Is it possible to catch an open form of tuberculosis. Is the closed form of tuberculosis contagious and how is it transmitted from person to person. Importance of climate for patients

What is an open form of tuberculosis, how is it transmitted? This question worries many people, because, despite the progress in the field of medicine, the number of people with this terrible disease is growing every year. But it pleases, at least that the percentage of deaths from this disease has decreased compared to previous years. Unfortunately, no one is immune from open pulmonary tuberculosis, such a formidable and intractable disease. Many famous people have died from this disease. Therefore, we will try to figure out how the disease occurs and how it is transmitted, consider the stages of the disease and methods of treatment. Because forewarned is forearmed!

The whole danger is that tuberculosis in an open form can be transmitted through contact with a sick person in just a few minutes. This happens when talking, coughing by airborne droplets. The form of open tuberculosis is very dangerous. Painful microbes in the patient's sputum easily enter the airspace when coughing. Therefore, people who fall ill with this form should be strictly in hospitals! As long as their sputum contains harmful bacteria.

It is dangerous that pathogenic microbes retain their existence for a very long time. They can even live dry. For example, if a patient spit sputum on the ground, the microbes of this terrible disease remain in it for a very long time. And people can get infected just by stepping on it or picking up something from the ground.

In addition, these bacteria are not affected by chemical treatment. They survive even after applying alkali to the surface. Therefore, they are difficult to kill, for example, with ordinary bleach.

Open pulmonary tuberculosis is characterized by the appearance on the surface of the lungs of small bubbles, cavities. As a result, a person begins to spit up blood. It is necessary to know the main signs of an open form of tuberculosis.

The sick person has the following symptoms:

1. Suffocating pulmonary cough, worse at night. In this case, hemoptysis is often observed.
2. A very large volume of sputum, reaching up to 100 ml.
3. Sweats at night.
4. Body temperature above 38.
5. Lack of appetite.
6. Rapid weight loss.
7. Pain in the chest.
8. Severe weakness, fatigue.

Possible variants of infection

Now let's try to figure out how this disease is transmitted. An open form of tuberculosis is an aggressive form of the disease, when pathogenic microbes contained in sputum that enter the air can harm other creatures. They can land on various objects. Therefore, the air in the room is contagious, as well as all the objects located there! You can also get infected through dishes in public catering establishments. Places with a large crowd of people (this can be: cafes, transport, train stations, etc.) pose a great danger in terms of infection. Through cuts, wounds, infection can also pass and tuberculosis can develop.

One long but close contact with a sick person can be more dangerous in terms of infection than many short ones. It is clear that kissing, sexual contact with a sick person is the most dangerous way of infection for a healthy person. Therefore, it is extremely important to avoid casual connections.

In order to prevent infection, the entrances to the phthisiatrician are usually located separately, or these doctors receive them in special remote dispensaries.

If the sputum does not already contain germs of the disease, then this is a closed form of tuberculosis. It is considered non-infectious.

Sometimes the source of infection can be ordinary livestock. An infected animal can infect humans.

The main stages of the disease

A person infected with the bacteria of this disease can live for many years without even knowing that this infection has settled in his body. Having accidentally met with a patient with tuberculosis or picked up bacteria by touching the objects on which they were located, a person at first does not experience anything. The infection lives in it, the immune system is working to suppress the bacteria, and the disease has not manifested itself. This may be the case for several years.

Then the manifestation of tuberculosis intoxication may begin.

A person may suddenly feel:

• fever
• weakness;
• lethargy.

It may have a slightly elevated temperature. But this is not yet a disease, but an allergic reaction to a virus.

Further, primary tuberculosis develops. Inflammation appears at the site of entry of bacteria in the lungs. Then it is covered with fibrous tissue. It absorbs calcium from the body and gradually hardens. Nodules form. On x-ray, such a change will already be noticeable. This is not yet an open form of tuberculosis. Koch's bacteria already live in the human body, but this is still little manifested.

Secondary tuberculosis begins when the immune system fails. This could be for many reasons. Perhaps the person caught a cold, or took some drugs that reduce immunity (for example, antibiotics). Or another infection has entered the human body. In this case, the disease develops rapidly, takes an open form.

Sometimes this stage manifests itself in a small temperature, lethargy. Therefore, sometimes this condition is mistaken for a cold.

