Tuberculosis open form. Peculiarities of treatment in children. What kind of disease is tuberculosis

The question of whether pulmonary tuberculosis is permanently cured is still open to most people. Despite the fact that experts have learned to identify this disease in the early stages, the number of chronic TB patients still remains high. This turns disease in the eyes of most people into most dangerous disease which is almost impossible to get rid of. However, it is not. Can tuberculosis be completely cured? It all depends on the stage at which the disease was detected, as well as how effectively the treatment was carried out.

How infection occurs

Tuberculosis is an infectious disease. Its causative agent is Koch's bacillus (or). A feature of this microorganism is its extraordinary vitality in the external environment, the ability to adapt to various adverse conditions. There are cases when Koch's wand in the body goes into a "dormant" state, which reduces to almost zero the ability to cure pulmonary tuberculosis until it manifests itself.

The infection occurs by airborne droplets. Koch sticks get into the air in the process of coughing, sneezing, and even when talking with a patient suffering from an open form of tuberculosis. When air is inhaled, microorganisms enter the body of a healthy person and infect the lungs.

Can TB be transmitted in other ways?

Unfortunately yes. If you exclude full contact with the sick, this will not give a 100% guarantee that a person will not become infected with this disease. Infection can also occur through the use of some household items, as well as simply by being in the place where the patient was previously. In the external environment, Koch's wand can live for about 30 days. Unprocessed food can become a source of infection. transmitted tuberculosis infection in utero: from mother to child.

Throughout life, a person more than once encounters Koch's wand and even becomes infected with tuberculosis. But this may not lead to a disease at all and even pass without a trace. The development of the disease depends on how strong the body and its protective properties are, how aggressive the infection is and how much it has entered the human body.

How tuberculosis manifests itself

Tuberculosis is curable if it detects itself in the early stages. Often the disease is disguised as influenza, bronchitis and even allergies. The best way detection of tuberculosis is a fluorographic examination, which adults must undergo annually. For children, the diagnosis of tuberculosis is carried out tuberculin test Mantu. The sooner an infection is detected, the higher the chance of a cure.

You should carefully monitor your health and in the case of the first signs indicating a disease, immediately consult a doctor. Without timely treatment disease can develop into severe form. You should not hope that the disease will be “cured” or go away on its own.

Next general symptoms tuberculosis can be observed within 3 weeks:

1. non-falling heat(above 38°C).
2. Increased sweating.
3. chest pain and persistent cough with sputum (sometimes mixed with blood).
4. Sudden weight loss.
5. Fast fatiguability.
6. Lack of appetite.

In addition to the lungs, Koch's wand can affect other parts of the body, including bones, skin, intestines, eyes, genitourinary system, and liver.

There are two . With an open form, mycobacteria are excreted with sputum into the external environment, the patient becomes dangerous to others. In this case, there are more chances to recover. With the closed form, the patient is not dangerous, microorganisms in the sputum are not detected. In this case, assigned x-ray examination, which reveals the disease, and subsequent treatment is determined.

Whether tuberculosis is curable depends largely on how timely the patient went to the doctor.

Tuberculosis treatment

You should not hope that the infection will go away by itself, relying only on the immune forces of the body.

Anti-tuberculosis therapy is always long and complex. Even with a relatively mild course of the disease, all prescriptions of the attending physician should be strictly followed. Interruptions in treatment or its premature termination can lead to the development of resistance to a number of infections. medicines. This type of disease becomes incurable and becomes chronic.

If you have been diagnosed with tuberculosis, then at the first stage you are being treated in a hospital where you are prescribed intensive therapy, which may include taking up to 4-5 drugs for tuberculosis. In epidemiological terms, inpatient treatment (from 2 to 4 months) is important because the patient becomes safe for others.

The basic principle by which tuberculosis can be cured is the continuous use of drugs. The average number of tablets is about 10 pieces per day, this is how you can suppress the spread of microbes in the body and subsequently achieve their complete destruction.

