Tuberculosis (TB)- causes, symptoms, diagnosis and treatment

  1. What is Tuberculosis and its cause?

Tuberculosis is a bacterial disease, mycobacterium tuberculosis named bacteria causes tuberculosis.  It is a communicating disease which means, it can spread from one person to another person. Mode of spread is droplet infection,  which means it can spread by small molecules exhale by the patient during cough or sneezing.

Mycobacterium tuberculosis is present in many persons especially in India but the disease occurs only in few persons. When latent infection converts into an active infection.  One-third of the world's population is believed to have latent TB.

Latent TB-

The bacteria remain in the body in an inactive state. They cause no symptoms and are not contagious, but they can become active.

Active TB-

The bacteria do cause symptoms and can be transmitted to others.

The Indian government has decided to eliminate TB from India till 2025.

Nikshay is a web app for tubercular patients.  All patients should be registered with this app.  Tuberculosis is now a notifiable disease.

2. What are the types of Tuberculosis?

  1. Pulmonary
  2. Lymph nodes
  3. Brain-  tubercular meningitis
  4. Abdomen-  Koch’s abdomen
  5. Renal TB
  6. Bone TB
  7. Genital organ TB.

 

3. High-risk group for TB?

  1. Persons who are immunosuppressant-  HIV patients, patients on steroid therapy,  patients on immunosuppressant drugs, post transplant patients.¸Å
  2. Diabetes mellitus
  3. Malnourished people
  4. Cancer patients.

4. What are the symptoms of Tuberculosis?

Following are the TB symptoms:-

  1. Cough-  dry or productive cough,  if the duration of cough is more than 2 weeks then tuberculosis must be ruled out.
  2. Fever-  low or high grade,  The Fever of TB  is mostly low-grade fever but it can be high grade also. It commonly raised during evening or night but it can occur throughout the day.
  3. Hemoptysis-  sometimes blood can also come with sputum.
  4. Breathlessness-  patient can have breathing difficulty sometimes.
  5. Weight loss-  acute weight loss can occur in TB infection.
  6. Loss of appetite
  7. Abdomen pain
  8. Chest pain
  9. Increased urinary frequency and burning micturition.
  10. lower abdomen pain
  11. Decreased urine output
  12. Infertility
  13. Altered mental sensorium
  14. Seizure

5. How can we make a diagnosis of Tuberculosis?

  1. CBC with ESR
  2. Sputum for AFB stain - at least two samples of sputum should be tested for AFB stain.
  3. Chest X-Ray
  4. Montaux text- skin test- small injection of PPD tuberculin, an extract of the TB bacterium, is made just below the inside forearm. The injection site should be checked after 2-3 days, and, if a hard, red bump has swollen up to a specific size, then it is likely that TB is present.
  5. Fluid examination
  6. Ultrasound 
  7. Gene x pert
  8. Bronchoscopy
  9. EBUS
  10. Thoracoscopy
  11. Cervical swab
  12. MRI

6. TB Vaccination

BCG injections are given to children to vaccinate them against tuberculosis.

7. What is the treatment of Tuberculosis?

It ( ATT )is available free of cost in government hospitals and dots center. (TB drugs)

Five drugs are first-line drugs (ATT)-  isoniazid, rifampicin, pyrazinamide,  ethambutol & streptomycin

Second-line drugs - Fluoroquinolones, Amikacin, capreomycin, Kanamycin, Ethionamide, Linezolid,

Duration of tuberculosis treatment depending on the patients' condition and the type of  TB

NOTE- Please complete the treatment without skipping the doses.  It will prevent from MDR or XDR tuberclosis.

8. How to prevent the spread of infection from patient?

  1. Take proper nutrition and high protein diet
  2. Quit smoking and alcohol
  3. Do not come in close contact with an empty stomach
  4. The patient should spit in the dustbin of the plastic bag with proper disposable facilities.  It should be disposed of after putting some antiseptic in the bag.
  5. The starting 15 days to 1 month are critical to spreading infection from one person to another.
  6. Dark and humid environment &  closed space can spread bacteria from one person to another.
  7. Immunocompromised patients.

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