Many have heard about tuberculosis, but few realize the real danger of this terrible disease. For many years, doctors around the world have studied the factors that contribute to the development of infection, the main signs and manifestations. During this time, it was found that the early stage of tuberculosis of the lungs and other organs can be asymptomatic, and the lack of treatment leads to serious complications.
Brief information about the disease
To date, the pathogenesis of tuberculosis has been studied in full. This is a dangerous and highly contagious disease caused by infectious pathogens from the genus of mycobacteria.
Several types of microorganisms are known to cause disease in humans. These include:
- human, most common, accounting for 92% of all recorded cases;
- bovine, leads to disease much less often, they get sick about 5%;
- intermediate, mainly common in South Africa, in Russia the disease is detected in 3%patients;
- murine and avian, found only in individuals with a history of immunodeficiency.
Few people know that the anatomy of tuberculosis is not limited to the respiratory organs. The bacillus also strikes:
- bones;
- gastrointestinal tract;
- genitourinary system;
- brain.
Regardless of location, the disease is extremely dangerous and inevitably leads to death if left untreated.
The disease has a long incubation period. The first symptoms may appear 3 months to 1 year after the introduction of the infectious agent.
Statistics
Medical workers around the world are seriously concerned about the rapid spread of the disease. Russia ranks 22nd in the list of countries.
Previously, the bulk of the infected were people serving sentences in prisons. But since the beginning of the 90s, an outbreak of the disease began, and the bacillus began to spread en masse.
New cases of tuberculosis were diagnosed daily among well-to-do families, most of the cases were children.
In the he althcare organization, this fact was associated with a decrease in the standard of living of citizens, which was just observed at that time and was caused by political restructuring of the country.
Over the years of this epidemic, experts have implemented a set of preventive measures to slightly stabilize the situation, to achieve a decrease in morbidity and mortality. This includes:
- vaccination of newborns in the hospital;
- Tracking for new infections using the Mantoux test (in children) and fluorography (in adults).
Tuberculosis bacillus is extremely resistant to environmental changes, therefore it remains viable for a long time in water, earth, etc. If basic personal hygiene rules are not followed, the risk of getting sick is quite high.
Characteristics
The primary pathogenesis is based on the penetration of a pathogenic bacillus into the body. Such people do not get sick immediately, therefore, there are no complaints.
With weakened immunity may occur:
- slight increase in body temperature;
- increased heart rate;
- heavy night sweats;
- blush combined with unnatural pallor of the skin;
- weakness, dizziness;
- cough;
- sputum streaked with blood.
Deterioration of the general condition occurs against the background of poisoning with microbial toxins. The higher the number, the more severe the symptoms.
The first signs of tuberculosis in patients with a strong immune system may be slight or absent.
The most severe course and rapid progression is observed in people with he alth problems.
If the microorganism struck:
- Bone tissue - there is severe pain in all joints and stiffness of movements.
- Brain - nausea, vomiting, severe headache and muscle pain present.
- Urinary system - the patient constantly feels the overflow of the bladder. In the later stages, there is blood in the urine.
- Gastrointestinal tract (GIT) - there is constant discomfort in the abdomen, nausea, scarlet streaks in the stool.
- Skin - nodules filled with pus form on its surface, which open up over time.
Against the background of a long course of tuberculosis, an inflammatory process of the granulomatous type occurs, which can be observed in any affected organ. To detect it, modern diagnostic methods are used.
Risk groups
Medicine has long proven that the pathogenesis of tuberculosis directly depends on the state of the body's defense system.
No one is safe from infection, but the people at greatest risk include:
- with HIV and AIDS;
- prisoners;
- suffering from various chronic diseases (digestive ulcers, diabetes, etc.);
- having bad habits;
- younger age;
- neglecting the rules of personal hygiene;
- regular contact with the infected;
- during pregnancy;
- experiencing regular stress;
- not getting essential vitamins and minerals;
- living in ecologically disadvantaged areas;
- from low-income families;
- no fixed abode.
When the pathological process is activated, the pathogenesis of tuberculosis is characterized by increasedcontagiousness.
