Tuberculosis symptoms are the first signs in adults. How tuberculosis manifests itself, measures against infection, how to treat. Symptoms of an acute course

Titles

If pulmonary tuberculosis is detected, symptoms in adults do not appear immediately. For a long time, the disease can proceed unnoticed by the patient. Tuberculosis is one of the most actual problems in modern medicine. The disease is characterized by pandemic spread. Tuberculosis is diagnosed in all countries of the world. In our country, the incidence is increasing every year. tuberculosis infection in most cases, it affects people of working age, as a result of which great economic damage is inflicted on the state. In addition, pulmonary tuberculosis is difficult to treat due to the resistance of the pathogen to many anti-tuberculosis drugs. What is the etiology, clinic and treatment of pulmonary tuberculosis?

Features of pulmonary tuberculosis

Tuberculosis is a chronic disease caused by Mycobacterium tuberculosis, which can affect various organs (lungs, skin, bones). The most common lesion is the lung tissue. The infectious agent is transmitted from a sick person using an aerosol mechanism. Today, millions of people are infected with Mycobacterium tuberculosis, but not all of them develop the disease. At healthy person immunity copes with bacteria and does not allow them to multiply. The most dangerous is active form tuberculosis, when a person constantly releases the pathogen into environment when talking, coughing, sneezing.

In children, the pulmonary form of tuberculosis occurs much less frequently. Mycobacteria are very resistant to adverse environmental factors. They are capable long time persist in the external environment. Symptoms of the disease in infected individuals most often appear in adolescence and young age. In women, the peak incidence occurs between the ages of 25 and 35. There are the following types of pulmonary tuberculosis:

• primary tuberculosis complex;
• focal tuberculosis;
• disseminated;
• infiltrative;
• tuberculoma;
• cavernous form;
• cirrhotic;
• fibrous-cavernous.

Sometimes there is a mixed form, in which tuberculosis is combined with pneumoconiosis. There are also primary and secondary forms of pathology.

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Etiological factors

Pulmonary tuberculosis develops through direct contact with a patient or in infected individuals with a decrease in immunity. Predisposing factors for the development of the disease are:

• crowding of teams;
• decrease in body resistance against the background of severe somatic pathology or HIV infection;
• mental and physical stress;
• drug use;
• alcohol abuse;
• smoking;
• the presence of diabetes;
• frequent hypothermia;
• living in damp, cold rooms.

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Clinical symptoms

Signs of tuberculosis infection are different. Early manifestations of the disease include:

• malaise;
• weakness;
• a slight increase in temperature;
• sweating at night;
• loss of appetite;
• dizziness;
• pallor skin;
• weight loss.

Often there is an increase lymph nodes. As the disease progresses, more specific manifestations are observed. They include:

• cough;
• chest pain;
• shortness of breath
• hemoptysis.

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Features of cough

Of all pulmonary symptoms the most specific is cough. It has the following features:

• initially dry, then becomes productive;
• in sputum, an admixture of blood or pus is often determined;
• often combined with hemoptysis;
• intensive;
• prolonged;
• occurs most often in the morning and intensifies in the evening.

Cough with each form of the disease is different. In the focal form, when there are several foci of inflammation in the lung tissue, the cough is mild or absent. In the case of the miliary form of infection, it is intense with thick sputum. Cough in this situation can occur for no reason. A loud, hysterical cough combined with a sore throat may indicate destructive processes in the lung tissue. Often this is observed in cirrhotic tuberculosis.

The occurrence of a morning cough is due to a change in body position. When a person sleeps, sputum accumulates in the bronchi and cannot come out. In the morning, when a person begins to walk and work, sputum begins to come out. All this is accompanied by a cough. cough is defense mechanism aimed at cleansing the lower and upper respiratory tract. An open form of tuberculosis is often accompanied by hemoptysis. It occurs in parallel with the cough. At the same time, fresh scarlet blood is found in the sputum. Coughing up blood, if left untreated, can cause pulmonary hemorrhage.

Cough with tuberculosis infection can be mistaken for symptoms of another disease (bronchitis, influenza, SARS, pneumonia). With tuberculosis of the lungs, the cough is chronic. It is not eliminated by simple mucolytics and antitussives. With bronchitis, laryngitis, most often the cough gradually regresses and disappears within 1-2 weeks. If the cough persists for a crescent or more, you should consult a doctor.

Often there are wheezing, runny nose. The temperature in tuberculosis in most cases does not exceed 38 degrees. High temperature indicates severe course illness. In our country, a fluorographic examination is organized annually to detect changes in the lung tissue and mass examination of the population.

Individuals with kidney, heart, malignant tumors. An important factor is poor nutrition (lack of vitamins and animal proteins in the diet). The risk group includes children, HIV-infected persons, persons serving sentences in places of deprivation of liberty. Signs of pulmonary tuberculosis in adults may occur when cohabitation with a sick person. Using the same cutlery, dishes, linen - all this is a risk factor for infection.

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Signs of various forms of tuberculosis

Need to be able to distinguish various forms pulmonary tuberculosis. The infiltrative form of the disease is often diagnosed. It is characterized by inflammatory changes in the lung tissue and caseous necrosis in the central part. This form occurs most often (more than half of all patients). The size of the infiltrate is different.

It varies from 1-2 cm to the size of a whole lung lobe. In some cases, in the absence of therapy, the site of inflammation can turn into a tuberculoma. With this form of the disease, patients may complain of:

• sweating;
• hyperthermia;
• weakness;
• malaise;
• weak cough with phlegm;
• hemoptysis.

Miliary tuberculosis is less common. With it, small tubercles (the size of a millet grain) form in the lung tissue. Often other organs are affected. The disease can occur in acute and chronic form. In this case, the entire tissue of the lung is not always affected. With limited inflammation, the tops of the lungs and subclavian areas are most often affected. In the case of extensive miliary pulmonary tuberculosis, sick people experience malaise, hacking cough, high fever, shortness of breath, headache, and dyspeptic disorders.

Good day, dear readers!

In today's article, we will consider with you such a disease as tuberculosis, as well as its first signs, symptoms, types, forms, stages, diagnosis, treatment, medicines, folk remedies, prevention of tuberculosis and other useful information associated with this disease. So…

What is tuberculosis?

contact way- the infection gets inside a person through the conjunctiva of the eyes, with kisses, sexual contact, through contact of contaminated objects with human blood (open wounds, scratches, manicure, pedicure, tattooing with contaminated objects), the use of patient hygiene items. You can also become infected with tuberculosis when caring for a sick animal - a cat, a dog, and others.

intrauterine infection- infection is transmitted to the baby through the placenta damaged by tuberculosis or during childbirth, from the mother. However, this occurs when the infection of the whole organism is affected, but if the expectant mother has pulmonary tuberculosis, the likelihood of infection of the baby is minimal.

