discovered tuberculosis. Forms of tuberculosis according to the clinical course. Treatment of an open form of tuberculosis

Mankind has known about tuberculosis for a long time, before it was called consumption. A couple of centuries ago, almost all patients died of tuberculosis. But, despite the availability of anti-tuberculosis drugs, tuberculosis is still considered a dangerous and very common disease.

According to the latest data, about 9 million cases are registered annually around the world. The growth of tuberculosis patients is associated with an increase in the number of people with HIV infection, because it is they who most often develop tuberculosis as a complication of the underlying disease.

How can you get tuberculosis? The causative agent of this infectious disease is tuberculosis bacillus, which is otherwise called the Koch stick. Tuberculosis (in an open form) is transmitted from a sick person to a healthy person through the air. Most often, transmission of infection occurs through contact with infected people, as well as through common household items. The immunity of a healthy person can destroy the disease-causing bacillus, however, too frequent contact with a sick person increases the likelihood of infection even with active work immune system.

With a weakened immune system, any infections penetrate the body faster and multiply faster in it. So the risk of infection is great for both a strong and a weakened organism.

open form

What is an open form of tuberculosis? There are several types of tuberculosis, among which one can distinguish open and closed forms. An open form of tuberculosis, unlike a closed form, is transmitted from a sick person to a healthy one. With a closed form, the disease is not contagious, since in this case the disease proceeds without the release of a pathogenic bacillus into the external environment. The open and closed form of the disease is most often determined with tuberculosis of the lungs, but there is also tuberculosis of the intestines, genital organs, and so on. All of them are accompanied by the release of bacteria in environment.

Incubation period open tuberculosis is about a month from the moment of infection, after this period of time bright symptoms begin to appear.

The mechanism for the development of tuberculosis is rather complicated, if the bacillus has entered the body, then it will never leave it. The development of the disease depends entirely on hereditary predisposition and on environmental factors. As mentioned above, strong immunity resists infection, and a person with weak immunity or a predisposition to this disease becomes ill.

The causative agents of the disease have a very complex metabolism, so they are very stable and variable as external conditions as well as to the conditions inside the person.

Open tuberculosis is divided into primary and secondary. From the terminology, it is clear that the primary form develops in a person who has not previously had tuberculosis and has not been in contact with a tubercle bacillus. secondary form is a recurring disease. In this case, the focus that took place earlier is scarred, and another focus develops.

Symptoms of an open form

How is the open form of tuberculosis manifested? Symptoms do not increase immediately, at first they do not cause discomfort to the sick person, but after incubation period ends, the patient develops a cough. At first the cough is dry, but over time it becomes wet. This symptom can last from a month or more. At this moment (with wet cough) open tuberculosis can be transmitted to healthy people. Sticks are transmitted through the air or through household items. They're in huge number contained in the patient's sputum, and, accordingly, are not only in the air, but also on surrounding objects.

The following signs of tuberculosis of the open form are weight loss, hemoptysis and subfebrile temperature, which most often rises in the late afternoon.

With secondary tuberculosis of an open form, the symptoms are somewhat different:

• the temperature rises to critical levels;
• the patient suffers greatly profuse sweating at night;
• excruciating and almost non-stop cough, most of all he worries the patient at night and in the morning;
• there are chest pains and aches in the joints;
• the skin turns grey.

Diagnosis of the disease

Open tuberculosis is diagnosed in a laboratory study of a pulmonary discharge of a patient or by bronchoscopy. Bronchoscopy is the removal of a small sample lung tissue to determine the presence of an infectious agent in it. In addition, the patient must do an x-ray of the lungs.

In some cases they do tuberculin test(Mantoux test). Most often, this study is carried out in relation to children. This test makes it possible to determine the degree of infection and tissue reactivity.

If there is a suspicion of an extrapulmonary form of the disease, a Koch test is performed. As additional measures diagnostics, ultrasound, CT scan, consultation with a neurologist, gastroenterologist, dermatologist and other narrow specialists can be prescribed.