But more often the temperature rises to high numbers, choking cough, excessive sweating.

In this case, it is necessary to conduct a sputum examination for tuberculosis bacteria as soon as possible. If for some reason this procedure cannot be done, such an examination method as bronchoscopy will help.

Prevention and treatment methods

An open form of tuberculosis is treated exclusively in a hospital setting, since it is the most contagious to others and is severe. Treatment is usually antibiotic. In complex therapy, other various drugs are also prescribed, which are selected individually. Usually therapy lasts about six months. Many are interested in the question: how long do people with this disease live? The answer is comforting. With proper diagnosis and effective treatment, symptoms can disappear for a long time.

The main thing is to do the following:

• comply with all doctor's prescriptions;
• after a course of treatment, lead a correct lifestyle without bad habits;
• increase immunity and undergo regular examinations on time.

Patients with a closed form can be treated at home, but often visit a doctor.

Prevention includes: a healthy lifestyle, the obligatory presence of fresh air, the avoidance of bad habits, a sufficient amount of sunlight. It is important to work on strengthening the immune system. It can be in various ways. From taking multivitamins to daily hardening. It is very useful to carry out frequent wet cleaning of the room. Be sure to eat well. Sometimes the right diet helps the fastest recovery of already sick people. It is advisable to use individual utensils and avoid coughing people. It is also useful to be examined more often, to make diagnostics. Every year it is necessary to undergo a fluorography. This will help to notice the beginning changes in the lungs. Diaskintest can be carried out once a year. It is freely sold in pharmacies.

If a tuberculosis patient lives in your house, you should visit a phthisiatrician. He will probably prescribe prophylactic drugs. It is necessary to regularly clean the premises with the help of special solutions. You can call specialists from the sanitary and epidemiological station to your home.

Even if the infection has already occurred, a visit to the doctor will help take the necessary measures for recovery.

Tuberculosis is a specific infectious process that is caused by a tubercle bacillus (Koch's bacillus). 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 characteristics of various forms of 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

As you know, tuberculosis is an 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 the disease development 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 BK+ (or TB+) - this means that microscopic examination of a 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, more often its equivalents are used BK- (or TB -).
A patient with a closed form of 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 “dormant” microbes remain for a long time. 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 lymphadenitis of intrathoracic 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 of 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 severe lymphangitis with involvement in the process of both deep and peripheral lymphatic network of the lung. 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 pulmonary tuberculosis is characterized by generalized formation of foci, predominantly of a productive nature, in the lungs, liver, spleen, intestines, and 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. According to the clinical course, a typhoid variant is distinguished, characterized by fever and pronounced intoxication; pulmonary, in which the clinical picture of the disease is dominated by symptoms of respiratory failure against the background of intoxication; meningeal (meningitis, meningoencephalitis), as manifestations of generalized tuberculosis. An x-ray examination is determined by a dense homogeneous dissemination in the form of small foci, located more often symmetrically and better visible 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.
When detecting fibro-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 pulmonary tuberculosis is characterized by the presence of inflammatory changes in the lungs, predominantly of an exudative nature with caseous necrosis in the center and relatively fast dynamics of the process (resorption or decay). Clinical manifestations of 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 an inflammatory reaction in the lung tissue by the type of acute caseous decay. The clinical picture is characterized by a serious condition of the patient, severe symptoms of intoxication, abundant catarrhal phenomena in the lungs, a sharp left shift in the leukocyte count, leukocytosis, and 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 radiographs, tuberculomas are detected as a rounded shadow with clear contours. In focus, crescent-shaped enlightenment due to decay, sometimes perifocal inflammation and a small number of bronchogenic foci, as well as areas of calcification, can be determined. 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). 3 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 pulmonary tuberculosis is characterized by the presence of a formed cavity, around which there may be a zone of a small non-refocal reaction - the absence of pronounced fibrous 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 variant is also characterized by a progressive course. Most often, such patients develop pulmonary heart failure, amyloidosis, frequent repeated hemoptysis and pulmonary bleeding, nonspecific infection (bacterial and fungal) is aggravated.