2. Violation of the functioning of the upper respiratory tract

Respiratory organs (nasal and oropharynx, trachea, bronchi) are protected from infection by mucociliary clearance. If you speak to plain language, then when an infection enters the body, special cells located in the mucous membrane of the respiratory organs secrete mucus, which envelops and sticks pathological microorganisms together. Further, with the help of sneezing or coughing, mucus, along with the infection, is thrown out of respiratory system out. If inflammatory processes are present in the respiratory organs, the functioning of the body's defenses is at risk, because. can freely penetrate into the bronchi, and then into the lungs.

3. Weakening of immunity against tuberculosis mycobacteria

Weaken the immune system, especially sweat in relation to Koch's wand, diseases and conditions such as -, AIDS, peptic ulcer, stressful situations, fasting, alcohol abuse and drugs, treatment with hormones and immunosuppressants, pregnancy, smoking and others. It has been established that a person who smokes a pack of cigarettes a day increases the risk of developing the disease by 2-4 times!

Koch's wand, settling in the lungs, if the immune system does not stop it, begins to slowly multiply. The delayed immune response is also due to the properties of this type of bacteria not to produce exotoxin, which could stimulate the production of phagocytosis. Being absorbed into the blood and lymphatic system, the infection spreads throughout the body, primarily enslaving the lungs, lymph nodes, the cortical layer of the kidneys, bones (epiphyses and metaphyses), fallopian tubes and most other organs and systems.

The incubation period of tuberculosis

The incubation period of tuberculosis, i.e. the period from the moment Koch's sticks hit until the first signs of the disease appear is from 2 to 12 weeks, on average - 6-8 weeks, sometimes a year or more.

Doctors note that when Koch's bacillus first enters the body, the development of tuberculosis occurs in 8% of cases, with each subsequent year, this percentage decreases.

The immune system's fight against tuberculosis

At this stage, the immune system, if it does not have immunity to Koch's wand, begins to produce it, and leukocytes enter the fight against infection, which, due to their low bactericidal potential, die. Further, macrophages are involved in the fight, however, due to its peculiarity, Koch's wand penetrates into the cells, and macrophages at this stage cannot do anything with them, and also begin to die gradually, and the infection is released into the intercellular space.

Important! Until immunity is developed, mycobacteria continue to increase their population in the body.

An effective fight against Mycobacterium tuberculosis begins when macrophages begin to interact with lymphocytes (T-helpers (CD4+) and T-suppressors (CD8+)). Thus, sensitized T-lymphocytes, releasing gamma-interferon, interleukin-2 (IL-2) and chemotoxins, activate the movement of macrophages towards the settling of Koch's bacillus, as well as their enzymatic and bactericidal activity against infection. If at this time, tumor necrosis factor-alpha is synthesized by macrophages and monocytes, then in combination with L-arginine, nitric oxide is formed, which also has an antimicrobial effect. Together, all these processes inhibit the activity of Mycobacterium tuberculosis, and the formed lysosomal enzymes generally destroy them.

If the immune system is in proper condition, each subsequent generation of macrophages becomes more and more stable and competent in the fight against Koch's bacilli, the body develops a strong immunity to tuberculosis.

The formation of tuberculous granuloma indicates a normal immune response to infection of the body, as well as the ability of the immune system to localize mycobacterial aggression. The appearance of tuberculous granuloma is due to the production of B-lymphocytes by macrophages, which in turn produce opsonating antibodies capable of enveloping and gluing the infection. Increased activity macrophages and their production of various mediators are transformed into Langhans epithelioid giant cells, which limit the site of infection and, accordingly, the localization of the inflammatory process. The appearance of a small area in the center of the granuloma caseous necrosis(curdled, white shade soft fabric) is due to the bodies of macrophages who died in the fight against tuberculosis infection.

A pronounced adequate immune response to Mycobacterium tuberculosis in the body is usually formed after 8 weeks from the moment the infection enters a person, and it usually begins after 2-3 weeks. It was after 8 weeks, thanks to the destruction of Koch's wand, inflammatory process begins to subside, but the immune system fails to completely remove the infection from the body. The retained infection remains inside the cells, and by preventing the formation of the phagolysosome, they remain inaccessible to lysosomal enzymes. This contributes to maintaining a sufficient level of immunological activity, but at the same time, the infection can stay in the body for many years, or even for life, and when the opportunity arises, i.e. adverse factors, weakening the immune system, re-activate and causing an inflammatory process.

Important! Koch's wand can be in a person, in an inactive form throughout his life, and under unfavorable conditions for a person, activate and provoke the development of the disease!

The development of tuberculosis when the immune system is weakened

In violation of the functioning of the immune system, the course of tuberculosis is more pronounced. This is due to the fact that with insufficient activity of macrophages, Koch's bacillus develops very rapidly, literally in geometric progression. Cells that cannot cope with the infection die en masse, and a large number of mediators with proteolytic enzymes entering the intercellular space damage the tissues surrounding the infection, which become “food” for the pathogenic microflora. The balance between T-lymphocytes is disturbed, which, because of this, succumb to a large population of Mycobacterium tuberculosis, while the latter begin to spread throughout the body, with acute clinical course illness. Individual locations of the granuloma increase, merge, increasing the inflammatory areas. Infection increases permeability vascular walls, leukocytes, monocytes, plasma proteins begin to enter the tissues, tuberculous granulomas caseous necrosis predominates. Damaged organs are covered with tubercles, prone to decay.

Tuberculosis statistics in figures and facts:

• More than from tuberculosis, people die only from AIDS;
• Against the background of HIV infection, a quarter of patients who become infected with Koch's bacillus die from tuberculosis;
• As of 2013, during the year, 9,000,000 people were diagnosed with tuberculosis, of which 1,500,000 died. In 2015, according to WHO statistics, there were 10,400,000 new cases of the disease, of which 5.9 million men, 3.5 million women and 1 million children;
• About 95% of all infections occur in Africans and Asians;
• One person suffering from chronic open form of tuberculosis infects about 15 people in one year;
• Most often, the disease occurs in persons aged 18 to 26 years, as well as in old age;
• Thanks to the efforts of modern medicine, and of course the grace of God, the trend in the number of deaths from tuberculosis has decreased in recent years, and every year it continues to decline. For example, in Russia, compared with 2000, in 2013 the number of deaths decreased by about 33%.
• In many cases, tuberculosis develops in healthcare workers in anti-tuberculosis facilities.

