Tuberculosis

Tuberculosis (TB) is a potentially serious infectious disease that mainly affects your lungs. The bacteria that cause tuberculosis are spread from one person to another through tiny droplets released into the air via coughs and sneezes.

Symptoms

Signs and symptoms of active TB include:

  • Coughing that lasts three or more weeks
  • Coughing up blood
  • Chest pain, or pain with breathing or coughing
  • Unintentional weight loss
  • Fatigue
  • Fever
  • Night sweats
  • Chills
  • Loss of appetite

Tuberculosis can also affect other parts of your body, including your kidneys, spine or brain. When TB occurs outside your lungs, signs and symptoms vary according to the organs involved.

When to see a doctor

See your doctor if you have

  • fever
  • unexplained weight loss
  • drenching night sweats or a persistent cough

These are often signs of TB, but they can also result from other medical problems.

Risk factors

Anyone can get tuberculosis, but certain factors can increase your risk of the disease. These factors include:

Weakened immune system

A healthy immune system often successfully fights TB bacteria, but your body can’t mount an effective defense if your resistance is low. A number of diseases and medications can weaken your immune system, including:

  • HIV/AIDS
  • Diabetes
  • End-stage kidney disease
  • Certain cancers
  • Cancer treatment, such as chemotherapy
  • Drugs to prevent rejection of transplanted organs
  • Some drugs used to treat rheumatoid arthritis, Crohn’s disease and psoriasis
  • Malnutrition
  • Very young or advanced age

Traveling or living in certain areas

The risk of contracting tuberculosis is higher for people who live in or travel to countries that have high rates of tuberculosis and drug-resistant tuberculosis, such as:

  • Sub-Saharan Africa
  • India
  • China
  • Russia
  • Pakistan

Poverty and substance abuse

  • Lack of medical care.
  • Substance abuse.
  • Tobacco use.

Complications

  • Spinal pain. Back pain and stiffness are common complications of tuberculosis.
  • Joint damage. Tuberculous arthritis usually affects the hips and knees.
  • Swelling of the membranes that cover your brain (meningitis).
  • Liver or kidney problems.
  • Heart disorders.

Tests and diagnosis

During the physical exam, your doctor will check your lymph nodes for swelling and use a stethoscope to listen carefully to the sounds your lungs make while you breathe.

The most commonly used diagnostic tool for tuberculosis are

  • Tuberculin test.
  • Blood tests.
  • Imaging tests. If you’ve had a positive skin test, your doctor is likely to order a chest X-ray or a CT scan.
  • Sputum tests. If your chest X-ray shows signs of tuberculosis, your doctor may take samples of your sputum — the mucus that comes up when you cough. The samples are tested for TB bacteria. Sputum samples can also be used to test for drug-resistant strains of TB.

Treatments and drugs

The most common medications used to treat tuberculosis include:

  • Isoniazid
  • Rifampin
  • Ethambutol
  • Pyrazinamide

If you have drug-resistant TB, a combination of antibiotics called fluoroquinolones and injectable medications, such as amikacin, kanamycin or capreomycin, are generally used for 20 to 30 months.

Completing treatment is essential

After a few weeks, you won’t be contagious and you may start to feel better. It might be tempting to stop taking your TB drugs. But it is crucial that you finish the full course of therapy and take the medications exactly as prescribed by your doctor. Stopping treatment too soon or skipping doses can allow the bacteria that are still alive to become resistant to those drugs, leading to TB that is much more dangerous and difficult to treat.

To help people stick with their treatment, a program called directly observed therapy (DOT) is recommended. In this approach, a health care worker administers your medication so that you don’t have to remember to take it on your own.

Prevention

If you have active TB, keep your germs to yourself. It generally takes a few weeks of treatment with TB medications before you’re not contagious anymore. Follow these tips to help keep your friends and family from getting sick:

  • Stay home. Don’t go to work or school or sleep in a room with other people during the first few weeks of treatment for active tuberculosis.
  • Ventilate the room. Tuberculosis germs spread more easily in small closed spaces where air doesn’t move. If it’s not too cold outdoors, open the windows and use a fan to blow indoor air outside.
  • Cover your mouth. Use a tissue to cover your mouth anytime you laugh, sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away.
  • Wear a mask. Wearing a surgical mask when you’re around other people during the first three weeks of treatment may help lessen the risk of transmission.

 

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