Tuberculosis is not curable folk methods, they can be used in adjuvant therapy and strictly under the supervision of a medical specialist.

After returning from inpatient treatment a person who has had tuberculosis should follow a number of important recommendations.

For example, to carry out special therapeutic gymnastics prescribed by a doctor; as much as possible to be in fresh clean air, taking walks in parks and green areas; eat healthy food, full of vitamins and micronutrients. It is necessary to cure tuberculosis only in a complex of measures, therefore, attention should be paid to all aspects of a healthy lifestyle.

When asked whether TB is being treated or not, modern doctors respond positively, since the guarantees of recovery in this disease are very high. However, one should remember about a number of cases when the disease is neglected. It is impossible to get rid of tuberculosis without treatment, so you should be attentive to any changes in the body and consult a doctor in a timely manner.

Disease prevention

People who are most at risk of developing tuberculosis are those who suffer from alcoholism, diabetes who have HIV infection. They should especially carefully monitor their health, immediately stop communicating with those who have been diagnosed with tuberculosis infection.

Healthy people, in order to minimize the risk of tuberculosis, should follow some recommendations that are quite simple to implement.

For example, you should spend as much time as possible on fresh air get out into nature as often as possible, as well as play sports; eat only carefully processed foods, especially dairy; wash your hands often; regularly ventilate the room; undergo an annual fluorographic examination in order to early detection possible disease.

Healthy eating, no bad habits increase immunity, and significantly reduce the risk of tuberculosis.

Judging by nutrition, you absolutely do not care about immunity and your body. You are very susceptible to diseases of the lungs and other organs! It's time to love yourself and start getting better. It is urgent to adjust your diet, to minimize fatty, floury, sweet and alcohol. Eat more vegetables and fruits, dairy products. Feed the body with the intake of vitamins, drink more water (precisely purified, mineral). Harden the body and reduce the amount of stress in life.

A dangerous disease is open form tuberculosis, in which infectious agents are excreted along with sputum. The course of the disease in this case is severe, and the patient presents serious danger to others as a source of infection.

being treated open tuberculosis in stationary conditions tuberculosis dispensary.

Tuberculosis open and closed form

In medicine, tuberculosis is considered in two versions - open and closed form. In the first case, there is an active isolation of bacteria, so the open form is designated as (BK+). When bacteria are not isolated, in this case the disease corresponds to the designation (BK-). Treatment of the open form occurs exclusively in stationary conditions, and the closed form is treated on an outpatient basis.

Koch's sticks are determined when the inflammatory process is accompanied by necrotic changes. Sputum, coughed up through the bronchi, in addition to mucus, contains specific tuberculous pus and microbacteria. The closed form is characterized by the absence of destroyed areas and links with the bronchial tree.

The difference between open and closed forms of tuberculosis is determined depending on a number of factors. The volume of damage to the lung tissue, the presence or absence of destroyed areas of the lung are taken into account. Bronchial patency directly affects the results of tests that determine the presence of Koch's sticks. During blockage, the data received may be incorrect. under the microscope tuberculosis bacillus visible only if copious excretion. Modern equipment captures the presence of even single bacteria. The boundary between the concepts of open and closed tuberculosis conditional. On the different stages disease, the excretion of bacteria can be intense or stop altogether.

Closed form of tuberculosis

Often in patients with tuberculosis there is no isolation of pathogenic microbacteria. Because of this, the disease is difficult to diagnose. Patients complain of symptoms characteristic of the common cold. That's why accurate diagnosis installed only with x-ray examination including using computed tomography.

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Closed form of tuberculosis

However, even modern ways diagnostics do not always allow to establish the difference between pneumonia and tuberculous inflammation. In such cases, a two-week anti-inflammatory therapy is carried out. During this period, the patient is prescribed antibiotics with a wide range actions. At the end of the course of therapy, radiography is repeated and, subject to clearing of the lungs, the patient is discharged from medical institution. If the original inflammatory changes, Doctor Diagnoses Tuberculosis. To detect a closed form of tuberculosis in children, an additional Mantoux test is performed.