History of tuberculosis

The first mention of tuberculosis was made in antiquity - in the days of Babylon, ancient india. This is evidenced by the excavations of archaeologists, who noticed signs of tuberculosis on some bones. The first scientific notes about this disease belong to Hippocrates, later - to the medieval Persian doctor Avicenna. The disease was noted in ancient Russian chronicles – Kyiv prince Svyatoslav Yaroslavich in 1076 suffered from tuberculosis of the lymphatic system.
The tuberculosis epidemic first spread in the 17th-18th centuries, when people began to actively build cities, develop industry, transport, expand trade, work in distant countries, and travel. Thus, Koch's wand began active migration around the world. During this period, the number of deaths from tuberculosis in Europe was about 15-20% of total lethal outcomes.

Among the most active researchers of this disease are Francis Silvia, M. Bailly (1761-1821), Rene Laennec (1781-1826), G.I. Sokolsky (1807-1886), Jean-Antoine Wilmain, Julius Conheim.

For the first time, the term "tuberculosis", with a description of several of its types, was introduced by the French scientist Rene Laennec.

Koch's wand was able to identify, and in 1882, the German doctor Robert Koch, using a microscope. He managed to do this by staining the infected sample with methylene blue and vesuvin.

Robert Koch was also able to isolate a solution with a bacterial culture - "Tuberculin", which is used for diagnostic purposes in our time.

Tuberculosis - ICD

ICD-10: A15-A19;
ICD-9: 010-018.

The symptoms of tuberculosis and its course largely depend on the form of the disease and the organ / system in which it developed. In the beginning, consider the first signs of tuberculosis, which are very similar to the symptoms of acute respiratory diseases(ORZ).

The first signs of tuberculosis

• Feeling, malaise, fatigue, weakness, increased drowsiness;
• The patient has no appetite, there is increased irritability;
• May be present, nightmares;
• increased sweating;
• Increased body temperature, which does not subside for a long time (a month or more), mild;
• Dry cough, aggravated at night and in the morning, having a paroxysmal character;
• The face takes on a pale color, while there is an unnatural flush on the cheeks;
• The eyes have an unhealthy gleam.

The main symptoms of tuberculosis

For greater accuracy, we suggest that you familiarize yourself with overview signs of tuberculosis, depending on the organ or system where the disease has developed.

Pulmonary tuberculosis characterized by pain in the chest, sometimes with a return to the hypochondrium or the area of ​​​​the scapula, aggravated by deep breath, wheezing in the lungs, rapid weight loss, an increase in the size of the lymph nodes (lymphadenopathy). Cough in pulmonary tuberculosis has a wet character, with sputum. With an infiltrative form of tuberculosis, blood particles are present in the sputum, and if blood is literally pouring from the patient, urgently call an ambulance!

Tuberculosis genitourinary system usually accompanied cloudy urine with the presence of blood in it, frequent and painful urination, aching pains lower abdomen, spotting, painful swelling scrotum with exudate;

Tuberculosis of bones and joints accompanied by destruction cartilage tissue, intervertebral discs, severe pain musculoskeletal system, and sometimes, a violation motor function a person, up to complete immobility;

Organ tuberculosis digestive tract accompanied by bloating and aching pain in it, the presence of blood in the feces, rapid weight loss, persistent subfebrile temperature;

Lupus accompanied by the appearance of dense painful nodules under the skin of the patient, breaking through when combing, from which a white curdled infiltrate is released;

Tuberculosis of the CNS (central nervous system) accompanied by a violation visual function, tinnitus, impaired coordination, hallucinations, fainting, and sometimes mental disorders, inflammation of the lining of the brain ( tuberculous meningitis), the appearance of a granuloma in the medulla;

Miliary tuberculosis characterized by numerous lesions - the appearance of multiple microgranules, the size of each of which is up to 2 mm in diameter. The reason for this process is the spread of infection throughout the body against the backdrop of a weakened immune system.

Tuberculosis of the lungs is often asymptomatic, and is detected only during a routine check-up, using fluorography or radiography chest, as well as with the help of tuberculin tests.

Complications of tuberculosis

• Partial or complete removal lung and other organs;
• Fatal outcome.

The causes of tuberculosis lie in two main factors - infection of the body and immunity vulnerable to this infection.

1. The causative agent of tuberculosis- Mycobacterium tuberculosis (MBT, Mycobacterium tuberculosis - infect humans), or as they are also called - Koch's sticks, as well as Mycobacterium bovis ( disease-causing in cattle), Mycobacterium africanum (African MBT species), Mycobacterium microti, Mycobacterium canettii. To date, scientists have identified 74 types of MBT, but this species infection is prone to mutation, and in enough short time, with which, in a sense, the complexity is also associated timely diagnosis and adequate treatment of tuberculosis.

Koch's wand under the influence various factors It tends to break up into small particles, then reassemble into a single organism and continue to infect a person or animal. MBT dimensions are only 1-10 microns (length) and 0.2-0.6 microns (width).

Outside a living organism, MBT remain viable from several days to many years, depending on environmental conditions, for example, in dried form - 18 months, in dairy products - 12 months, in water - 5 months, sputum dried on clothes - about 4 months, on the pages of a book - 3 months, while on a dusty road - 10 days. Koch sticks do not like sunlight, boiling water.

The best conditions for settling and reproduction of the MBT is a temperature of 29-42 ° C, a dark, warm and humid room. Tuberculosis bacteria tolerate freezing freely, retaining their pathological activity even 30 years after thawing.

Important! Clinical manifestations (symptoms) of tuberculosis largely depend on the type of MBT, as well as the state of health of the infected organism.

Mycobacterium tuberculosis is transmitted by airborne, contact and alimentary routes, as well as in utero. We talked about the ways of MBT transmission at the beginning of the article.

2. Weakened immune system mainly due to the presence chronic diseases, especially infectious nature( , AIDS, ), adverse conditions residence (, antisocial and unsanitary conditions), poor-quality or insufficient nutrition, taking certain medications (immunosuppressants, etc.), smoking, drinking alcoholic beverages and drugs.

3. When it comes to human infection by airborne droplets, then for the MBT to settle and penetrate into the body, an inflammatory process is necessary in the upper respiratory organs, otherwise the infection will simply stick together and be thrown back into the environment through coughing or sneezing.

Tuberculosis is classified as follows:

According to the localization of the disease:

Pulmonary form- tuberculosis of the lungs, bronchi, pleura, trachea and larynx, which can proceed according to the following type:

• primary tuberculosis complex (tuberculous pneumonia + lymphadenitis, lymphangitis)
• tuberculous bronchoadenitis, isolated lymphadenitis.