Shapes
The duration of treatment depends on the type of infection, the prognosis of the likelihood of infecting other people. There are the following phases of tuberculosis:
- Open. Seen in lung injury. If the sputum analysis confirmed the presence of pathogens in it, the person is contagious.
- Closed. If the result is negative, the patient is not a carrier of the disease.
If the stick first entered the body, they talk about the primary form, otherwise, about the secondary.
In addition, the disease may differ in the nature of the lesion:
- miliary;
- disseminated;
- infiltrative;
- limited;
- cheesy;
- fibrous-cavernous;
- tuberculoma;
- cavernous;
- cirrhotic;
- tuberculous pleurisy.
Course of illness in childhood and pregnancy
The etiology of tuberculosis shows that people with a weak immune system are most susceptible to infection. Such a violation may be congenital, but most often appears in the process of life, under the influence of various factors.
In childhood, the protective system is not fully formed, so the risk of infection increases inversely with the age of the child. That is, the younger he is, the more likely the penetration of a malicious wand.
After infection, the disease proceeds in exactly the same way as in adults, but in a more severe form. Has no specific differences.
Tuberculosis during pregnancy is not a reason for its termination.
The transition to the active phase can be observed in the first trimester or after delivery. The rest of the time it is less common. This is due to the activity of the immune system and hormonal changes in the body.
Infection of the fetus is not always observed. This is mainly characteristic of the following forms:
- fibro-cavernous;
- heavy destructive;
- disseminated.
Such pathogens easily cross the placental barrier, leading to severe disorders in the fetus.
After an accurate diagnosis is made, the patient is under the control of a gynecologist and a phthisiatrician.
Treatment begins immediately, while drugs are selected that have the least negative impact on the unborn child.
If the disease is detected on time, the prognosis for the woman and the baby is favorable, but there are exceptions. Sometimes abortion is still recommended.
Examination
After the appearance of the first suspicious signs, patients rarely visit a doctor, but in vain. Behind the mask of harmless fatigue, not only tuberculosis, but also other terrible diseases can be hidden.
Even a slight deterioration in well-being without signs of acute respiratory infections, but with elevated body temperature should be a reason to visit a doctor.
The initial examination will be carried out by a therapist who will listen to all complaints, take into account the etiology of tuberculosis and give a referral for general tests (blood and urine) and other necessary studies, this can be:
- Fluorography. It is held once a year, starting from the age of 15. Allows you to identify pulmonary tuberculosis and other pathologies of the respiratory system. It is included in the list of mandatory examinations when applying for a job, before leaving for the army, etc. If the result of fluorography is controversial, then an additional x-ray is taken.
- Mantoux reaction. Many mistakenly confuse it with a vaccine. This is a special type of diagnosis of tuberculosis. It is carried out for all babies aged 1 to 14 - 15 years, sometimes up to 17. Tuberculin is injected under the skin with a small needle. It contains the waste products of pathogenic bacilli. After such contact, a "button" should appear. To evaluate the result, measure its diameter.
- Enzymatic immunoassay (ELISA). Allows you to determine the presence of a microorganism in the blood at the time of the study.
- Sputum analysis according to Ziehl-Neelsen. It is carried out for all patients with a prolonged cough. Sputum is stained with a special solution that allows you to determine the presence of pathogenic bacilli.
- Bacteriological culture. Allows you to find out which wand provoked the disease. Sowing matures for about 1-2 months, but gives a very accurate result, allowing you to choose an effective therapy.
If tuberculosis of other organs is suspected, additionally carry out:
- x-ray;
- MRI or CT of affected area;
- encephalogram, etc.
The pathogenesis of tuberculosis is very similar to many other diseases, such as cancer, so it is not always possible to suspect it immediately.
Treatment
The selection of therapy mainly depends on the pathogenesis and clinic of tuberculosis. It is carried out under the supervision of phthisiatricians and takes a long period. In most cases, this is 2 years, a little less often 3-4.
The choice of drug regimen depends on many factors. As a rule, the doctor makes such a decision based on:
- patient condition;
- his age and gender;
- survey results, etc.
Main goals of treatment:
- make the patient non-infectious;
- stimulate the healing of damaged tissue;
- restore he alth.