Cirrhotic tuberculosis of the lungs

Cirrhotic pulmonary tuberculosis is characterized by the growth of coarse connective tissue in the lungs in the pleura as a result of involution of fibrous-cavernous, chronic disseminated, massive infiltrative pulmonary tuberculosis, pleural lesions, tuberculosis of the intrathoracic lymph nodes, complicated by bronchopulmonary lesions. Cirrhotic tuberculosis should include processes in which tuberculous changes in the lungs persist with clinical signs of process activity, a tendency to periodic exacerbations, and 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 cavity with bronchogonal screening and repeated prolonged 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 a combination of clinical and radiological signs, and the nature of pleurisy is determined by puncture of the 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 the accumulation of purulent exudate, is a special form of 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 a chronic course. Chronic empyema is characterized by an undulating course. Morphological changes in the pleura are manifested by cicatricial degeneration, the development of specific granulation tissue in the thickness of the pleura that has lost its function. Empyema should be included in the diagnosis.

The lack of scheduled medical examinations, the open migration of people from countries with poor health conditions, and the illiteracy of the population have led to the fact that in the twenty-first century there is still a high risk of contracting an open form of tuberculosis, since this disease is transmitted in several ways.

On the way to work, at school or in the store, you can meet a person with an open, active form of the disease, who spreads mycobacteria around him without even knowing it.

The paradox of the situation is that the open form of tuberculosis has been thoroughly studied, but neither available rapid tests nor new effective drugs for the disease have been invented. Therapy is carried out with drugs that were treated twenty years ago. Even in prosperous countries, mortality from tuberculosis is high.

In contact with

What is an open form of tuberculosis?

There is an open and a closed form of the disease. Most often, the open form is transmitted: a person becomes a distributor of bacilli by coughing or in any other way. This happens due to the rupture of the capsule, which protects the mycobacterium from attacks by the immune system. The opening of the capsule leads to the penetration of Koch's bacillus into the blood, through which it spreads throughout the body and is transmitted to others.

The favorite localization of mycobacteria is the lung tissue, so the disease most often affects the lungs. But in the case of a generalized form of tuberculosis, any organ can become infected, including the brain.

Upon penetration into tissues, cell destruction begins, with the formation of deep cavities. The area of ​​tissue decay depends on the duration of the course of the disease and the timeliness of treatment. Without timely therapy, a patient with an open, active form of tuberculosis dies.

The main signs of an open form of tuberculosis

The open form in its active stage has symptoms indicating the presence of an infection in the body:

• Cough, especially severe during exertion, at night, may be accompanied by the release of blood from the lungs, while the maximum number of bacteria is transmitted to others;
• copious sputum, the amount of which can reach one hundred milliliters per day;
• night sweats;
• severe weakness, apathy, decreased vitality;
• weight loss without following any diet, a person loses a lot of weight in a short time.

Ways of transmission of infection

The main route by which an open form of tuberculosis is transmitted is airborne. At the same time, it is not necessary to closely communicate with the sick person, since the particles of saliva that fly out when coughing contain thousands of mycobacteria. Koch's wand is very resistant to damage, survives well in the external environment and is transmitted through the air.

In order to become infected, you just need to inhale air with dust particles on which bacteria have settled, or use the dishes from which the patient ate. Street cafes, train stations, public transport are places potentially dangerous in terms of infection with tuberculosis, it is there that the infection is transmitted.

Contact with the sick: what is the risk of infection?

The patient may not know that he is progressing until hemoptysis (open form) begins. The symptomatology of tuberculosis often resembles the usual or. During this period of time, he actively spreads mycobacteria around him, (they are transmitted by all means) with which others are infected. There is a certain risk of infection, the degree of which in contact with the patient depends on:

• The duration of communication with a carrier of an open type disease. A casual one-time meeting is less dangerous than regular, albeit short-term contacts;
• communication density. Living in the same area with the patient will certainly lead to infection, because the bacterium is transmitted in several ways, while working together is less dangerous in terms of infection;

A single kiss or sexual contact is more dangerous than fleeting, albeit regular meetings.

• health status. A strong immune system can protect against an attack by Koch's wand and will not work, even if contact with the patient was close and prolonged.