Extrapulmonary form:

• Tuberculosis of bones and joints;
• Lupus;
• Tuberculosis digestive system;
• Tuberculosis of the genitourinary system;
• Tuberculosis of the central nervous system and meninges;
• Eye tuberculosis.

By form:

• tuberculoma;
• latent tuberculosis;
• focal (limited) tuberculosis;
• miliary tuberculosis;
• infiltrative tuberculosis;
• disseminated tuberculosis;
• cavernous tuberculosis;
• fibrous-cavernous tuberculosis;
• cirrhotic tuberculosis;
• caseous pneumonia.

Type:

primary tuberculosis is acute form diseases. The development of the disease occurs for the first time, and is usually observed in children under 5 years of age, which is due to an incompletely formed immune system. There is no threat to the surrounding people, although the course of the disease is acute, with a pronounced clinical picture.

Secondary tuberculosis characterized by the development of the disease after remission, due to its exacerbation, or due to infection of the body with another type of Koch's wand. Concerning, secondary form adult patients are more susceptible to the disease. The internal course of the disease is accompanied by the formation of new foci of inflammation, sometimes merging with each other, forming extensive cavities with exudate. Secondary tuberculosis is a chronic form of this disease, and with complications, despite the efforts of doctors, many patients die. A great rarity is the spontaneous return of the disease from the stage of exacerbation to the stage of remission. A patient with a chronic form of tuberculosis is a danger to the people around him, because. when coughing, sneezing and other aspects of life, a pathogenic infection is released into the environment.

Diagnosis of tuberculosis

Diagnosis of tuberculosis includes the following types of examination:

• Tuberculin diagnostics ("Mantoux test");
• Bacteriological analysis;
• Linked immunosorbent assay.

Tuberculosis treatment

How to treat tuberculosis? Treatment of tuberculosis can only be started after a thorough diagnosis, as well as identifying the type of Koch's bacillus, the stage of the disease and comorbidities.

Treatment for tuberculosis includes:

1. Drug treatment
1.1. Chemotherapy;
1.2. Supportive care;
2. Surgical treatment;
3. Rehabilitation in sanatorium-resort specialized institutions.

Important! A patient with tuberculosis must strictly adhere to the treatment regimen prescribed by the attending physician, otherwise the results of many months of work may come to naught.

1. Drug treatment

Important! Before using drugs, be sure to consult your doctor!

1.1. Chemotherapy

Mycobacterium tuberculosis (MBT) refers to bacteria, so the treatment of tuberculosis is primarily based on the use of antibacterial drugs.

Due to the predisposition of MBT to rapid mutation and large quantity its genotypes, as well as resistance (resistance) to certain substances, antibacterial therapy most often includes the use of several antibiotics at the same time. Based on this, modern medicine has identified 3 treatment regimens:

• three-component(2 antibiotics + PAS) - "Isoniazid", "Streptomycin" and "Para-aminosalicylic acid" (PAS)
• four-component(4 pairs of antibiotics), in international practice it is designated by the term "DOTS" - "Isoniazid" / "Ftivazid", "Streptomycin" / "Kanamycin", "Rifabutin" / "Rifampicin", "Pyrazinamide" / "Ethionamide".
• five-component- 4 pairs of antibiotics of the "DOTS" scheme + 1 antibiotic of the 2nd, 3rd or 4th generation ("Ciprofloxacin", "Cycloserine", "Capreomycin" and others)

For the best efficiency, the attending physician selects and combines certain drugs, as well as the duration of their administration.

Treatment of tuberculosis also consists of two main phases of therapy:

• Intensive (duration 2-6 months), which is aimed at stopping the infection and stopping the destructive process in the body, preventing the active release of the infection into the environment and resorption of the infiltrate with exudate;
• Prolonged (up to 2-4 years) - is aimed at the complete healing of tissues damaged by the infection, as well as the restoration and strengthening of the patient's immune system.

1.2. Supportive care

The following groups of drugs are aimed at improving the course of the disease, strengthening the body and accelerating recovery.

Probiotics. This group preparations restores the normal microflora in the digestive organs, necessary for the normal assimilation and digestion of food. This is due to the fact that antibiotics pathogenic microflora, destroy most of the beneficial bacteria that are in the intestines of any healthy person. Among the probiotics can be identified - "Linex", "Bifiform".

Hepatoprotectors. A conditional group that includes funds aimed at strengthening and restoring liver cells. In fact, hepatoprotectors protect the liver from the pathological effects of antibiotics on it. Among hepatoprotectors, one can distinguish - "", " Lipoic acid”, “Silimar”, “Ursonan”, “Phosphogliv”, “”.

Sorbents. The microflora in the course of its life activity release toxins, which, together with the infection that died from antibiotics, poison the body, causing symptoms such as loss of appetite, nausea, vomiting, and others. To remove toxic substances from the body, sorbents (detoxification therapy) are used, among which are Acetylcysteine, Atoxil, Albumin, Rheosorbilact, as well as drinking plenty of water, preferably with the addition of vitamin C.

Immunostimulants. This group of drugs stimulates the immune system, which in turn leads to an increase in the fight against infection and to more speedy recovery. Among the immunostimulants can be identified - "Biostim", "Galavit", "Glutoxim", "Imudon", "Ximedon".

It is a natural immunostimulant, a large amount of which is present in, raspberries, cranberries,.

Antipyretic drugs. They are used to relieve high body temperature, however, remember that this group of drugs is recommended to be used at a high temperature - from 38.5 ° C (if it lasts 5 or more days. Among the antipyretics, one can distinguish - "", "", "".

Non-steroidal anti-inflammatory drugs (NSAIDs)- are used to relieve pain. Among them are - "Indomethacin", "", "Naproxen", "Chlotazol".

Glucocorticoids (hormones)- are used in cases where the pain could not be stopped by NSAIDs, as well as in a severe course of tuberculosis with unbearable pain. However, they cannot be used for a long time, since they have an immunosuppressive effect, as well as a number of other side effects. Among the glucocorticoids can be identified - "Prednisolone", "Hydrocortisone".

To save the central nervous system from damage, as well as to maintain its normal functioning, appoint -, glutamic acid and ATP.

To accelerate cell regeneration and restoration of infected tissues are prescribed - Glunat, Methyluracil, Aloe Vera and others.

2. Surgical treatment of tuberculosis

Surgical intervention in the treatment of tuberculosis implies the following types of therapy:

• Collapse therapy (artificial pneumothorax or pneumoperitoneum) - based on squeezing and fixing the lung by introducing sterile air into the pleural cavity, which leads to a gradual fusion of cavities and prevention of active release of Koch's bacillus into the environment;
• Speleotomy or cavernectomy - removal of the largest caverns that are not amenable to conservative treatment;
• Lobectomy, bilobectomy, pneumonectomy, pulmonectomy - removal of one lobe or part of a lung that is not amenable to conservative treatment, or the complete removal of such a lung.
• Valved bronchoblocking is designed to normalize the breathing of patients, and is based on the installation of miniature valves in the mouths of the bronchi to prevent them from sticking together.

