Miliary tuberculosis is a rather serious disease that is often confused with typhoid fever. The disease affects various systems of internal organs, from the liver to the lungs. This form of TB is diagnosed in a small number of people.
Description of the disease
Miliary pulmonary tuberculosis is an acute form of the disease, characterized by the appearance of lesions simultaneously in several organs. Allocate acute and chronic stage of the pathology. The latter is considered the most dangerous. The acute form usually develops against the background of infection of the bloodstream by pathogenic microorganisms. As the disease progresses, they penetrate more and more organs, infecting them. Against the background of extensive infection, the membranes of the brain are seriously affected.
The main causative agent of the disease is Mycobacterium tuberculosis, which, as a result of the weakening of the body's defenses, penetrate into the body in large quantities. Subsequently, they spread along with the blood stream.
According to experts, on three men,suffering from tuberculosis, there is only one woman with a similar diagnosis. Most often, pathology is diagnosed among the stronger sex, whose age varies from 20 to 40 years.
Miliary tuberculosis is considered a socially determined disease, as its prevalence among the population is determined by living conditions. Epidemic trouble is explained by active migration flows, a drop in the level of material opportunities, an increase in the number of socially unadapted people.
Causes of disease
Tuberculosis is caused by bacteria of the genus Mycobacterium. In total there are more than 70 species. They are common in water, soil, air, and animals. For humans, only a few species are of particular danger, which scientists conditionally combine into the M. tuberculosis complex. The spread of pathogenic bacteria occurs in one of three ways: from the primary source of infection, from old tuberculosis foci, or as a result of surgical operations on an organ already affected by the disease.
At increased risk of developing this disease are children who have not been vaccinated in a timely manner, people with immunodeficiency or who have been taking drugs for a long time to suppress the excessive activity of the body's defenses.
What signs help to recognize miliary TB?
The symptoms of this disease are not specific, they depend on the area of the lesion. To the general signs that patients usually complain about,include the following:
- Weakness in the body.
- Fever.
- Temperature increase.
- Pronounced intoxication.
- Weight loss.
- Breathing problems.
- Cyanosis of the skin.
- Excessive night sweats.
- Dry cough.
The disease can occur in an acute, chronic or acute form. Each of them has its own characteristics.
The chronic form proceeds in waves. This means that the exacerbation phase is replaced by remission. Patients seek help from a doctor with complaints of decreased ability to work, a sharp decrease in body weight, and rapid fatigue. In some cases, hemoptysis is present.
Acute miliary tuberculosis is usually severe and its symptoms vary depending on the location of the inflammation. In some patients, doctors note severe pulmonary insufficiency against the background of fever and intoxication syndrome. The lungs are usually affected over the entire surface. If rashes are observed exclusively in the subclavian areas, we are talking about the so-called limited miliary tuberculosis. This type of pathology is asymptomatic, sometimes subfebrile temperature and dry cough are recorded.
The most acute form of the disease is otherwise referred to as tuberculous sepsis. It has a fast pace. Literally 2-3 weeks after the onset of primary symptoms, a fatal outcome is possible. This disease is characterized by high fever and dyspeptic disorders. Many patients complain aboutsevere headaches. This symptom is explained by a serious vascular lesion and involvement of the meninges in the pathological process.
Forms of miliary tuberculosis
Depending on the prevalence of symptoms, the disease is divided into the following forms:
- Pulmonary. Against the background of general intoxication, signs of respiratory failure appear.
- Typhoid. Rashes occur in all systems of internal organs. This form of the disease is characterized by the appearance of fever and signs of general intoxication, so it is often confused with typhoid fever.
- Meningeal. Differs in the presence of infectious foci in the meninges.
Diagnosis
In case of unreasonable weight loss, night sweats, feeling of weakness and loss of appetite, it is recommended to seek advice from a specialized specialist, namely a phthisiatrician or an infectious disease specialist.
Diagnosis of miliary tuberculosis includes the following procedures:
- Complete blood count.
- Lumbar puncture.
- CT of the brain and chest.
- Ultrasound of internal organs.
- Chest x-ray.
- Echocardiography.
Based on the results of the tests, the doctor can confirm or refute the diagnosis of "miliary tuberculosis". Symptoms that characterize a person’s condition do not allow us to assert 100% about the presence of an ailment. Only instrumental diagnostics can help establish the final diagnosis.
What treatment is needed?
Therapy of this disease requires a lot of effort and time. For almost a year, the patient is forced to take several medications. Usually prescribed "Streptomycin", "Isoniazid", "Rifampicin", "Moxifloxacin". Doctors explain such a variety of medicines by the fact that each remedy individually has a certain effect on the course of treatment, and together they can all overcome the disease.
Miliary pulmonary tuberculosis also provides for other types of mandatory therapeutic procedures (breathing exercises, physiotherapy, taking immunostimulating drugs). The patient must adhere to the correct regime of work and rest, clearly follow all the recommendations of the doctor. Particular attention must be paid to the diet. It should be diversified with dairy products.
If the patient lives with young children, temporary hospitalization for 3-4 weeks is usually recommended.
Surgical treatment
Many patients with this disease are prescribed surgery, which involves the excision of part of the lung. Resection is recommended for cicatricial structures of the bronchi, patients with hemoptysis.
It is possible to use other methods of treatment, including combined ones. In especially serious cases, it is usually recommended to remove part of the lung or the entire organ, apply an artificial pneumothorax, and drain the cavity.
Forecast
Certainly, the treatment of miliary tuberculosis with the use of chemotherapy is an important stage in the fight against the disease. Before the active use of anti-tuberculosis drugs, the mortality of patients with this diagnosis was almost 100%. Timely and competent therapy today can reduce these figures to 10%. The earlier the diagnosis is made and appropriate treatment initiated, the higher the chances of a favorable prognosis. Most deaths from this disease are recorded in the first few weeks of the patients' stay in a medical facility. Experts attribute such sad statistics to the late start of therapy.
The chance of recurrence is only 4%. If the patient follows all the doctor's instructions and strictly takes the prescribed medications, the chances of re-infection are noticeably reduced.
Complications of the disease
In the absence of timely treatment, the following complications may develop: the formation of multiple cavities in the lungs, bronchogenic dissemination, caseous pneumonia.
Preventive measures
Miliary tuberculosis is usually diagnosed in certain social strata (persons with low material income, migrants, etc.). Men get sick several times more often and more intensely than women. At risk are people between the ages of 20 and approximately 39 years old.
Prevention of this pathology primarily implies the complete exclusion of close contact with people who have signs of pulmonary diseases. Not less importantprovide proper and rational nutrition in order to strengthen immunity. Doctors recommend moderate hardening.
Miliary tuberculosis can be prevented by reducing the influence of factors that negatively affect immunity. These include frequent hypothermia, lack of physical activity, starvation, work in adverse conditions.
The state should carry out anti-epidemic measures in disadvantaged regions. In addition, funds should be allocated from the budgets for the treatment of patients with such a diagnosis. If there is a high risk of tuberculosis in the region, people should undergo a medical examination when they start working.
Conclusion
In this article, we told what constitutes such a disease as miliary tuberculosis. Photos of patients with such a diagnosis can be viewed in specialized medical reference books. This disease is diagnosed less and less today, and cases of death are recorded less and less. Doctors warn that timely detection of the disease can minimize the likelihood of complications, which include death.