Prevention measures: how not to get sick

If it turns out that someone in the environment or in the family suffers from tuberculosis, which is transmitted rapidly, preventive measures should be taken to protect themselves from the disease:

• Be sure to consult a phthisiatrician. The doctor will prescribe the necessary examination and preventive course of medications;
• within six months it is necessary to organize enhanced nutrition, with a predominance of natural protein foods and animal fats. In the past, it was high-quality nutrition that helped cure consumptive patients .;

Fresh air and lack of stress is a prerequisite in the fight against tuberculosis of any form. It is necessary to provide the immune system with all the conditions for a full-fledged fight against mycobacteria.

• it is advisable to lead a healthy, planned, measured lifestyle, exclude alcohol intake for the entire period of prevention, quit smoking. According to statistics, smoking is especially dangerous for those infected with mycobacteria, as it has an extremely negative effect on the condition of the respiratory tract, aggravating the patient's condition;
• the room should be treated with special solutions. Primarily, this is done by employees of the sanitary and epidemiological station. The next few months require daily wet cleaning, ventilation of the house and textiles.

Tuberculosis is one of the most dangerous infectious diseases and currently has, in addition to medical, an acute social character. According to WHO, in Russia, 80 people for every 100 thousand of the population suffer from this disease.

The danger of pulmonary tuberculosis is that in an open form it is transmitted even with short-term contact. People do not always advertise the disease, and sometimes they are not aware of it. And, although the disease has been thoroughly studied, effective measures have been developed to combat it, mortality from tuberculosis continues to remain at a high level. Therefore, everyone needs to know what tuberculosis is, how the open form of the disease is transmitted, how it differs from the closed form, and how the symptoms manifest.

The open and closed forms of tuberculosis differ in that in the first case, a person infected with Koch's bacillus is an active carrier of infection, spreading mycobacteria around him, which are easily transmitted into the body of a person in contact with a sick person. In a closed form, a TB patient is not contagious, and the risk of catching an infection from him is minimal.

Koch's wand is highly resistant to environmental factors, remains viable for a long time on various surfaces, and is difficult to destroy with disinfectants. Patients with tuberculosis should be isolated while the disease is in an open form. The problem is that antisocial elements of society often do not seek medical help, spreading the disease. If such cases are detected, carriers should be subjected to compulsory quarantine.

What is the risk of infection through contact with a patient

People sometimes do not suspect that they have tuberculosis. According to the clinical picture, the open form of the disease may resemble prolonged bronchitis and other infections of the upper respiratory tract. Only when blood appears in the sputum, there is a reason to be examined for tuberculosis.

The risk of infection depends on several factors. First of all, the state of the immune system plays a role: if it is in order, then immune cells will easily beat off the attack of pathogenic microorganisms. Both the duration and density of contact with the carrier of the disease are important, living in the same territory with those infected with tuberculosis, sharing dishes, bathrooms, towels greatly increases the possibility of infection.

Koch's wand in the patient's sputum

With a single meeting with a patient, the risk is small, but regular, albeit short-term contacts increase it. Close contact (kissing, hugging, sexual relations) almost completely leads to infection.

Symptoms

The incubation period for tuberculosis is two to three months. Symptoms are in many ways similar to other infectious diseases, but there are some features. The most preferred for mycobacteria is lung tissue. Penetrating into the tissues of the lungs and other human organs, pathogenic microorganisms destroy the cellular structure, forming cavities.

Symptoms of an open form:

• elevated temperature;
• severe hacking cough with copious sputum;
• the presence of blood in the sputum;
• severe pain in the sternum;
• shortness of breath, difficulty breathing;
• general lethargy, decreased tone;
• profuse night sweats;
• sudden weight loss due to loss of appetite.

Symptoms of tuberculosis are diverse and largely non-specific. An accurate diagnosis can only be made after laboratory tests.

Stages of the disease

There are three stages of the disease.

1. The latent stage in the open form does not appear.
2. Primary is diagnosed in patients who do not have a history of tuberculosis. This phase can proceed in the absence of pronounced manifestations or with symptoms characteristic of inflammatory processes in the lungs. If the primary stage poses a danger to those in contact with the carrier, then the secondary one in an open form is dangerous both for others and for the infected person himself.
3. Secondary tuberculosis develops as a result of re-infection against the background of a weakened immune system. This stage is characterized by intensive progression and penetration of pathogenic bacteria into other organs and tissues.