Treatment prognosis

At early detection in the body of Koch's bacillus, careful diagnosis and strict observance by the patient of the prescriptions of the attending physician, the prognosis for recovery from tuberculosis is very positive.

The unfavorable outcome of the disease in most cases is due to the advanced form of the disease, as well as the frivolous attitude of patients towards it.

However, remember, even if the doctors put a cross on the sick, there are many testimonies when such a person turned to God in prayer and received a full recovery, even with such deadly diseases as.

Important! Before using folk remedies for the treatment of tuberculosis, be sure to consult your doctor!

Pine pollen. Essential oils coniferous trees they have a bactericidal effect, in addition, they fill the air with pure ozone, improving the functioning of the respiratory system, and to put it simply, a person breathes much easier among coniferous trees. To prepare a folk remedy for tuberculosis based on coniferous gifts, you need 1 tbsp. mix a spoonful of pine pollen with 150 g of lime honey. You need to use the remedy 1 teaspoon 20 minutes before meals, 3 times a day, for 60 days, after which a 2-week break is made and the course is repeated. keep it folk remedy from tuberculosis you need in the refrigerator.

Pine pollen tea. Mix 2 tbsp. spoons of pine pollen, dried lime blossom and marshmallow root. Pour 500 ml of boiling water over the prepared collection, let it brew for about an hour. Then pour 100 g of infusion into a glass and add boiling water to it so that the glass is full. You need to drink such tea 4 times a day, a glass, 30 minutes before meals.

Garlic. Grind 2 cloves, fill them with a glass of water, let it brew for a day, and in the morning, before eating, drink the infusion. The course of treatment is 2-3 months.

Garlic, horseradish and honey. Make a slurry of 400 g of garlic and the same amount of horseradish, then mix it with 1 kg butter and 5 kg. Next, the mixture should be infused in a boiling water bath for 5-10 minutes, stirring occasionally, cool and take 50 g before meals. The tool is considered effective in pulmonary tuberculosis.

Iceland moss (cetraria). Put in an enamel saucepan 2 tbsp. spoons of chopped Icelandic moss and pour it with 500 ml of clean cold water, then bring the product to a boil, boil it over low heat for another 7-10 minutes with the lid closed. Next, the product must be filtered, set aside in a jar for insisting. The remedy should be drunk during the day, for 3-4 approaches, before meals. The course of treatment is 1 month, with advanced forms - up to 6 months, but after each month, take a 2-3 week break. For improvement palatability, you can add a little honey or milk to the broth.

Aloe. Mix in an enamel saucepan 1 crushed large fleshy leaf with 300 g of liquid linden honey and fill them with half a glass of clean cold water. Bring the mixture to a boil, then simmer it for about 2 hours with the lid tightly closed. Next, the remedy must be filtered and taken 1 tbsp. spoon before meals, 3 times a day, for 2 months, and you need to store it in a glass jar in the refrigerator.

Vinegar. Add to a glass container 100 g of freshly grated horseradish, 2 tbsp. spoons of 9% apple cider vinegar and 1 tbsp. a spoonful of honey, mix everything thoroughly and take this folk remedy for tuberculosis 1 teaspoon 20 minutes before meals, 3 times a day until the medicine runs out. Then a 2-3 week break is made and the course is repeated. You need to store the product in the refrigerator.

Dill. Pour into a small enamel saucepan 1 tbsp. spoon with a slide of dill seeds and fill them with 500 ml of clean cold water. Bring the product to a boil, boil it under a covered lid over low heat for about 5 minutes, then set the product aside overnight to infuse. In the morning, strain the remedy and drink it during the day, in 5 doses. It is necessary to take this medicine for tuberculosis within 6 months, and it is better to store it in a glass container in the refrigerator or in a cool dark place.

Tuberculosis prevention includes the following activities:

• Vaccination - BCG vaccine (BCG), however, this vaccine in some cases may itself contribute to the development of certain types of tuberculosis, for example, joints and bones;
• Carrying out tuberculin tests - Mantoux reaction;
• Periodic (1 time per year) fluorographic examination;
• Compliance;
• You need to save yourself from, if necessary, change jobs;
• Don't let ;

  Tuberculosis video

Tuberculosis in adults is a disease caused by acid-fast strains of Mycobacterium tuberculosis. Infection with this type of mycobacterium tuberculosis occurs when talking with a person suffering from an open form, in which Koch's bacillus is released along with droplets of infected sputum into the environment. Most people who are bacterial excretors are unaware of the development of the tuberculous process in their bodies. The discovery of the fact that Koch's bacillus is released often occurs by chance when visiting a therapist's office for some other reason or when conducting an unplanned prophylactic fluorogram, for example, when applying for a new job. Is it worth mentioning how many people they manage to infect during the time of ignorance of the deplorable state of their condition.

Causes of tuberculosis in adults

The cause of the development of tuberculosis in adults are acid-resistant strains of Mycobacterium tuberculosis (Koch's sticks). Koch's wand has been known since ancient times, humanity has been fighting the consequences of infection with this pathogen for more than one century. Such a long unsuccessful struggle is associated with the extreme viability of this bacterium.

The distinguishing features of this microorganism is the huge variety of gene variations in the bacterial cell wall. This is associated with certain difficulties in the treatment of tuberculosis in adults. In addition, Koch's wand is capable of long-term persistence in the human body. Forming inactive forms of existence, such as L-forms, the rod is able to exist for a long time in a "dormant" state. In addition, Koch's rod prevents the completion of phagocytosis by macrophage cells, which leads to the preservation of viable bacteria in the macrophages themselves, whose task was to destroy the mycobacterium. Often this happens when a person’s immunity fails, for example, with general exhaustion, with immunodeficiency states, during the period of recovery of the body after an illness, with human abuse harmful substances such as smoking tobacco and smoking mixtures, frequent use of alcohol, drugs.

The penetration of Koch bacteria occurs mainly through Airways. This route of transmission is called airborne. When talking with a person who excretes mycobacterium in huge number contained in droplets of sputum, which is released along with the air from the respiratory tract of the patient and with the air enters the lungs of the interlocutor.

Often a sick person spits infectious sputum on the ground, where it dries and mixes with street dust. At strong wind Dust rises into the air, which can enter the respiratory tract of a person.

Available household way transmission of tuberculosis in adults when using shared utensils, a toothbrush. Rarely seen at present.