A feature of this type of disease is the absence of infection during the development pathological processes outside the lungs when other systems and organs are affected, such as the liver, kidneys, spleen, joints and spine. AT initial stage the disease is a small foci, limited to areas of inflammation. lung tissue is not yet destroyed, a person does not feel disease state and does not apply for medical assistance. For the timely detection of pathology, it is necessary to conduct an annual fluorographic examination. In this case, the treatment will not take much time and will quickly achieve a positive result.

With an open form of tuberculosis, the diagnosis is made immediately after the sputum tests and the results are obtained. Additional information gives an x-ray that reveals destroyed areas in the lungs. Knowing the symptoms of the disease, it is necessary to begin treatment as soon as possible. In this case, it is much easier to recover and achieve a full recovery.

Symptoms of an open form of tuberculosis

Tuberculosis develops gradually, passing through several stages in turn. Each one is different in intensity. infectious process and your own symptoms.

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Cough with tuberculosis

Signs of primary tuberculosis in an open form develop in those patients who have not previously had contact with the causative agent of this disease. At the site of penetration of the infection, an inflammatory reaction develops, which proceeds easily. At the site of inflammation, curdled nodules are formed - caseoses, gradually turning into fibrosis, which is a connective tissue. Further, calcification is formed in this place, visible on the radiograph during the study. chest. In the process of the development of the disease, tuberculosis mycobacteria are located at the edges of the inflammation and do not manifest themselves in any way. Reactivation of the disease occurs due to reduced immunity and a weakened body.

The development of secondary tuberculosis occurs in persons previously exposed to infection. In this case, scars and calcification are also formed. Sometimes such tuberculosis breaks into the respiratory organs, causing pneumonia and spreading along with the bloodstream to the pia mater of the brain, bones, spleen and liver. At this stage, symptoms appear that progress over a long time. Knowledge of the symptoms, together with a comprehensive examination, allows you to make the correct diagnosis in a short time.

An open form of tuberculosis how you can get infected

The main danger of infection is posed by patients with an open form of tuberculosis, actively excreting Koch's bacilli in environment. When coughing, sneezing or talking, mycobacteria are released. Their distribution in the air occurs within a radius of 2 - 6 meters. They get on the dust, and then, along with it, are deposited on the floor and furniture, maintaining viability for a long time.

Infection leads to close contact with tuberculosis patients through personal belongings, dishes and other places where sputum with tuberculosis bacilli has got. In some cases, infection occurs from sick animals. The reason is direct contact and consumption of meat and dairy products obtained from them.

An open form of tuberculosis is dangerous disease that everyone needs to know about. Most often, this disease affects the lungs, but other organs can also be affected.

it infection was one of the most common causes deaths of adults and children in the 19th century. In the 20th century, mortality has declined. Nowadays this disease is great social problem. What you need to know in order not to get infected?

The risk group includes several categories of people:

1. HIV-infected. Tuberculosis develops as a complication of the disease.
2. Doctors. When in contact with sick people, they must be extremely careful, because it is very contagious disease. When coughing and sneezing, bacteria are transmitted from person to person with small droplets of liquid, so a mask and gloves are required condition for any healthcare worker when they are providing treatment.
3. Pensioners. elderly organism prone to infections.
4. Homeless. Poor sanitation is a threat of open tuberculosis.
5. People with weakened immune systems. Patients with cancer, diabetes, as well as people suffering from alcohol and drug addiction.

What happens when you get tuberculosis?

1. primary stage. If infection has occurred, mild inflammatory response. Doctors report that incubation period open tuberculosis lasts from 60 to 90 days. The focus of infection begins to turn into a nodule called caseosis. At this stage, there is usually no bright symptoms. Then the seal grows connective tissue. It becomes fibrosis and begins to absorb calcium. On x-ray of the lungs, such seals are successfully detected.
2. Latent period. If a person plays sports and eats properly, a “sleeping” period may begin. Sometimes it lasts for months and years. An infected person can live in peace and feel great without knowing about the disease. The infection will lie dormant, waiting for the immune system to weaken.
3. Secondary period. This is open tuberculosis. The focus of infection breaks through, bacteria enter the upper Airways. Lungs weaken, pneumonia can begin. Also, the infection with the bloodstream enters the liver, bones, spleen, and even the meninges. The affected organs seem to be sown with disease-causing grains, which are called "millet". This is a miliary form of tuberculosis (in Latin "milium" - "millet"). the main task doctors - to identify bacteria in the sputum mass. This is done by staining or endoscopy.

