Tuberculosis

Tuberculosis is an infectious disease caused by a germ called Mycobacterium tuberculosis. In most cases, TB infection invades lungs, although the germ can affect almost any tissue or organ in the body. Most common of the TB symptoms is persistent cough with phlegm, which doesn’t go away for more than 3 weeks. Tuberculosis treatment usually includes a long-term course of medications to eradicate TB infection, although in some cases, a surgery may be needed to repair the damaged caused by tuberculosis. More detailed information about this condition, its symptoms, as well as tuberculosis treatment options and diagnostic services (bronchoscopy, sputum test), is presented below.

Tuberculosis (TB) is a bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person. It is a serious condition, but can be cured with proper treatment. TB mainly affects the lungs. However, it can affect any part of the body, including the glands, bones and nervous system.

What is the most contagious type of tuberculosis?

The type that affects the lungs is the most contagious. Usually, it only spreads after prolonged exposure to someone diagnosed with the disease. For instance, it spreads within a family living in the same house.

Most of the time, the immune system kills the bacteria in healthy people and you don’t experience any symptoms.

Sometimes, the immune system may not be able to kill the bacteria but it manages to prevent it from spreading in the body. When this happens, you will not experience any symptoms. However, the bacteria will remain in your body. This type of tuberculosis is known as “latent TB”.

What happens if the immune system fails to contain the infection?

When the immune system fail to contain the infection, the disease can spread to other parts of the body and you will experience the symptoms within a few weeks or months. When this happens, it is known as “active TB”.

Latent TB could potentially develop into an active TB infection if your immune system weakens.

TB is not spread from:

• • Sharing drinking containers

 

• Cigarettes
• Saliva shared from kissing.
• Shaking someone’s hand
• Sharing food
• Touching bed linens or toilet seats
• Sharing toothbrushes

 

TB SYMPTOMS

• Persistent coughing (may last more than 3 weeks and usually brings up phlegm, which may be bloody)
• Weight loss
• Night sweats
• Fever
• Fatigue
• Loss of appetite
• Swellings (haven’t gone away after a few weeks)

TUBERCULOSIS TREATMENT

Medicines for Tuberculosis treatment

Several antibiotics are used at the same time to treat active tuberculosis (TB) disease. For people who have multidrug-resistant TB, treatment may continue for as long as 24 months. These antibiotics are given as pills or injections. For active TB, there are different treatment recommendations for children, pregnant women, people who have HIV and TB, and people who have drug-resistant TB.

Vaccination to prevent the disease

Bacille Calmette-Guerin (BCG) is a vaccine for tuberculosis (TB) disease. In countries with a high prevalence of TB, this vaccination is given to prevent childhood tuberculosis, meningitis and miliary disease.

Surgery to repair the damaged caused by TB infection

Surgery sometimes may be needed to remove or repair organs damaged by TB in parts of the body other than the lungs (extrapulmonary TB) or to prevent other rare complications, such as:

• TB infection of the brain (TB meningitis): Your doctor may surgically place a tube (shunt) that drains excess fluid from the brain to prevent a buildup of pressure that can further damage the brain.
• TB infections of the heart (TB pericarditis): Your surgeon may partially remove or repair the infected sac around the heart.
• TB infection of the kidneys (renal TB): Your surgeon may need to either remove your infected kidney or repair the kidney or other parts of the urinary system.
• TB infection of the joints: You may need surgery to repair damaged areas of your spine or joints (orthopedic surgery).

HOW IS TUBERCULOSIS DIAGNOSED?

• History taking: It’s important to get an accurate history in diagnosing and treating TB. Early intervention and treatment is very important in treating this disease.
• Physical examination: A doctor will use a stethoscope to listen to your breathing for abnormal sounds that indicate a problem in your lungs to look for signs of TB. The doctor will also look for signs of a TB infection in other parts of the body apart from your lungs (extrapulmonary TB).
• Screening of family members for tuberculosis: In some circumstances, you may need to be tested to check for latent TB (when you have been infected with TB bacteria, but do not have any symptoms). For example, you may need to be screened if you have been in close contact with someone known to have an active TB infection (an infection that causes symptoms), or if you have recently spent time in a country where TB levels are high. If you have just moved to the UK from a country where TB is common, you may be screened when you arrive or your GP may suggest screening when you register as a patient.
• Sputum culture and cytology: The best way to diagnose active TB is through mucus testing from the lungs. However, a sputum culture may take 1 to 8 weeks to show results. The sputum sample is examined to determine whether there are abnormal cells. Sputum can be found in the lungs and in the airways leading to the lungs. This substance is different from saliva. Sputum cytology is performed to detect certain noncancerous lung conditions and may also be performed when lung cancer is suspected.
• Chest X-ray: This may be ordered if you have a positive tuberculin skin test, experience symptoms of active TB or if you have an uncertain reaction to the tuberculin skin test.
• Rapid blood test (Interferon-gamma Release Assays): This can help diagnose latent TB when the results from a tuberculin skin test are uncertain. It can also tell if a person who has had a BCG vaccination has TB. This test only requires one visit instead of two visits as required for the tuberculin skin test.
• Bronchoscopy: The fiberoptic bronchoscope, a flexible tube about as big around as a pencil, is slid into either the nose or the mouth and passed down the back of the throat, into the trachea, and into each lung. There are no pain fibers in the tracheobronchial tree, so the procedure does not hurt. Topical lidocaine is sprayed into the back of the throat to inhibit the gag reflex and light sedation is given. The patient may cough during the procedure, so small doses of lidocaine are sprayed into the lungs occasionally during the procedure to numb the cough receptors. The procedure can take from 5 minutes to an hour.
• EBUS-TBNA (Endobronchial Ultrasound-Guided Transbronchial Needle Aspirate): Endobronchial ultrasound-guided transbronchial needle aspiration is a special technique used to take samples of body tissue from inside the chest. It is also known as EBUS TBNA for short. The procedure is carried out using a special kind of bronchoscope. This is a thin flexible kind of ‘telescope’ which passes through the mouth and into the airways. The bronchoscope (often shortened to ‘scope’) allows doctors to see inside the lungs and carry out the procedure. Endobronchial means from inside or within the bronchus. The bronchi (the term for two bronchus) are large tube-like airways. They take air from the windpipe (trachea) to the smaller airways, called the bronchioles. During the procedure ultrasound is used to help the doctor doing the test see the structures just outside the airways. This gives the test the first part of its name. The scope also contains a very fine needle. This needle is used to take samples of body tissue by pushing through the bronchus to the tissue on the other side. The needle holds the sample of tissue; this is called aspiration. Transbronchial means across the bronchus, giving the name transbronchial needle aspiration. It may be used to diagnose conditions such as sarcoidosis or tuberculosis.