Initially, getting into the respiratory organs of a person, mycobacterium is localized in its lymphatic system develop primary forms of tuberculosis in adults. Further, if the body does not come to the rescue adequate treatment, the tuberculous process is progressing. Initially, the generalization of the process occurs lymphogenously, and after the formation of areas of caseous necrosis (caverns), Koch's sticks can break into the bloodstream and damage to other organs is added to the already existing forms of pulmonary tuberculosis.

With the formation of cavities in the lungs, tuberculosis in adults ceases to be closed form because Koch's sticks through the bronchial tree begin to be released into the environment with sputum when coughing and sneezing. From this moment on, a person becomes a bacterio-excretor and extremely dangerous for his environment.

The first signs of tuberculosis in adults

Studies have shown that in 90-95% of people, the primary entry of Mycobacterium tuberculosis into the body is limited to minor specific changes, and the progression of the process does not occur and a detailed clinical picture does not develop. This category of people, as a rule, has a properly delivered BCG vaccination and a well-functioning immune system.

The remaining five to ten percent of people develop the initial signs of TB in adults. Initial signs tuberculosis in adults are associated primarily with intoxication syndrome. After entering the body, Koch's bacillus can be localized in the lymphatic system (the most common option), kidneys, lungs, joints, pleura and other organs, but, regardless of its primary location, intoxication syndrome will always be the first manifestation of tuberculosis in adults. Sometimes the intoxication syndrome remains the only manifestation of the tuberculous process.

Intoxication manifestations are associated with the fact that the stick releases toxic products into the body during its life, plus the changes occurring in human tissues are also accompanied by the formation of products that disrupt cellular metabolism.

All these changes result, first of all, in functional disorders CNS, namely mood variability, frequent irritability, apathy. The tolerance to physical and mental stress, a person quickly gets tired and slowly recovers, becomes distracted.

Vegetative disorders are noted: increased sweating at night, interruptions in the work of the heart (), which are felt by patients as periodic fading of the heart. Unstable body temperature. Temperature at short intervals time rises to subfebrile figures, more often it occurs in the evening hours.

Also, the first signs of tuberculosis in adults include an increase in peripheral lymph nodes, more often the cubital and supraclavicular group are exposed to this. They moderately increase in size, do not form "packages" between themselves and with surrounding tissues, respectively, they are mobile, soft-elastic in their consistency. In a chronic course, they are significantly compacted, reaching a stony density.

If a person's immune system works properly, then, having developed inflammatory response subsides, Mycobacterium tuberculosis is eliminated from the body, but some of them are able to persist in the body for a long time in the form of "dormant" forms (L-forms).

If there is a fact of immunodeficiency, then to intoxication syndrome other clinical manifestations join.

The primary forms of tuberculosis in adults are: tuberculosis intoxication, tuberculosis of the intrathoracic lymph nodes (CHN) and primary tuberculosis complex (PTC).

With VLLU tuberculosis, with the progression of the process, a special bitonal cough joins the intoxication syndrome. Its appearance is associated with compression of the bronchi and trachea by enlarged VLH. For the same reason, the development of obstructive bronchitis, which is not corrected by conventional methods of treatment, is possible.

PTK also has a cough, but with different characteristics, with little sputum production. In the lungs, moist fine bubbling rales are possible, which erroneously leads to the suspicion of the development of pneumonia.

Symptoms and signs of tuberculosis in adults

If the primary forms were not recognized or were successfully treated, but the “dormant” forms of mycobacteria remained, which subsequently reactivated, then the process progresses (dissemination) with the formation of extrapulmonary foci.

Other forms of pulmonary tuberculosis in adults are also possible: focal, miliary, infiltrative, caseous pneumonia, and many others.

Disseminated pulmonary tuberculosis in adults can occur as an acute, subacute, and chronic process.

The acute process begins abruptly with severe symptoms of intoxication, possibly allergic rashes. Toxic defeat The central nervous system can be expressed up to the appearance of confusion and delirium, which resembles a picture. Such patients are often first hospitalized in the infectious diseases department.

The appearance of shortness of breath due to the development of emphysema, as well as fine bubbling rales in the lungs, is characteristic. the microorganism affects the interalveolar septa and the wall of the alveoli itself. Along the capillaries, gray-yellow foci the size of millet develop. This form of tuberculosis is called miliary. The lesions are located symmetrically in both lungs. The patient suffers from a painful hacking cough, which is the result of the intrabronchial location of miliary foci.

An acute process is possible if the pathogen has a high virulence, and the human body suffers from immunodeficiency states. With timely proper treatment, the foci completely resolve, and emphysema regresses. If this does not happen, then two months is enough for the patient to die.

The subacute process is less pronounced, the lesions are larger, and the symmetry of their location is broken. There is a discrepancy between the poor clinical picture and the rather extensive lung involvement. In the first place in the symptoms are mild symptoms of intoxication. Patients often do not consider their condition dangerous and do not go to the doctor until complications (pleurisy, tuberculosis of the larynx) appear, the signs of which are pain in the side, a significant rise in temperature, and hoarseness.

When examining such a patient, dry or wet rales can be heard above the foci, usually in the interscapular region.

The chronic course of disseminated pulmonary tuberculosis is possible in the absence of timely diagnosis, which makes it possible for mycobacteria to infect new and new areas of the lung with repeated waves of lymphogenous dissemination. This gives a picture of the "floor-by-floor" arrangement of foci in the lungs. Clinical picture slowly enriched by an increase in symptoms. The course of this form of tuberculosis in adults is undulating, with the process subsiding almost asymptomatic. The chronic course ends with the development of pronounced fibrotic changes, and in the absence of treatment, the formation of caverns.

Another form of tuberculosis in adults is focal. The process is within one or two lobules; already treated patients suffer from it more often. The formation of decay cavities in such foci leads to the release of caseous masses into the bronchus, a picture of caseous bronchitis develops.

With the formation of decay cavities, adjacent blood vessels are also destroyed, and blood appears in the sputum. Initially allocated fresh blood, which, then, is replaced by expectoration dark clots. The discharge of dark clots lasts for several days.

The progression of the tuberculous process often leads to the appearance of symptoms.

Diagnosis and analysis for tuberculosis in adults

Detection of tuberculosis in adults begins with a survey and a general examination of the patient. The survey reveals the dynamics of the clinical picture, the likelihood of contact with patients, as well as the presence in the immediate environment of people at risk of developing tuberculosis in adults.

When examining patients with progressive forms of pulmonary tuberculosis, the appearance of the patient, which has long been described in the literature, attracts attention. This is the so-called habitus phtisicus. Attention is drawn to general exhaustion, pronounced pallor of the skin, on which a bright blush and sparkle of the eyes stand out. The intercostal spaces are widened due to developed emphysema, the shoulder blades protrude. This appearance is characteristic of advanced tuberculosis in adults.