Treatment of the disease

First of all everything medical measures designed to kill bacteria. There are four groups for this. antibacterial drugs. Treatment, as a rule, is carried out inpatient, after the release of bacteria into sputum, and from it into the environment, stops, the patient can continue treatment on an outpatient basis. The treatment is long - it can take a year or more. After the therapeutic course, the patient is recommended treatment in sanatoriums that specialize in the treatment of tuberculosis.

Bed rest is prescribed for those patients in whom lung destruction is very pronounced. For everyone else, on the contrary, vigorous activity is highly recommended - walks, physiotherapy and so on.

If a therapeutic treatment does not give effect, surgical treatment may be prescribed. Most often, an incomplete resection of the lung is performed, as well as the removal of segments that have been affected. The main problem in the treatment of the disease is the extreme resistance of the bacillus to drugs. In addition, with such long-term treatment The patient may experience various side effects antibiotic therapy.

As for the life expectancy of a patient with tuberculosis, this is very individual. It all depends on the correctness of the chosen therapy, the lifestyle of the patient, the form of the disease. Completely defeat tuberculosis modern medicine can not. All those around the patient must undergo twice a year diagnostic examination, if necessary, they are prescribed treatment to prevent the disease.

Complications of the disease

Tuberculosis is a dangerous disease that can cause severe complications and consequences. As a result of the lack of therapy or non-compliance with all medical recommendations, the following conditions may develop:

• pulmonary bleeding;
• oxygen deficiency - respiratory failure;
• inflammation of the outer lining of the lungs - pleurisy;
• air may accumulate in the pleural region, such a phenomenon is possible when the alveoli or the bronchus itself is ruptured;
• heart failure resulting from pathological processes in the pulmonary system;
• TB infection can spread to other organs.

Prognosis for the disease

If the disease is detected on time, and the patient exactly complies with all the doctor's prescriptions, then the prognosis can be called favorable. After the tuberculous foci heal, and the symptoms disappear, they talk about clinical recovery.

If there is no treatment, then death from tuberculosis occurs in 50% of cases. Risk lethal outcome increases in HIV-infected people, in the elderly, and in people with diabetes.

Disease prevention

The most effective prevention of tuberculosis today is vaccination. The child receives the first vaccine while still in the maternity hospital. As for adults, they are vaccinated according to indications.

Knowing how tuberculosis is transmitted, it is necessary to follow preventive measures. The main prevention of tuberculosis is the observance of sanitary standards and the annual preventive examination. In addition, a preventive measure is to increase immunity.

If a person follows simple rules prevention, the risk of infection is markedly reduced, and, consequently, the prevalence of this terrible disease in society.

Tuberculosis is very terrible disease, which can be open or closed. The first case is the most dangerous, because bacterial excretions (sputum, saliva, etc.) contain tuberculous microbes, and this is detected when bacteriological research(sowing). What is the risk of contracting tuberculosis with an open form?

Features of the open form

Bacterial secretions are characteristic of any type of disease when the lungs, lymph nodes, organs are infected. genitourinary system, gastrointestinal tract. The presence of bacteria in saliva is the most important indicator infectious danger for patients, because it comes from people who release microbes into the air.

Watch a film about the fate of one person who contracted tuberculosis.

Today, laboratory tests are underpowered, so many people infected with tuberculosis do not find mycobacteria in culture. So, officially people are considered non-infectious, but at the same time they are a serious threat to the surrounding society. That is why medicine cannot guarantee 100% protection for people who have constant contact with infected people. At the same time, there is a 30% chance that a person will develop the disease in an active form.

Symptoms of infection

Throughout the year, after you have stopped contacting the infected, you must definitely follow those that require a visit to a tuberculosis dispensary for examinations (lung fluorography). The main open forms of tuberculosis:

• Prolonged unreasonable decrease in the total mass;
• prolonged dry cough (more than 20 days);
• constant (up to 37-38 °);
• inflammation and swelling of the lymph nodes;
• general lethargy and malaise of the body;
• the appearance of pain in the sternum;

You definitely need to be examined in a tuberculosis dispensary in such situations:

• After prolonged contact with infected people;
• in the immediate environment there are people who have had tuberculosis (there is a high risk of a genetic tendency to infection);
• in case of reduced immunity;
• long-term use of hormones, cytostatic drugs;
• bad habits, chronic stress.

