Tuberculosis (TB) – Symptoms, treatment, prevention,causes

Tuberculosis is a contagious disease that is caused by bacteria and it affects the lungs. It is also called TB or consumption disease.

tuberculosis - symptoms, treatment and causes

Recent statistics from the World Health Organisation (WHO) has rated Tuberculosis among the top ten leading causes of death in the world.

This disease is caused by a type of bacteria called Mycobacterium tuberculosis which is spread from one person to another.

If this disease is not checked earlier, it can spread to the brain and spine.

Consumption disease or tuberculosis can be treated, cured and even prevented but if proper care is not taken then deaths might occur. Statistics have put TB deaths can possibly occur in about a third of the people who fell ill if not properly cared for in terms of medication and application of other proper therapies.

Types of Tuberculosis

There are different types of tuberculosis and the most common of them are;

Pulmonary Tuberculosis

Pulmonary tuberculosis is in different types such as;

  • Pulmonary Tuberculosis Pneumonia – This type of tuberculosis presents itself in the form of Pneumonia and it is very infectious. It is common in young children, elderly, and people with a suppressed immune system. The victims commonly experience a high fever and cough.
  • Laryngeal TB – This affects the larynx and vocal cords and is also very infectious. Its most common symptom is hoarseness.
  • Cavitary TB – This type of TB affects the highly oxygenated upper lobes of the lungs. Mycobacterium tuberculosis progressively destroys the lungs forming cavities and enlarging the air sacs. Its common symptoms are; fever, weight loss, coughing blood and sweating at night
  • Miliary Tuberculosis – This type of TB usually occurs after an infection or due to HIV infection which suppresses the immune system. It can also occur due to the constant use of immunosuppressive drugs. It is usually diagnosed using a chest x-ray which shows small nodules throughout the lungs which resemble millet seeds. Its common symptoms are; fever, weight loss, and sweating at night.
  • TB Pleurisy – This occurs due to the inflammation of the pleural membrane due to the infection of lungs by Mycobacterium tuberculosis. Its common symptoms are; shortness of breath and chest pain.

Extra-pulmonary Tuberculosis

This type of tuberculosis occurs in a different part of the body other than the lungs. It is common in immunosuppressed people and children.

Its different types are;

  • Lymph node TB – This occurs in the lymph nodes after the bacteria gets trapped and it replicates. It is very common in children and women. It is said to contribute 20% – 40% of extrapulmonary TB.
  • Pericardial TB – This is caused by the infection of the pericardium which causes the space between the pericardium and the heart to fill with fluid. It is a very serious form of extrapulmonary TB as it can cause cardiovascular infection and eventual death during treatment.
  • Skeletal TB – This type of tuberculosis affects the bones and joints. It commonly affects the spine causing fractures and deformity of the back.
  • Genitourinary TB – This is the second most common of TB and it results from the reactivation of old and dormant Mycobacterium tuberculosis pathogens. It affects the urinary tract and genitals. It can show symptoms like; dysuria, flank pain, and a painful scrotal mass.
  • Gastrointestinal TB – This type of TB is ranked as the sixth most common but its cases are rare in the United States. It is caused when Mycobacterium tuberculosis affects the abdominal lymphatics, peritoneum, hollow and solid abdominal organs.
  • Tuberculosis Meningitis – This is caused by infection of the membrane between the brain and the spinal cord. It is a very fatal type of TB. It can cause headaches, coma, and stroke.
  • Renal Tuberculosis – This causes white blood cells to be present in urine and it can also spread to the reproductive system and cause sterility.

Primary TB

This is a first-time infection on a person who has never been infected with TB or has never been immunized. It is also called Ghon’s complex or Childhood TB.

Secondary TB

This is a recurrent infection on a person who has been affected in the past and treated or even immunized. It is also called Post-primary infection, re-infection or chronic TB.

Active TB

This type of TB spreads all over the body and is highly contagious.

Latent TB

This type of TB does not spread throughout the body and is not contagious. The person has the bacteria but the immune system fights it and it is stopped from spreading.