On the early stages of the development of the tuberculous process, it is difficult to detect any changes during the examination of the patient.

On examination, it is necessary to check for the presence of scars after setting BCG.

Routine blood and urine tests are not pathognomonic. In a general blood test, there may be a content of toxic granularity in neutrophils. In a biochemical blood test, liver enzymes may be increased.

Detection of tuberculosis in adults is associated primarily with x-ray examination. The main sign of pulmonary tuberculosis on x-rays are focal shadows in the lungs. With lymphogenous spread of the process, shadows are located in one lung and more often in the middle sections, and with lympho-hematogenous spread - in both lungs and relatively symmetrically.

Miliary pulmonary tuberculosis is detected on x-ray only on the tenth - fourteenth day of its existence. These are small symmetrically located foci along the entire length of the lungs. The foci can line up in a chain or accompany the vessels throughout their entire length.

In the subacute form of disseminated tuberculosis in adults, the foci are larger (5-10 mm), have fuzzy edges, and can merge into areas of blackout. Destructive zones look like areas of enlightenment in the center of foci of darkening, sometimes they take the form of a ring. In addition, calcifications can be found in the lymph nodes.

At chronic process X-ray picture is polymorphic, foci different size, do not merge, in the upper parts of the lungs are larger than in the lower ones. Caverns can be detected, they look like an annular shadow with clear edges.

To detect mycobacteria laboratory methods the following diagnostic material is collected: sputum, bronchial washings, biopsy obtained from the affected organs, discharge and swabs from wounds. The collected material is subjected to Ziehl-Neelsen staining followed by microbiological examination.

Under fluorescence microscopy, the Koch rod glows golden.

The cultural method is associated with a long wait for results (acid-resistant MBT grow at the beginning of the second week after sowing), so it is not used for rapid diagnosis.

How helper method Computed tomography can be used to make a diagnosis.

Treatment of tuberculosis in adults

Early diagnosis of tuberculosis in adults is essential to start adequate therapy as soon as possible.

Treatment of pulmonary tuberculosis in adults is associated with the use of a complex of anti-tuberculosis drugs. It must be remembered that drugs should affect not only the multiplying forms of mycobacteria, but also the "dormant" L-forms.

Five chemotherapy drugs meet these parameters: Isoniazid, Rifampicin, Ethambutol, Streptomycin and Pyrazinamide. To overcome drug resistance to one or two drugs, a combination of four is prescribed medicines: Rifampicin + Isoniazid + Pyrazinamide + Streptomycin or Ethambutol The course of treatment with these drugs is long, two to three months.

Treatment of pulmonary tuberculosis in adults is not limited to the appointment of anti-tuberculosis drugs. It is necessary to support the patient's immune system, stimulate reparative processes in the lungs. These goals are achieved by prescribing a complex of vitamins, antioxidants (Tocopherol, Sodium thiosulfate), to maintain immunity, immunostimulating drugs (Levamisole, Decaris) are prescribed.

Treatment of pulmonary tuberculosis in adults also aims to minimize the development of fibrotic changes in the affected areas of the lungs. For this, Lidaza is successfully used, it is also possible to use glucocorticosteroids, but it should be remembered that they contribute to the suppression of immunity, which is highly undesirable.

A high-calorie diet is recommended, patients should not limit themselves to a variety of foods. It is advisable to enrich the diet with dairy, sour-milk foods, i.e. rich in calcium salts. Calcium salts contribute to the elimination of the allergic component of the tuberculosis process.

Koumiss therapy has been successfully used in the treatment of pulmonary tuberculosis in adults. This is a product rich in vitamins, microelements, so necessary for the recovery of the body after an illness. In addition, mare's milk contributes better job digestive system. When using koumiss, a person exhausted by the disease quickly gains the missing kilograms.

Prevention of tuberculosis in adults

Specific prevention of tuberculosis in adults begins in early childhood, when the child is given the first BCG vaccination. The protective forces created by this vaccine are enough for about seven years, then the vaccination must be repeated, provided that the person has not been infected with Mycobacterium tuberculosis. In adulthood, the absence of infection with Koch's wand is very rare.

Early diagnosis of tuberculosis in adults is a measure to prevent the spread of Koch's bacillus among the population. For this purpose, mass fluorographic examinations are carried out. Fluorographs can be both stationary and mobile. The use of mobile fluorographs allows for routine examinations rural population as well as employees of large enterprises.

Stationary fluorographs are used for preventive examinations in a clinic setting.

In order to prevent the spread of mycobacterium tuberculosis, specialized hospitals in which patients undergo treatment have been moved outside the city, more often this is an area with coniferous trees. they have antiseptic properties.

After hospitalization of patients in a specialized hospital, final disinfection is carried out in the outbreak.

In addition, persons with newly diagnosed signs of a tuberculous process, as well as people who have undergone treatment for this disease having expressed residual effects a course of chemotherapy is carried out to avoid reactivation of the tuberculosis process.

It is also necessary to improve the household culture of the population to prevent the entry of infected sputum into the soil. Patients with pulmonary tuberculosis should have on hand a special container with a lid for collecting sputum containing Koch's sticks. In addition, it is necessary to observe simple hygiene skills, use individual dishes.

Tuberculosis in adults - which doctor will help? If you have or only suspect the development of tuberculosis, you should immediately contact a doctor such as an infectious disease specialist.

To date, tuberculosis is one of the most dangerous and serious infectious diseases.

It is about 30% of total number diagnosed cases. In 92%, the tuberculosis process affects the lungs.

Effective treatment of tuberculosis in adults is possible only with timely detection and adequate therapy. It is necessary to know the first symptoms of the disease, what measures should be taken, and seek medical help in time.

Modern medicine is well acquainted with the signs of tuberculosis, has an extensive knowledge base about the diagnosis and treatment of this disease.

It is widely believed that tuberculosis is a disease that affects antisocial elements and people with difficult living conditions. This is not so, every adult has a risk of getting infected.

Tuberculosis affects one third of the world's population. However, the role of the social factor in the spread of tuberculosis is very high.

1. people with severe infectious diseases, especially chronic stages;
2. HIV-infected and AIDS patients;
3. people with diseases endocrine system especially with diabetes;
4. patients taking certain drugs that reduce the body's defenses, patients on dialysis and after organ transplants;
5. people suffering from drug addiction;
6. people in places of detention;
7. people without a fixed place of residence or leading an asocial lifestyle.

You can also select age categories with high probability tuberculosis infections: these are children under 10 years old and elderly people over 60 years old.