Tuberculosis infection

In case of contact with bacterial excretions or contaminated things, there is a high risk of infection of healthy people - this is affected by the strength of pathogens and susceptibility human organisms. According to statistics, one bacterial excretor can infect up to 10 people during the year.

How can you get infected with an open form of tuberculosis:

• Short-term contacts with patients who have abundant bacterial excretion;
• prolonged contact with infected people (joint life, work, study);
• close bodily contact with bacteria.

When infected, it can develop clinically severe illness. The average person has a 10% chance of being infected. The risk of infection is affected by the functioning of the immune system, and the likelihood increases in such conditions:

• The first 5 years after complete recovery;
• puberty in adolescents;
• re-infection;
• the presence of immunodeficiency viruses;
• concomitant infections and diseases (insulin resistance, diabetes mellitus);
• taking glucocorticoids and immunosuppressants.

Methods of infection

Tuberculous infections are the most dangerous in the case of an open form (isolation of mycobacteria by patients). Often, germs spread in families or permanent communities. The risk of spreading bacteria is greatly reduced if timely detection and isolation of patients. An important role is played by the places of penetration of microbes into organisms.

How tuberculosis is transmitted with an open form:

• Airborne spread;
• entering the digestive tract through food;
• in case of close bodily contact;
• inside the womb from mother to child.

Spread through the air

Bacteria are released into the surrounding atmosphere in the form of droplets during coughing, sneezing and talking with patients. On inspiration, microbes penetrate the lungs of a healthy interlocutor. Based on the strength of the cough and the volume of bacterial droplets, they are able to spread to different distances: during a cough - 2 meters, sneezing - 9 meters. Usually, sputum is scattered within a radius of 100 cm near the bacterioexcretor.

Drops of tuberculous bacteria settle on the ground and, drying up, turn into micro dust. At the same time, microbes are viable for about 3 weeks. In the event of strong wind gusts, dust sweeping and people moving, microparticles containing tuberculosis bacteria rise up, penetrating the lungs and infecting healthy people.

Infection in the esophagus

According to the results laboratory research, for infection in digestive tract much more mycobacteria are needed than with the airborne method. So, by inhaling contaminated air, you can become infected with one or two microbes, and by eating food - more than a hundred.

Features of the distribution of Koch's sticks in the case of the alimentary route of infection are demonstratively shown on the basis of data litigation in Lübeck, which were published in many information sources. Then, by an absurd coincidence, more than 250 infants were orally administered not BCG, but a tuberculosis culture (Kiel strains) for vaccination. Because of this infection, 70 children died, 130 babies fell ill, but were cured, and 55 were not infected. An autopsy of 20 dead babies showed that in almost all cases inflammatory processes were localized in the digestive tract.

The main feature of this method of infection is that mesenteric lymph nodes are often affected by tuberculosis. Note that tuberculosis microbes enter the gastrointestinal tract also due to the ingestion of their own secretions (with pulmonary tuberculosis), which is officially confirmed by fluid flotation after gastric lavage.

Infection due to body contact

Koch's stick in an enlarged size.

In medicine, cases of infection of people with tuberculosis through the connective membrane of the eye have been recorded. Patients often develop acute conjunctivitis or inflammation of the lacrimal sacs. situations when healthy people become infected due to close bodily contact with the skin of an infected person, are extremely rare. There have been isolated situations when people became infected with tuberculosis through contact of damaged skin of the hands with sick animals (in particular, milkmaids and cows).

intrauterine infection

In medicine, cases of infection of a child from a sick mother are officially registered. This was found out after the death of babies within 5 days after birth and autopsy of their corpses. According to doctors, infection occurs through the placenta from a sick mother or through direct contact of damaged areas of the placenta with an infected obstetrician during childbirth. This method infection is the rarest.