Diagnostics

The phthisiatrician collects and analyzes data for anamnesis, finding out possible ways of contracting tuberculosis. An accurate diagnosis is possible only after a series of studies. One hundred percent confidence can be obtained by conducting bacteriological studies of sputum and the isolation of mycobacteria in it. If Koch's bacillus did not appear in the sputum and washing water from the bronchi, then we can conclude that the test is negative. Diagnostic methods also include fluorography, biopsy of bronchial and lung tissue, and endoscopic examinations.

Treatment

Treatment of an open form of tuberculosis is carried out exclusively in a hospital, in special medical institutions. This is due to the fact that with an open form of the disease, isolation of tuberculosis patients is necessary in order to prevent the spread of infection. If you understand that you have shown the first signs of the disease, you should immediately seek medical help and undergo an examination.

With an open form of tuberculosis, drug treatment is prescribed, aimed at the destruction of Koch's sticks.

The drugs are prescribed by the attending physician, selecting them individually for each case.

Tuberculosis treatment is a lengthy process, taking, at best, six months. In the event of complications, ineffectiveness of the selected therapy, the development of a secondary form of the disease, therapy can continue for an even longer time. For treatment, rather heavy preparations containing chemicals that suppress the vital activity of mycobacteria are used. Therapy is carried out on the basis of a complex of such drugs, an open form of tuberculosis involves a combination of 4 or more drugs.

In addition to anti-tuberculosis drugs, immunomodulators and means for symptomatic treatment are prescribed. During therapy, the patient is shown compliance with the daily regimen, good nutrition and intake of vitamin-mineral complexes. It is required to give up bad habits: smoking, drinking alcohol. You can live with tuberculosis for a long time if you strictly follow the doctor's recommendations.

Preventive measures

Specific prevention consists in timely vaccination. Vaccination against tuberculosis () is included in the mandatory schedule throughout the Russian Federation. In order to timely detect tuberculosis, it is necessary to undergo an annual fluorography.

Prevention of tuberculosis includes: maintaining a healthy lifestyle, good nutrition and maintaining normal immune properties of the body. If someone in your environment has been diagnosed with tuberculosis, observation by a phthisiatrician is indicated. The duration of observation depends on the density and duration of contact. SES workers once carry out the treatment of the place of residence of the infected, after which it is necessary to regularly carry out wet cleaning with the use of disinfectants, airing the rooms.

Tuberculosis is one of the most common infections in the world today. The causative agent of this pathology is. Its danger lies in the fact that you can get infected by airborne droplets, that is, during normal contact with a person. A sick person is especially dangerous for others if the pathology proceeds in an open form, since a large number of mycobacteria are released along with his sputum. An open form of tuberculosis is especially dangerous for people with low immunity.

The concept of open tuberculosis

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

Treatment of patients with an open form of tuberculosis takes place strictly in, since bacteria spread easily when a person coughs.

The main danger of open tuberculosis

The main feature and danger lies in the fact that with an open form of mycobacteria, they are constantly isolated and, accordingly, other people are constantly being infected. The incubation period of tuberculosis lasts 2-3 months. Only after this time, the first symptoms of an open form of the disease begin to appear.

Why is the incubation period longer?

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

Open tuberculosis primary and secondary

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

• primary;
• secondary.

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

Symptoms of open tuberculosis

Symptoms of open and closed forms of the disease are significantly different.

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

There is always a manifestation of a dry type of cough, then it changes to wet. Such a cough lasts for a person for 3 weeks or more. It is a wet cough that is most dangerous, since it produces sputum, which contains mycobacteria.
Gradually, over time, a person may notice blood impurities in the sputum, which is already an alarming symptom. In addition, there are other general signs of an open form of tuberculosis, for example, rapid weight loss, appetite disorders, decreased performance and general weakness.

In addition, the open form is characterized by a regular increase, especially in the evenings.
If a person progresses secondary open tuberculosis, then high body temperature is recorded - up to 39 degrees. Also frequent symptoms of an open form of tuberculosis are increased sweating at night, there are also:

• pain in the joints;
• pallor of the skin;
• the cough is active in the morning and at night.

Tubintoxication

It is manifested by general malaise, lethargy, a moderate rise in body temperature and soreness in the joints. If there is Koch's wand in the human body, then intoxication will appear after stress or due to other factors that weaken the immune system. Tuberculosis intoxication occurs as an allergic reaction to the pathogen.

