Tubberculosis

Tubberculosis

By Faozat Aragbaiye
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Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. Tuberculosis generally affects the lungs, but can affect other parts of the body, Most infections do not have symptoms in which case it is known as latent tuberculosis. About 10% of latent infections progress to active disease which, if left untreated, kills about half of those affected. There is distinction between two kinds of tuberculosis infection: latent and active.

Latent TB- the bacteria remain in the body in an inactive stage. 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.

Transmission

Tuberculosis is contagious, but it’s not easy to catch. The disease is spread through air. The germs are released as tiny droplets when a sick person sneezes, coughs, talks, laughs or sings and the nasty germs were breathed in by a healthy person , the person can get infected especially when the immunity of the healthy person is reduced. A lot of time would have to be spent around the infected person. The incubation period may vary from about two to twelve weeks.

People at risk of tuberculosis

• A friend, co-worker, or family member of a person with active tuberculosis disease.
• Live or travel to areas where tuberculosis is common, like Russia, Africa, Eastern Europe, Asia, Latin America, and the Caribbean
• Homeless people, people with HIV, and IV drug users
• Healthcare providers.

Because of low immunity,  people with the following ailments can also be at risk of tuberculosis. These are

• Diabetes
• Severe kidney disease
• Head and neck cancers
• Low body weight and malnutrition
• Transplant patients.
• People undergoing immunosuppressive therapy.
• Babies and young children also are at greater risk because their immune system are not fully developed.

Early warning signs

The symptoms of TB disease include:

• Feeling sick or weak
• Loss of appetite and weight loss
• Chills, fever, and night sweats
• A severe cough that lasts for more than 3 weeks
• Chest pain

TB can also affect other parts of the body but pulmonary TB is responsible for the majority (about 85%) of TB infections.

 Symptoms will depend on the part it affects. The classical clinical symptoms and signs of pulmonary TB may include the following:

• Chronic cough
• Haemoptysis ( coughing up bloody sputum)
• Shortness of breath
• Swollen lymph nodes
• Pneumonitis ( may be the only symptom in the elderly)

The following includes the signs and symptoms of additional types of TB:

• Skeletal TB (Pott’s disease): spinal pain, back pain, back stiffness, paralysis is possible
• TB meningitis: headaches, (variable in length but persistent), mental changes, coma.
• TB arthritis: usually pain in a single joint(hips and knees most common)
• Genitourinary TB: dysuria, flank pain, increased frequency, masses or lumps ( granulomas)
• Gastrointestinal TB: difficulty swallowing, nonhealing ulcers, abdominal pain, malabsorption, diarrhea (may be bloody)
• Miliary TB: many small nodules widespread in organs that resemble millet seeds ( hence its name).
• Pleural TB: empyema and pleural effusions
• Multidrug –resistant tuberculosis (MDR TB): patients infected with TB bacteria that are resistant to multiple drugs.
• XDR TB: patients infected with TB bacteria that are resistant to some of the most effective anti-TB medications. XDR means extensively drug resistant.
• Caseous TB: Necrotic ( dead and dying) tissue that infected with TB organism has a soft, dry, and cheesy appearance.
• End-stage TB: Patients may suffer fever, constant coughing, shortness of breath, weight loss, mental changes and blood in sputum before death.

Diagnosis

• Chest x-ray
• Acid-fast stain and culture
• Tuberculin skin test( TST)or interferon-gamma release assay(IGRA)
• PCR test (polymerase chain reaction)

Treatment

Treatment of TB depends on the type of infection and drug sensitivity of the mycobacteria. For latent TB, three anti –TB drugs are used in four different recommended schedules.

Treatment of drug-resistant ( or antibiotic resistant) tuberculosis. TB can be difficult and the patients might require second-line drugs.

Complications

Although some patients may not develop complications, others range from mild to severe complications, including death. Some of the more severe complications include : lung function damage, bone pain ( spine, ribs, and joints), meningitis, kidney and/ or liver malfunction, cardiac tamponade and visual disturbances.

Prognosis

For most people who live in areas where diagnosis and treatment is available, the prognosis of TB is good if they complete treatment protocols.. Drug-resistant TB is more difficult to treat , and the prognosis is not as good.The same poor prognosis occurs for those patients who are immunocompromised ( for example , HIV-positive individuals), elderly, and patients with previous infection and treatment for TB.

Prevention

• Screening those at risk
• Treatment of those infected
• Vaccination