Tuberculosis (TB)

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Overview

Tuberculosis is a highly infectious, and transmissible disease, most commonly in the lung, but can occur in other organs as well. The bacteria Mycobacterium tuberculosis causes it. It is found much more commonly in undeveloped countries. In patients with HIV, the incidence of TB is higher, as a lowered immune response, makes a patient unable to fight the infection.

Causes

The bacterium, Mycobacterium tuberculosis causes it. The bacteria is spread via person to person by air borne transmission. This means that if a person with TB coughs, sneezes, talks, laughs, or spits, microscopic droplets of water, carrying the bacteria, enter the air. When this air is drawn in by a healthy person, that person can also get infected.

It’s easier to get the infection from someone you live with, so precautions must be taken.

Symptoms

TB has 2 forms, a latent form, that is the inactive form of the disease, which does not have any symptoms (but the patient still can develop symptoms at a later stage when the disease becomes active), and, an active form, that manifests with some of the following symptoms:

  • Coughing, lasting for more than 3 weeks
  • Coughing up blood
  • Fever
  • Chills
  • Night sweats
  • Weight loss (when the patient isn’t trying to lose weight)
  • Loss of appetite

These symptoms vary according to the organ in which the infection is active, for example, abdominal TB can present with diarrhea, and TB of the spine can manifest as back pain.

Diagnosis

The diagnosis of TB is made easily by symptoms, and signs found on proper clinical examination of the patient, however, some of the following tests are helpful in confirming the diagnosis:

PPD tuberculin skin test

  • Blood tests
  • Chest X-ray
  • Chest CT scan
  • Sputum test (to check the presence of the bacteria in the sputum)

Treatment

For the treatment of TB, a 9 month course of a combination of 4 drugs is necessary. The drugs most commonly used are:

  • Isoniazid
  • Rifampin
  • Ethambutol
  • Pyrazinamide

It is very important to complete the entire course of medication for 9 months, otherwise the disease may come back, and this time it could become resistant to the drugs.

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