Precautionary measures

Many people think about the open form of tuberculosis. The answer is unambiguous: it is treated, but only in. But doctors recommend observing certain requirements in order to eliminate the risk of contracting tuberculosis, because any therapy is severe stress for the body, especially with long-term treatment.

To reduce the likelihood of infection with tuberculosis after contact with patients, it is recommended to adhere to the following requirements:

• It is necessary to exclude smoking and the use of alcohol-containing drinks;
• in daily ration nutrition, at least 150 grams of products containing animal fats (meat and dairy products, fish, eggs, etc.) must be added;
• be sure to take a sufficient amount of vitamin complexes;
• it is undesirable to replenish the diet with products of synthetic origin (chips, crackers, fast food);
• need to walk outside as much as possible, move as much as possible and stick to
• close contact with infected people should be avoided;
• it is important to regularly visit the clinic for preventive examinations (do fluorography of the lungs).

Tuberculosis is a specific infectious process the causative agent, which is a tubercle bacillus (Koch's wand). Forms of tuberculosis (types of manifestation of the disease) can be very different. The prognosis of the disease, the type of treatment, the risk to the life of the patient, and much more depend on the form of tuberculosis. At the same time, knowledge of the features various forms tuberculosis will help to better navigate the mechanisms of the development of the disease and understand the complexity of the specifics of tuberculosis as a disease.

Open and closed form of tuberculosis

It is well known that tuberculosis is infectious disease, and, as with many other infectious diseases, tuberculosis patients may or may not be contagious. Unlike other infectious diseases (for example, hepatitis B or C), for which the patient's contagiousness is maintained for almost the entire duration of the disease, in the case of tuberculosis, the patient's status (infectious / non-infectious) may vary depending on the stage of development of the disease and the effectiveness of the treatment taken. The term open tuberculosis means that the patient releases microbes that cause tuberculosis into the environment. This term is applied mainly to pulmonary tuberculosis, in which the release of microbes occurs when coughing, expectoration of sputum. Open tuberculosis is also called CD+ (or TB+), which means that when microscopic examination The patient's sputum smear revealed the bacteria that cause tuberculosis (KK - Koch's bacillus, TB - tubercle bacillus). In contrast to the CD+ form of tuberculosis, there is a CD- (or TB-) form, which means that the patient does not shed germs into the environment and is not contagious. The term " closed tuberculosis» is rarely used, its equivalents BK- (or TB -) are more often used.
Patient with closed form tuberculosis cannot infect other people.

Primary and secondary tuberculosis

It is customary to talk about primary tuberculosis in the case when the disease developed at the first contact of the patient with microbes. In the case of primary tuberculosis, the patient's body is not yet familiar with the infection. Primary tuberculosis ends with the formation of petrified foci of inflammation, in which for a long time dormant microbes remain. In some cases (for example, with a decrease in immunity), the infection can reactivate and cause a new episode of the disease. In this case, it is customary to speak of secondary tuberculosis. In the case of secondary tuberculosis, the patient's body is already familiar with the infection and therefore the disease proceeds differently than in people who have contracted tuberculosis for the first time.
Tuberculosis of the lungs can take many forms:

Primary tuberculosis complex (tuberculous pneumonia focus + lymphangitis + mediastinal lymphadenitis)
- isolated intrathoracic lymphadenitis lymph nodes.

Based on the prevalence of pulmonary tuberculosis, there are:

Disseminated pulmonary tuberculosis

Disseminated pulmonary tuberculosis is characterized by the presence of multiple specific foci in the lungs; at the onset of the disease, a predominantly exudative-necrotic reaction occurs, followed by the development of productive inflammation. Variants of disseminated tuberculosis are distinguished by pathogenesis and clinical picture. Depending on the path of spread of Mycobacterium tuberculosis, hematogenous and lymphobronchogenic disseminated tuberculosis are distinguished. Both variants can have subacute and chronic onset of the disease.
Subacute disseminated tuberculosis develops gradually, but is also characterized by severe symptoms intoxication. With hematogenous genesis of subacute disseminated tuberculosis, the same type of focal dissemination is localized in the upper and cortical parts of the lungs, with lymphogenous genesis, the foci are located in groups in the basal and lower parts of the lungs against the background of pronounced lymphangitis with involvement of both the deep and peripheral lymphatic network of the lung in the process. Against the background of foci in subacute disseminated tuberculosis, thin-walled cavities with mild perifocal inflammation can be determined. More often they are located on symmetrical areas of the lungs, these cavities are called "stamped" caverns.