How do people get open tuberculosis?

Everyone must know how this disease is transmitted in order to protect themselves and their children.

Infection occurs in two ways:

1. Airborne. Bacteria travel directly through saliva. It can be coughing, sneezing, kissing.
2. Contact household. Infection through objects of common use.

The causative agent of the disease is Koch's wand, which is not afraid of disinfection with acids and alkalis. This type of bacteria remains unharmed even if it falls on objects or on the surface of the earth. And if a direct carrier of the infection sneezed or coughed on you, the infection will be instant. Koch's wand enters the lungs and into the blood.

Important! It is forbidden to use cutlery of people who have been diagnosed with an open form of tuberculosis!

Bacteria from the sputum of the lungs are so dangerous that the patient is isolated for the duration of treatment. For this, specialized dispensaries are provided. With a closed form, bacteria with liquid drops are not excreted, so this type of tuberculosis is not so dangerous.

Do you know ? We have prepared information on treatment, symptoms and prevention, complete information.

Symptoms and causes of the disease, diagnostic methods.

Types of diagnostics

To detect disease in early stage in order to prevent the development of an open form, specialists carry out the following procedures:

1. Mantoux test. Tuberculin is injected under the skin. If with each dose of the drug the size of the papule increases by more than 5 cm, we can talk about suspicion of infection.
2. Diaskin test. This is the newest alternative to Mantu. This test has high accuracy, it is prescribed if the diameter of the papule after the Mantoux test is suspicious.
3. The picture shows fibrous seals.
4. Blood analysis. it additional method diagnosis before starting treatment.

Symptoms

The symptoms of tuberculosis are similar to those of various viral diseases. But there are a number of distinguishing features:

1. Persistent cough.
2. Lethargy, apathy.
3. Elevated temperature.
4. Sweating.
5. Hemoptysis.

At the first stage, the signs of the disease are not so obvious. The carrier of the infection may not know about his illness, go to work, come into contact with people, transmitting to others terrible infection. How many people can he infect before he knows he has a problem? That's why it's important to arm yourself with knowledge about TB.

Treatment

Often, upon learning of the diagnosis, people panic. They are afraid of losing friends and jobs. But in the service in such cases, a long sick leave is provided, and true friends will never turn away. Many begin to wonder how long it is possible to live with open tuberculosis.

If treatment is not carried out, patients with such a diagnosis usually live no more than six months.

Here it is important to consult a doctor in time, who will refer the patient to a tuberculosis dispensary. This is an isolated institution created to eliminate the spread of Koch's wand:

1. Sputum is allowed to spit only in special containers that are closed with a lid.
2. Paper handkerchiefs are not thrown away, but burned.
3. Plates, spoons and cups are all individual.
4. Towels and bed sheets are also intended for personal use only.
5. Rooms are frequently ventilated and disinfected.

The specialist prescribes antibiotics, the treatment lasts an average of about six months. AT severe cases the course can take up to two years. To overcome the disease, the doctor combines different drugs.

After recovery, in order to avoid relapse, patients are given recommendations:

1. To give up smoking.
2. Refusal of alcohol.
3. Regular exercise.
4. Mandatory medical examinations in a tuberculosis dispensary.

Open tuberculosis - insidious disease. But this is not a sentence. If the therapy regimen is drawn up correctly and all recommendations are clearly followed, the open form can be cured.

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 are infected, The lymph nodes, organs 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 high risk genetic predisposition 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. Work influences the risk of infection immune system, and the probability 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).