A positive result can be achieved with the following drugs:
- Para-aminosalicylic acid.
- "Streptomycin".
- "Kanamycin".
- "Rifampicin".
- "Ftivazid".
- "Pyrazinamide".
- "Ethionamide".
Mainly use 3, 4 or 5 components at the same time.
The use of chemotherapy courses is mandatory, the duration and dosage of which is determined individually.
After the use of aggressive medications, the process of tissue regeneration occurs slowly and not quite as it should, therefore, for the natural process of tissue repair, phthisiatricians often prescribe pathogenetic treatment. This includes a whole range of activities that allow you to achieve good results. These include reception:
- anti-inflammatory drugs;
- immunomodulators;
- enzymes;
- B vitamins;
- sorbents;
- drugs to protect and restore the liver (hepatoprotectors);
- glutamic acid;
- anticoagulants;
- antikinins;
- anabolics;
- antiallergic drugs, etc.
Operation
Most often, the initial forms of the disease do not require surgical treatment. In advanced cases, such methods are indispensable. In case of lung damage, carry out:
- Lobectomy.
- Resection.
- Bilobectomy.
- Pulmonectomy.
- Cavernectomy.
- Pneumothorax.
Given the pathogenesis of extrapulmonary tuberculosis, surgical intervention can also be applied to it.
When complications from the infected gastrointestinal tract appear, a planned or emergency operation is prescribed to eliminate the consequences.
Tuberculosis of the central nervous system is treated mainly with conservative means. If they do not help, proceed to the removal of pathological foci. These are very complex procedures that can lead to irreversible consequences.
Purulent granulomas of the skin can also be operated on.
The main purpose of such measures is to eliminate the consequences of the disease and, if possible, restore the operation of the affected systems.
What to do to avoid getting infected
Despite the desperate struggle of doctors with tuberculosis, pathology is still very common among the population, so it will not be out of place to know how to protect yourself andyour loved ones:
- Vaccination. They make such a vaccination at the request of the parents, but you should not refuse it. It allows the baby to develop a strong immunity against infection, which becomes strongest after reaching 1 year. As a result, the child does not get TB or only has mild TB.
- Regular examination. Allows you to identify the disease in the early stages, conduct effective treatment and prevent infection of a large number of people. This includes the Mantoux test and fluorography.
Some groups of patients are indicated for prophylactic chemotherapy courses, these are individuals:
- Having weak immunity and chronic diseases of the lungs, gastrointestinal tract, central nervous system.
- Living in the same room with the infected.
- Having changes in the respiratory tract due to tuberculosis.
- Children with poor Mantoux results.
In addition to medical measures, there are a number of recommendations that can reduce the risk of developing the disease. For this you need:
- exercise regularly;
- eat he althy food;
- fight addictions;
- wash hands thoroughly before eating and after visiting public places;
- limit contact with a sick person;
- it is good to disinfect with whiteness the room in which the infected person is located;
- take vitamins and Omega-3 preparations regularly.
All TB doctors know onea little secret on how to reduce the risk of contracting tuberculosis. To do this, you need to have breakfast in the morning and avoid long hungry periods during the day (especially if you need to use public transport). It is believed that in this way the bacillus has practically no chance of entering the body.
Complications
Negative consequences of tuberculosis are noted by people who delay visits to the doctor and neglect diagnosis. A neglected form can threaten a person:
- cardiac and respiratory failure;
- bleeding from affected organs;
- formation of ulcers, fistulas;
- impaired kidney and liver function;
- development of granulomas throughout the body;
- amyloidosis;
- pneumothorax;
- impaired motor function;
- paralysis;
- sepsis;
- gangrene;
- necrosis;
- coma;
- fatal.
When complications appear, the prognosis for the disease is extremely unfavorable.
From the foregoing, we can conclude that the disease provokes a variety of symptoms. The first signs of pulmonary tuberculosis may be manifested by a prolonged cough that is not eliminated by mucolytic drugs. This should alert the patient and make him see a doctor. It is worth remembering that the disease responds well to treatment with timely treatment, and in the event of a transition to a neglected form, there is a high risk of developing complications that inevitably lead to painful death.