Stages of TB infection

Tuberculosis occurs in four major stages;

  • Early infection – This is the initial stage of infection. At this stage, the immune system is trying to fight back the infection. No prominent symptoms can be witnessed here except cough and dyspnea.
  • Early primary progressive (Active) – This stage occurs after the immune system fails to control the infection at the initial stage. Tissue inflammation occurs and victims can have a fever, weight loss, fatigue, and non-productive cough. Diagnosis at this stage is very difficult.
  • Late primary progressive (Active) – At this stage of TB, the cough becomes productive and more symptoms such as anemia and rales appear. Diagnosis at this stage involves sputum culture.
  • Latent stage – At this stage Mycobacterium tuberculosis persists in the body and symptoms can be witnessed but the victims are highly volatile to reactivation of the disease.

Causes of Tuberculosis

Tuberculosis is caused by Mycobacterium tuberculosis. This type of bacteria is usually spread from one person to another through active forms such as coughing, laughing, sneezing, spitting, and speaking. If an infected person does any of that when they are near you, there is a higher probability that you will get infected.

Most people get tuberculosis at home from infected relatives. There is also a higher chance of getting TB if you are with an infected person in a crowded place or enclosed place.

There are several risk factors that can increase the probability of getting TB. They include;

  • Living with family members who have active TB infection
  • Having a suppressed immune system due to co constant use of immunosuppressants
  • Having a chronic disease such as diabetes
  • Substance abuse, for example, alcohol
  • Poor dieting

Symptoms of TB

Most people never show symptoms when infected with TB except a cough only which might be blood-tinged.

When the signs and symptoms show up, they can include;

  • Chest pain
  • Chronic cough or blood-tinged cough
  • Chills
  • Fatigue
  • Malaise
  • Loss of appetite
  • Fever
  • Sweating at night
  • Reduction in muscle mass
  • Phlegm
  • Swollen lymph nodes
  • Shortness of breath
  • Weight loss

The presence of any of those conditions can indicate you are ill so see your doctor right away to get diagnosed and treated.

Prevention

To prevent TB infection, you can do any of the following;

  • Cover your mouth with handkerchief or tissue when you sneeze or cough
  • Wash hands with soap and water after coughing or sneezing
  • Ventilate your house properly for good air circulation
  • Take all medications as prescribed by the doctor
  • Don’t stay in the same room with a person who is infected
  • Advice people who are infected to start medication immediately
  • Be cautious with public places. You can avoid them completely
  • Keep all medical appointments

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Diagnosis of Tuberculosis

Methods that can be used for the diagnosis of tuberculosis are;

  • Medical history –   A doctor will examine the possibility of the patient having any other disease such as HIV or anemia. They will also examine if the patient has been ill or hospitalized before coming for diagnosis.
  • Physical examination – The patient will be asked for any signs and symptoms that they have witnessed. The doctor can also just observe on his own for the symptoms that the patient might be having. This will help set a base for the next diagnostic step.
  • Mantoux tuberculin skin test (TST) – In this test, the doctor injects a small amount of fluid called tuberculin in the lower part of the arm into the skin. A trained medical professional will then read the test after 48 – 72 hours.
  • TB Blood test – This test is used to measure your immune system strength and its reaction to Mycobacterium tuberculosis. If the test is positive, it means you are infected with TB
  • Chest Radiograph – This test is used to detect possible chest abnormalities such as lesions which can appear in different shapes, sizes, and density. This will help in showing the possibility of TB infection.
  • Acid-first-bacilli test – Sputum smear or other specimens are checked for the presence of acid-first-bacilli. If it is present then the person has TB but is not a perfect diagnostic test as some acid-first-bacilli are not Mycobacterium tuberculosis
  • Sputum culture – This is usually carried out after the acid-first-bacilli test to confirm the results. A positive culture test will show the person has tuberculosis.
  • Drug resistance – All patients are treated for the possibility of the resistance of Mycobacterium tuberculosis. This will help in administering appropriate medication for the elimination of the bacteria.

Treatment

Treatment of Tuberculosis usually involves the use of drugs. There are drugs that have been approved by the US Food and Drug Administration (FDA). The drugs include;

  • Isoniazid
  • Rifampin
  • Ethambutol
  • Pyrazinamide

Treatment of drug-resistant TB should be treated under close management and consultation by an expert as it can have life-threatening effects.

Side effects of medication

There are few but uncommon side effects of TB medication. They include;

  • Fever that lasts for 3 or more days
  • Jaundice
  • Dark urine
  • Appetite loss
  • Possible nausea or vomiting
  • Skin rash
  • Numbness of hands and feet
  • Lower abdominal pain
  • Fatigue
  • Dizziness

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