In the course of the development of the disease, disorders of other organs and systems appear. The most common lesion is the gastrointestinal tract.

Infection

Mycobacteria, getting into the air, settle on various objects and surfaces, can retain their viability for a very long time in adverse conditions, and after that they are able to re-enter the body and develop pathologically, therefore the open form of tuberculosis is very aggressive.

From person to person

It's no secret that open tuberculosis is most often transmitted directly through person-to-person contact. It can be concluded that if a person with an open form of pathology has been indoors for a long time, then the air and objects located there are infected and dangerous to others.

Infection can occur through utensils, for example, in catering establishments. Also, bacteria can be found in places where there is a constant flow of people - public transport, train stations, shopping centers, hospitals and clinics, etc.

Another way of infection is skin damage: cuts and wounds, through which bacteria enter the body.

From animal to human

Very rarely, human infection occurs from cattle. How is tuberculosis transmitted in this case? Through milk. Such infection can manifest itself for a person in both open and closed forms of the disease, while the incubation period of tuberculosis will be shorter.

Doctors note that it is highly likely that you can become infected after prolonged close contact with the patient, and if the meetings are regular, but not long, then this is not so dangerous.

More susceptible to infection

• people with autoimmune diseases (for example, HIV infection);
• the elderly and children;
• patients with reduced immunity;
• population living in poor social and living conditions;
• patients who regularly take hormonal therapy;
• people with peptic ulcer.

There is also a risk of infection for healthcare workers who are in constant contact with infected patients, especially TB doctors.

Diagnostics

Symptoms of an open form of tuberculosis are not only pronounced clinically, but also have laboratory and radiological signs.

Traditional Methods

The main method of diagnosis is x-ray. This is a fast and affordable study. In this case, the focus will be visible, which is darkened in the picture, there will still be caverns of different sizes and an increase in the pattern of the lung tissue.
Studies conducted directly on humans include the Mantoux test, in which tuberculin is injected subcutaneously. If the papule after injection increases by 0.5 cm, then this means that infection has occurred. However, this is true provided that a year ago the Mantoux test showed a negative result.

Important! Today it has been proven that such a study often gives false results.

Modern methods of diagnosing tuberculosis

A modern method would be a sputum or blood test. This method is much more accurate.
Sometimes a patient is prescribed computed tomography to accurately confirm the diagnosis.
TB doctors recommend seeking medical help if a person has been in contact with a patient for a long time. Also, those whose close relatives are infected should be regularly examined, this is also due to a genetic predisposition. A person should be examined if his immunity is reduced due to various diseases. You should immediately consult a doctor if a child or teenager has come into contact with a sick person.

Treatment of open tuberculosis

An open form of tuberculosis is a dangerous disease, so treatment must necessarily take place in a hospital. Tuberculosis is treated, but individual therapy is selected for each patient. It is always included. Typically, antibiotic therapy includes 4 components. This is important, as Koch's bacillus often shows resistance to drugs. Treatment continues for 3-6 months.
After properly selected treatment, the disease passes into a closed form, and the person is no longer contagious.

How to prolong remission

In order for the remission to continue, you must carefully follow the doctor's instructions and take drugs that are selected and combined only by a doctor. Additionally, you need to regularly take tests, monitoring your condition.
In addition, the patient needs maintenance therapy, since long-term use of antibiotics negatively affects the body. And after the main therapy, the patient recovers for a long time. In the treatment of adults with an open form of tuberculosis, sorbents are prescribed that help increase the body's resistance and other drugs. It is necessary to use anti-inflammatory drugs, and if adults already see the first signs of the disease with complex therapy.
Be sure to take multivitamins. This is important, both for those who have been treated for open tuberculosis, and for other people for prevention.

Prognosis for open tuberculosis

With tuberculosis in an open form, doctors give positive prognosis, but only if the diagnosis is made on time and the correct therapy is prescribed. People with this form of the disease live long if they lead the right lifestyle, eat right. Be sure to take your prescribed medication regularly. Mortality among tuberculosis patients is due precisely to non-compliance with these conditions.
Statistics show that if tuberculosis is not treated, then a person will live no more than 5-6 years.