination plays an important role, but also a whole range of measures aimed at eliminating social and everyday factors that contribute to the spread of the disease.

When is the BCG vaccination given?

The official vaccination calendar in our country is regulated in the maternity hospital, on the 3-5th day after birth. If there was no opportunity to get vaccinated in the maternity hospital or there was a medical exemption from vaccination due to the child’s illness, it is done at the local clinic, but with a preliminary Mantoux test.

The vaccine is administered exclusively intradermally in the area between the upper and middle third of the left shoulder, in a dose equal to 0.1 ml of the drug.

Indications for revaccination are indicators of the Mantoux reaction, as well as the incidence of tuberculosis in the person’s place of residence. Revaccination with BCG according to the vaccination schedule is carried out at 7 and 15 years of age, respectively.

An important point in vaccination against tuberculosis is the fact that BCG vaccination cannot be given together with other vaccines! Moreover, given that the BCG vaccination has a delayed reaction, any other vaccines can be administered only after 30-35 days!

In this regard, BCG vaccination for newborns is done after, which is already carried out in the maternity hospital. After this, the baby enters a period of immunological rest for up to 2 months.

Reaction to BCG vaccination

Every parent should know that the BCG vaccine has a specific vaccination reaction, which manifests itself 1-1.5 months after the injection (4-6 weeks) and can last up to 4.5 months!

The onset of the reaction is accompanied by redness or darkening of the vaccine injection site. Moreover, the injection area may turn blue, purple or even black, which is not a reason to consult a doctor, as this is a normal variant.

Next, the formation of an abscess or red vesicle with liquid contents protruding above the skin occurs. In the first case, the abscess may burst and contents may be released from it for some time. Don’t be afraid of this and try to speed up the healing of the abscess by applying disinfectant solutions, antibiotics, etc. Just cover the area with clean gauze and change it as it gets dirty. Remember that the healing period of an abscess can last up to 4.5 months.

In the second case, when the healing process proceeds without suppuration, but with the formation of a red vesicle, it becomes covered with a crust, which after a while falls off and a scar with a diameter of 2-10 mm is formed in its place. Do not try to remove the crust by force!

Swelling of the injection site, itching, as well as an increase in temperature in a newborn up to 38 degrees after vaccination and during the period of vaccination reaction are also normal options. If the temperature rises after revaccination at 7 or 14 years old, be sure to consult a doctor.

Nonspecific measures to prevent tuberculosis may include maintaining a healthy lifestyle and proper nutrition, rich in vitamins, nutrients. Adults and children should get enough calories they need. Children with early age It is recommended to maintain an active lifestyle, do gymnastics in the morning, and spend more time in the fresh air. In schools and other institutions, living conditions must be checked, and regular wet cleaning and ventilation must be carried out. Particular attention in the prevention of tuberculosis is given to smoking cessation, since all smokers are at greatest risk of lung damage.

Complications after tuberculosis

Tuberculous meningitis is an inflammation of the meninges that occurs as a secondary disease after tuberculosis. This form of the disease is quite rare and, in most cases, occurs in people with or who have recovered from tuberculosis.

The cause of a disease such as tuberculous meningitis is the spread of harmful pathogens from the source of inflammation in the respiratory system to the brain. As mentioned above, most often, this type of disease is secondary, against the background of the development of tuberculosis. The main causative agent of both diseases is acid-fast bacteria, or, in other words, tuberculosis microbacteria.

Tuberculous meningitis is transmitted, like tuberculosis itself, by airborne droplets or food through contact with a carrier of the infection. In the case of the spread of this disease, people, animals and even birds can be carriers of dangerous tuberculosis microbacteria.

It is also characteristic that when harmful microorganisms enter the body of a healthy person, the immune system which works properly, tuberculosis bacteria are almost always destroyed. Therefore, the conditions necessary for the full development of the disease include weakened immunity, low speed defensive reaction body. It is the poorly developed immune system that is the reason that tuberculous meningitis occurs in children.

First of all, when it enters the respiratory system, the disease is localized there. Then, penetrating into the blood, tuberculosis microbacteria are transported by the circulatory system to the meninges. It is from this moment that the development of a secondary disease called tuberculous meningitis begins.