Miliary tuberculosis of the lungs

Miliary tuberculosis lungs is characterized by generalized formation of foci, predominantly of a productive nature, in the lungs, liver, spleen, intestines, meninges. Less commonly, miliary tuberculosis occurs as a lesion of the lungs only. Miliary tuberculosis most often manifests itself as acute disseminated tuberculosis of hematogenous origin. By clinical course emit a typhoid variant characterized by fever and pronounced intoxication; pulmonary, in which symptoms predominate in the clinical picture of the disease respiratory failure against the background of intoxication; meningeal (meningitis, meningoencephalitis), as manifestations of generalized tuberculosis. At x-ray examination dense homogeneous dissemination is determined in the form of small foci, located more often symmetrically and visible better on radiographs and tomograms.

Focal (limited) pulmonary tuberculosis

Focal pulmonary tuberculosis is characterized by the presence of a few foci, predominantly of a productive nature, localized in a limited area of ​​​​one or both lungs and occupying 1-2 segments, and an asymptomatic clinical course. Focal forms include both recent, fresh (soft focal) processes with lesions less than 10 mm in size, and older (fibrous focal) formations with pronounced signs of process activity. Fresh focal tuberculosis is characterized by the presence of weakly contoured (soft) focal shadows with slightly blurred edges. With significantly pronounced perifocal changes that have developed along the periphery of the focus in the form of broncholobular confluent foci; should be defined as infiltrative pulmonary tuberculosis. Fibrous-focal tuberculosis is manifested by the presence of dense foci, sometimes with the inclusion of lime, fibrous changes in the form of strands and areas of hyperneumatosis. During the period of exacerbation, fresh, soft foci may also be detected. With focal tuberculosis, intoxication phenomena and "chest" symptoms, as a rule, occur in patients during an exacerbation, in the phase of infiltration or decay.
Upon detection of fibrosis focal changes by X-ray fluorography, it is necessary to conduct a thorough examination of patients to exclude the activity of the process. In the absence of pronounced signs of activity, fibro-focal changes should be regarded as cured tuberculosis.

Infiltrative pulmonary tuberculosis

Infiltrative tuberculosis lung is characterized by the presence of inflammatory changes in the lungs, predominantly exudative in nature with caseous necrosis in the center and relatively fast dynamics of the process (resorption or disintegration). Clinical manifestations infiltrative tuberculosis depend on the prevalence and severity of infiltrative-inflammatory (perifocal and caseous-necrotic) changes in the lungs. There are the following clinical and radiological variants of infiltrative pulmonary tuberculosis: lobular, round, cloudy, periocissuritis, lobit. In addition, caseous pneumonia, which is characterized by more pronounced caseous changes in the affected area, belongs to infiltrative tuberculosis. All clinical and radiological variants of infiltrative tuberculosis are characterized not only by the presence of an infiltrative shadow, often with decay, but also by bronchogenic seeding. Infiltrative pulmonary tuberculosis can proceed inaperceptively and is recognized only by X-ray examination. More often, the process clinically proceeds under a mass of other diseases (pneumonia, protracted influenza, bronchitis, catarrh of the upper respiratory tract, etc.), in most patients there is an acute and subacute onset of the disease. One of the symptoms of infiltrative tuberculosis may be hemoptysis in the general satisfactory condition of the patient).

Caseous pneumonia

Caseous pneumonia is characterized by the presence of lung tissue inflammatory response by the type of acute caseous decay. The clinical picture is characterized serious condition patient, severe symptoms of intoxication, profuse catarrhal phenomena in the lungs, a sharp left shift in leukocyte formula, leukocytosis, massive bacterial excretion. With the rapid liquefaction of caseous masses, a giant cavity or multiple small cavities are formed. Caseous pneumonia can be either an independent manifestation of the disease or as a complicated course of infiltrative, disseminated and fibrous-cavernous pulmonary tuberculosis.