This is due to the fact that the immune system in childhood and old age does not work as efficiently.

The risk of contracting tuberculosis increases if there is constant contact with an infected person. This category includes medical personnel working with tuberculosis patients. With a single contact, the likelihood of infection is lower than with regular contact.

You need to know that mycobacteria remain viable in an open environment for a long time and are resistant to most disinfectants.

Koch's wand, once in the body, may not manifest itself in any way. In order for pulmonary tuberculosis to move from a latent form to an active one, the body must experience stress. Infection can provoke the progression of the disease, a sharp decline immunity against the background of malnutrition, stay in unsanitary conditions, abuse of alcohol, drugs.

The first manifestations of tuberculosis

The appearance of the first symptoms of pulmonary tuberculosis depends on the individual physiological and pathogenetic data of a particular patient.

The severity of symptoms depends on how much time has passed since the infection, as well as on the state of the body's defenses, the presence of concomitant diseases, working conditions, climatic conditions, the influence of external factors.

After a person is infected with Koch's wand, a long time can pass before the first signs of the disease appear. If the immune system copes with its functions, then its cells easily repel the attack of the aggressor.

A person may not even suspect that he is ill for a long time, even if the disease occurs in an open form. This is due to the fact that the disease in the early stages does not manifest severe symptoms. And if there are any ailments, a person most often takes them for signs of other diseases.

This disguise is one of the main dangers of tuberculosis.

The main symptom of tuberculosis is the separation of sputum interspersed with blood. But in the early period, it manifests itself only if the infection is massive, the disease progresses rapidly.

First, pulmonary tuberculosis gives signs characteristic of many infectious diseases. These include: general malaise, subfertile temperature values, profuse night sweats, dry unproductive cough, headaches, a complex of asthenic symptoms, lack of appetite.

Depending on the general condition health symptoms such as cardiopalmus, hypotension, lymphadenitis, liver hyperplasia. In most cases, a neurological syndrome is formed.

Its manifestations include:

1. irritability;
2. nervousness;
3. dizziness;
4. decrease in working capacity;
5. fast fatiguability;
6. sleep disturbances, apathy.

The first signs of pulmonary tuberculosis that appear can be mistaken for symptoms of infectious diseases of the upper respiratory tract. Some ignore the appearance of neurological manifestations, attributing to fatigue, constant employment and other life realities.

Detection of tuberculosis in the early stages

Lungs in the early stages allows the totality specific features. It is necessary to undergo regular medical examinations, planned diagnostic examinations to do a fluorography.

Tuberculosis is manifested by a complex variety of symptoms. Experienced specialist, comparing and analyzing the data of the anamnesis, may suspect that the patient has this severe pathology, to appoint analyzes and researches.

What signs indicate the presence of pulmonary tuberculosis?

Cough in pulmonary tuberculosis

Tuberculosis of the lungs is characterized by chest symptoms, the main of which is cough.

If any cough does not go away within two or three weeks, you should immediately consult a pulmonologist and undergo an examination. As a rule, in the early stages, the patient's cough is dry, with a small amount of sputum.

The most severe attacks of coughing torment the patient in the morning, after assuming an upright position. This is due to the fact that during a long stay in horizontal position the sensitivity of the mucosa decreases, a significant amount of sputum accumulates in the upper respiratory tract, and when changing posture it causes the urge to cough.

As the disease progresses, exudation begins, the formation of cavities, and the cough intensifies, it can appear at any time of the day. A characteristic symptom is incessant bouts of coughing.

The patient chokes and suffocates, but until the airways clear at least a little, the cough does not stop. In the case of the transition of the disease to the form of a closed focus, the cough may disappear altogether.

Temperature

One of the main signs of tuberculosis is a slightly but constantly elevated temperature.

Usually during the day the body temperature is within the normal range, rises in evening time and is accompanied by fever and chills.

The use of antipyretics either has no effect, or briefly reduces temperature indicators, causing profuse sweating, headache and general weakness. If this symptom lasts more than two or three weeks, then the infectious process is progressing, you should immediately consult a doctor.

Sputum with blood

Hemoptysis is a hallmark symptom of infiltrative pulmonary tuberculosis. Blood in the sputum due to hypertension, thickening of the walls and rupture blood vessels in the site of infection.

Such a sign is very alarming, since with such a vascular reaction, the development of massive pulmonary bleeding, which are one of the causes of death in tuberculosis.

chest pain

The tuberculous process in the lungs is often accompanied by pain in the chest, in the hypochondrium, which is aggravated by movement. In cases where the disease affects, in addition to the lungs, the pleural cavity, the pain is more pronounced.

Spirometry reveals a slowing of breathing from the side of the lesion, which is the reason for conducting studies to detect tuberculosis.

Dyspnea

With massive damage to the lungs by mycobacteria, shortness of breath may appear in the early stages of the disease.

In the presence of infiltration, the formation of cavities and granulomas, with an active fibrous and cirrhotic process, the patient develops shortness of breath.

At first, it manifests itself in physical activity As the disease progresses, dyspnea may be present even at rest.

Changing external data

Visual assessment of the patient helps to see the presence of a pathological process. In patients with tuberculosis, facial features are aggravated, the nose is sharpened, and cheeks droop. The person looks haggard, there is a waxy pallor of the skin, while there is an unhealthy blush on the cheeks on the face.

One of the signs of infection is a decrease in appetite, as a result of which a patient with tuberculosis rapidly loses weight. However, in some cases, the appetite may remain normal, and the weight is nevertheless reduced. All people infected with tuberculosis look “exhausted”, emaciated, while a person can continue to eat normally.

Wheezing

The most pronounced wheezing becomes on inspiration. Wheezes are wet and dry.

With a limited tuberculous process, vesicular respiration is heard, but most often tuberculosis gives a weakening of the speed and strength of inhalation. Usually this phenomenon is unilateral.

Lymphadenitis

One of the first symptoms of tuberculosis is an increase in lymph nodes. Most often, the lymph nodes under the armpits, behind the ears and on the neck increase. The phenomenon is painless.

Laboratory tests during this period do not show significant changes in the blood count, but the disease progresses.

Tuberculosis is extremely difficult to detect in the early stages. The clinical picture of symptoms in initial period erased diseases. Symptoms are either absent at all, or they are similar to manifestations of other infectious diseases.

Laboratory tests for early stage may indicate the absence of pathogens in the test material. Under these conditions, the diagnosis is significantly difficult. However, science does not stand still, and today physicians will be able to understand the pathogenesis of the disease even with minimal input.

Therefore, you should not postpone a visit to a therapist, phthisiatrician and pulmonologist if at least a few symptoms of an unhealthy condition appear.