WHO global strategy on tuberculosis

At the next scheduled WHO assembly in Geneva, which lasted from May 19 to May 24, 2014, a global resolution on tuberculosis was adopted, starting from 2015 and ending in 2035. The adopted resolution urgently emphasized the need to implement various measures to reduce the incidence of tuberculosis, improve the quality of treatment and reduce the number of treatment-resistant cases of the disease.

According to the adopted resolution, its main strategy is to eliminate the global tuberculosis epidemic, within the framework of which the following goals are set:

• reduction in tuberculosis incidence by 90%;
• reduction in mortality from tuberculosis by 95%.

Based on statistics, the number of people who fall ill with tuberculosis every year is not decreasing as quickly as expected. This is despite the fact that the world community is on track to achieve the Millennium Development Goal, which aims to stop the spread of tuberculosis by 2015.

In 2014, tuberculosis is still one of the most dangerous and deadly diseases on the planet, found in all its regions. Thus, in 2012, according to official data, 8.6 million people fell ill with tuberculosis, and 1.3 million people died. At the same time, the number of cases of resistant tuberculosis in 2012 was 450,000.

In view of this, the adopted resolution calls on governments of all countries to assist, adapt and implement the strategy. The document emphasizes the need and importance of involving partners from sectors other than the health sector in the resolution: labor resources, immigration, social protection, justice.

A proposal was also made to the WHO Secretariat to assist Member States in implementing and adapting the strategy. The strategy covers the time period from 2015 to 2035. The implementation and success of the resolution will be assessed in 2020, 2025 and 2030.

Anyone can get tuberculosis, because the tuberculosis bacillus is transmitted by airborne droplets from a sick person, and then by contact after coughing on household objects. People who have an open form of tuberculosis are considered potentially dangerous to others, especially children. To protect yourself from infection, you need to know about the symptoms of open tuberculosis and how to protect yourself from it.

Most often, the open form is characteristic of the pulmonary form of tuberculosis.

If you don’t finish eating, you’ll constantly be in stressful situation And nervous tension, then if the tuberculosis bacillus gets in, signs of tuberculosis will develop, which often lead to death.

The number of cases is likely to increase. Outbreaks of infection are recurring due to an increase in the number of HIV-infected patients in whom this disease manifests itself as a complication.

What is open form of tuberculosis?

In addition to HIV-infected patients, the risk group for the disease includes elderly people, medical workers, patients with reduced immunity due to concomitant or past diseases, children, as well as people living in poor social and living conditions. Extremely rarely, infection occurs through consumption of meat, eggs or milk of infected animals.

The open form of tuberculosis has severe symptoms and constantly releases mycobacteria that infect the surrounding area. This is its difference from the closed form of the disease. Tank culture (smear microscopy) in sputum and saliva detects Koch's bacillus, determined by a laboratory staining method.

Open tuberculosis can be primary and secondary:

1. The primary type develops in people who have not previously been in contact with a carrier of the tuberculosis bacillus. Most often it is asymptomatic, characterized by only mild inflammation in the lungs. Then the inflamed focus transforms into a caseous (cheesy) node, being replaced by fibrous growth and forming calcifications, which are detected on x-rays of the lungs.
2. Secondary pulmonary tuberculosis develops in patients who previously had tuberculosis and is called miliary. With this type, the primary lesion is scarred and calcified, but with certain conditions, can break into the lung tissue or spread mycobacteria with blood to other organs and systems of the body (bones, brain, spleen, liver). The infection is called miliary because the tissue of organs affected by tuberculosis resembles millet grains in appearance. This is very clearly visible on an X-ray of the lungs.

Open tuberculosis is not subject to self-treatment, which in any case will be ineffective. It involves therapy in a specialized department of a tuberculosis dispensary for six months (using 4-5 different types of medications), which can take years. If you consult a doctor in a timely manner and follow all instructions, the prognosis will be open tuberculosis favorable Otherwise, the patient may die from complications.

The disease is confirmed by x-rays and computed tomography.

Symptoms

Clinical manifestations increase gradually. At first, the symptoms are not felt and do not cause discomfort to the patient, but over time, a constant dry cough appears, which then becomes wet. The duration of the cough symptom is three or more weeks. It is the main danger factor of the open form (with wet coughing), since the sputum contains microbes.

The patient quickly loses weight, loses his appetite, and may experience hemoptysis. The temperature rises in the evenings to low-grade levels, weakness and lethargy are present. The miliary form of secondary tuberculosis progresses over several months. Begins aggressive course a disease characterized by the following symptoms:

• high fever up to 39°C;
• night sweats;
• incessant dry cough, especially in the morning and at night;
• pain in the joints and behind the sternum;
• pale skin.

