Tuberculosis is described as a bacterial, granulomatous disease of primarily the lungs and it may go on to disseminate to other parts of the body. The infective pathogen is called Mycobacterium tuberculosis.
A Pulmonologist is the only person who can come to your rescue if you have this disease going on.
HOW IT GROWS
The initial site of action of M tuberculosis is in the lungs. Initially, it shows up in the form of a primary lesion and/or a granuloma known as a Ghon focus, which is usually subpleural and often found in the upper zones of the lung. The granuloma is a highly organized structure formed by the aggregation of multinucleated giant cells, epithelioid cells, fibroblasts, and foam cells, all surrounded by a rim of lymphocytes. Granuloma keeps the infection from extending beyond the primary site.
The granulomas can assume latency. The reactivation of the infection because of the discussed risk factors leaves a cavity within the lung tissue. Lower zones are commonly affected in the secondary or reactivated TB. It is a more aggressive form hence it can seed into the circulation and settle in distant locations like the brain and spine thereby producing severe complications.
RISK FACTORS
Tuberculosis is a respiratory disease that generally spreads via aerosol. This makes overcrowding or working in facilities like nursing homes and hospitals a major risk factor for the transmission of infection. Individuals with impaired immunity such as HIV patients, diabetics, renal impairment, malignancy, and malnutrition patients are highly susceptible to contracting this disease following exposure to TB patients. Chemotherapy or immunosuppressive medications such as for those about to undergo an organ transplant also heightens the risk of tuberculosis.
CLINICAL FEATURES
Latent tuberculosis is asymptomatic. However, the active pulmonary disease may manifest:
- Chronic cough for more than three weeks
- Coughing up blood or blood-stain sputum (hemoptysis)
- Chest pain
- Fatigue
- Fever with chills and night sweats
- Reduced appetite
- Weight loss
Tuberculous meningitis presents with:
- An intermittent or persistent headache lasting more than a few weeks
- Mild neurological changes
- Fever may or may not be present
Skeletal tuberculosis, also referred to as Pott disease, most often produces:
- Spinal pain and stiffness; joints, hip, or knee may also be involved
- Paralysis of the lower half of the body
Genitourinary tuberculosis exhibits:
- Flank pain
- Lower urinary tract symptoms (LUTS) such as dysuria, frequency, and urgency
- Any site along the gastrointestinal tract can be targeted by miliary tuberculosis thus causing ulcers, dysphagia, pain, malabsorption, diarrhea, or hematochezia
TREATMENT
Tuberculosis is treated by anti-tuberculous therapy. A four-drug regimen lasting 6 to 12 months, depending on the severity of the infection, is the only therapeutic approach for an active disease. The drugs include isoniazid, rifampin, pyrazinamide, and ethambutol. If latent, the regimen includes isoniazid, rifampin, either of the two or a dual therapy for about 9 months to eliminate the dormant bacteria inside the body. In the case of resistant and multi-resistant strains, further second-line agents are incorporated into the regimen of TB.
PREVENTION
Precautions during travel and regular interaction can significantly reduce the spread of the disease. Avoid crowded areas, especially in the early phases of therapy, and always cover your mouth when you cough or sneeze. Additionally, it is crucial to receive a TB vaccination early on in life (the BCG vaccine), particularly in infancy when the disease is prevalent or endemic.
Dr. Syed Azfer Hussain is one of the acknowledged pulmonologists for the treatment of respiratory conditions and lungs. Book an appointment at your earliest online for further investigation through our website.
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