Tuberculoma of the lungs

Pulmonary tuberculoma unites encapsulated caseous foci of great size more than 1 cm in diameter, diverse in genesis. There are tuberculomas of infiltrative-pneumonic type, homogeneous, layered, conglomerate and so-called "pseudotuberculomas" - filled cavities. On x-ray, tuberculomas are detected in the form of a shadow round shape with clear contours. In focus, crescent-shaped enlightenment due to decay, sometimes perifocal inflammation and a small amount of bronchogenic foci, as well as areas of calcification. Tuberculomas are single and multiple. There are small tuberculomas (up to 2 cm in diameter), medium (2-4 cm) and large (more than 4 cm in diameter). Three clinical variants of the course of tuberculoma have been identified: progressive, characterized by the appearance at some stage of the disease of disintegration, perifocal inflammation around the tuberculoma, bronchogenic seeding in the surrounding lung tissue, stable - the absence of radiological changes in the process of monitoring the patient or rare exacerbations without signs of progression of tuberculoma; regressive, characterized by a slow decrease in tuberculoma, followed by the formation of a focus or group of foci, an induction field, or a combination of these changes in its place.).

Cavernous tuberculosis of the lungs

Cavernous tuberculosis lung is characterized by the presence of a formed cavity, around which there may be a zone of small non-reef focal reactions, the absence expressed fibrotic changes in the lung tissue surrounding the cavity and the possible presence of a few focal changes both around the cavity and in the opposite lung. Cavernous tuberculosis develops in patients with infiltrative, disseminated, focal tuberculosis, with the decay of tuberculomas, with late detection of the disease, when the decay phase ends with the formation of a cavity, and the signs of the original form disappear. Radiologically, the cavity in the lung is defined as an annular shadow with thin or wider walls. Cavernous tuberculosis is characterized by the presence of an elastic, rigid, less often fibrous cavity in a patient.

Fibrous-cavernous pulmonary tuberculosis

Fibrous-cavernous pulmonary tuberculosis is characterized by the presence of a fibrous cavity, the development of fibrous changes in the lung tissue surrounding the cavity. The foci of bronchogenic screening of various prescription are characteristic both around the cavity and in the opposite lung. As a rule, the bronchi draining the cavity are affected. Other morphological changes in the lungs also develop: pneumosclerosis, emphysema, bronchiectasis. Fibrous-cavernous tuberculosis is formed from an infiltrative, tricky or disseminated process with a progressive course of the disease. The extent of changes in the lungs can be different, the process is unilateral and bilateral with the presence of one or multiple cavities.
Clinical manifestations of fibrous-cavernous tuberculosis are diverse, they are caused not only by tuberculosis itself, but also by changes in the lung tissue around the cavity, as well as by developed complications. There are three clinical variants of the course of fibrous-cavernous pulmonary tuberculosis: limited and relatively stable fibrous-cavernous tuberculosis, when, due to chemotherapy, a certain stabilization of the process occurs and an exacerbation may be absent for several years; progressive fibro-cavernous tuberculosis, characterized by a change of exacerbations and remissions, and the periods between them can be different - short and long, during the period of exacerbation new areas of inflammation appear with the formation of "daughter" cavities, sometimes the lung can collapse completely, in some patients with ineffective treatment the progressive course of the process ends with the development of caseous pneumonia; fibrous-cavernous tuberculosis with the presence of various complications- most often this option is also characterized by a progressive course. Most often, such patients develop pulmonary heart failure, amyloidosis, frequent repeated hemoptysis and pulmonary bleeding, exacerbated nonspecific infection (bacterial and fungal).