Then the overall tone of the body decreases and gastrointestinal disorder occurs.

After contact with a patient with tuberculosis, you need to pay attention to changes in your general condition and come for a consultation with a phthisiatrician, especially if the contact was long-term.

In order not to become infected, you need to eat rationally, not smoke, increase your immunity, take vitamins, avoid close contacts with tuberculosis patients, and also do not refuse annual medical examinations and do fluorography. Advice from an experienced TB doctor: before visiting public places It is advisable to eat a hearty meal. Koch's bacillus more easily infects the body of people who forget to eat on time (“loves hunger”).

Signs of open tuberculosis

The time from the time Mycobacterium tuberculosis enters the body until the development of signs of the disease is approximately 2-3 months. The diagnosis is confirmed by fluorography, x-ray, CT.

Signs of open tuberculosis are: clinical (symptomatic), laboratory (the pathogen is detected in tests) and radiographic (all the signs of tuberculosis are present - a focus of darkening, the presence of cavities of different sizes, increased pulmonary pattern).

Signs are detected using the tuberculin Mantoux test. If the reaction is negative, and a year later positive, with an increased size of the papules, they speak of infection. In the presence of weakness, persistent low-grade fever, noticeable by the patient, we can talk about signs of tuberculosis intoxication. The open form may well pass almost unnoticed with an inactive flow. But with severe fever, sweating and constant cough a more active phase of infection begins.

The open form of tuberculosis has the following main signs, confirmed by laboratory tests of sputum for the presence of bacilli or bronchoscopy:

1. Cough, persistent, dry, then with sputum.
2. Hemoptysis, which may be complicated by pulmonary hemorrhage.

If the disease is suspected after contact with a tuberculosis patient, infection can be suspected at an early stage. If you consult a doctor in a timely manner, tuberculosis is curable. If the patient delays treatment, then in the future it will be much more difficult to cope with the infection. The earlier treatment is started, the higher the recovery rate.

Health to you!

One of the most common infections in our modern world is tuberculosis. The causative agent of this pathology is. Its danger lies in the fact that it can be infected through airborne droplets, that is, through normal contact with a person. A sick person is especially dangerous for others if the pathology occurs in an open form, since a large number of mycobacteria are released along with his sputum. The open form of tuberculosis is especially dangerous for people with low immunity.

The concept of open tuberculosis

Tuberculosis, in which there is a constant release of mycobacteria into the external environment, is called open. Transmitted this form illnesses after contact with infected person in just a few minutes. Therefore, patients with bacterial excretion are subject to immediate hospitalization. Bacterial excretion is process-confirmed excretion to patients in environment Mycobacterium tuberculosis.

Treatment of patients with open form of tuberculosis takes place strictly, since bacteria spread without much difficulty when a person coughs.

The main danger of open tuberculosis

The main feature and danger is that in the open form, mycobacteria are constantly released and, accordingly, other people are constantly becoming infected. The incubation period of tuberculosis lasts 2-3 months. Only after this time have passed the first symptoms of the open form of the disease begin to appear.

Why is it possible to lengthen the incubation period?

But there may be another situation when incubation period lasts much longer. A person can be infected with Koch's bacillus for several years, and there will be no signs of illness, but upon contact with an infected person, tuberculosis intoxication will appear. After this, the open form of pulmonary tuberculosis will begin.

Open tuberculosis primary and secondary

The open form of pulmonary tuberculosis is divided into 2 types:

• primary;
• secondary.

The primary type occurs in people who have not been in contact with an infected person. In this case, there will be inflammation of the lungs, which is mild, and then a focus is formed, which degenerates into a caseous node with the presence of fibrous tissue.
Secondary type - also called. It is typical for people who have already suffered from this disease. In this case, a person already has a primary lesion that has healed, but when exposed to certain factors, it becomes inflamed and breaks out again, and mycobacteria begin to circulate throughout the body. The lungs with secondary tuberculosis acquire a structure similar to millet grains (hence the name “miliary”), this is clearly visible on x-rays.

Symptoms of open tuberculosis

Symptoms of open and closed forms of the disease differ significantly.

Important! The open form of tuberculosis and its symptoms do not appear at all at first.