Cirrhotic tuberculosis of the lungs

Cirrhotic pulmonary tuberculosis is characterized by the growth of rough connective tissue in the lungs in the pleura as a result of involution fibrous-cavernous, chronic disseminated, massive infiltrative pulmonary tuberculosis, pleural lesions, tuberculosis of the intrathoracic lymph nodes, complicated by bronchopulmonary lesions. To cirrhotic tuberculosis should be attributed the processes in which tuberculous changes in the lungs persist with clinical signs activity of the process, a tendency to periodic exacerbations, periodically there is a meager bacterial excretion. Cirrhotic tuberculosis is segmental and lobar, limited and widespread, unilateral and bilateral, it is characterized by the development of bronchiectasis, pulmonary emphysema, symptoms of pulmonary and cardiovascular insufficiency are observed.
Cirrhotic changes, in which the presence of a fibrous cavern with bronchogonal screening and repeated long-term bacterial excretion, should be attributed to fibrous-cavernous tuberculosis. Cirrhosis of the lungs, which are post-tuberculous changes without signs of activity, should be distinguished from cirrhotic tuberculosis. In the classification, cirrhosis of the lungs is classified as residual changes after clinical cure.

Tuberculous pleurisy

Tuberculous pleurisy often accompanies pulmonary and extrapulmonary tuberculosis. It occurs mainly in the primary tuberculosis complex, tuberculosis of the intrathoracic lymph nodes, disseminated pulmonary tuberculosis. Fibrous-cavernous pulmonary tuberculosis is characterized by the presence of a fibrous cavity, the development of fibrous changes in the lung tissue surrounding the cavity. The foci of bronchogenic screening of various prescription are characteristic both around the cavity and in the opposite lung. As a rule, the bronchi draining the cavity are affected. Other morphological changes in the lungs also develop: pneumosclerosis, emphysema, bronchiectasis. Fibrous-cavernous tuberculosis is formed from an infiltrative, tricky or disseminated process with a progressive course of the disease. The extent of changes in the lungs can be different, the process is unilateral and bilateral with the presence of one or multiple cavities. Tuberculous pleurisy are serous serofibrinous, purulent, less often - hemorrhagic. The diagnosis of pleurisy is established by the combination of clinical and radiological signs, and the nature of pleurisy - with puncture pleural cavity or biopsy of the pleura. Pneumopleuritis (the presence of air and fluid in the pleural cavity) occurs with spontaneous pneumothorax or as a complication of therapeutic pneumothorax.

Tuberculosis of the pleura, accompanied by accumulation purulent exudate, represents special form exudative pleurisy- empyema. It develops with a widespread caveous lesion of the pleura, as well as as a result of perforation of the cavity or subpleural foci, may be complicated by the formation of a bronchial or thoracic fistula and take chronic course. Chronic empyema is characterized by an undulating course. Morphological changes in the pleura are manifested by cicatricial degeneration, the development of a specific granulation tissue in the thickness of the pleura that has lost its function. Empyema should be included in the diagnosis.

Whether an open form of tuberculosis is treated, and how to recognize its symptoms, we will describe below. Tuberculosis, like many respiratory diseases It is transmitted by airborne droplets, but unlike the common cold, it is very dangerous, especially if you start its treatment. The disease can be of two forms: closed and open. The latter is dangerous because, upon contact with a sick person of this form, you can easily become infected from him, his sputum already contains the tuberculosis virus. Such a patient can infect up to 15 people in a year.

What is an open form of tuberculosis?

Sometimes, if a person has not been fully treated, an open form of tuberculosis can turn into chronic form. And in the case of a complete refusal to take medication, it threatens with a fatal outcome.

Folk remedies

Human nutrition during therapy also plays an important role. For him, foods rich in vitamins and proteins are selected, a variety of vegetables, meat, fish and fruits in any form are very useful. Since the open form of tuberculosis heavily burdens the liver and provokes intoxication of the whole organism. It is very important to get out of it harmful substances, vegetables such as carrots, beets and cabbage will help with this. Taking honey on an empty stomach also removes negative substances. A mixture of melted lard and milk also helps.

Treatment of an open form of tuberculosis can take several years. Those who do not have such long time, which needs to be allocated for treatment, they can decide on drastic measures and resort to surgery. After it, the affected part of the lung is cut out, but there are times when such an intervention does not work.