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Tuberculosis

The tuberculosis chronic infection, caused by a bacillus, which can affect other organs besides the lung.

Two concepts must be clearly differentiated:

  1. tuberculosis infection: previous or current contact with the tubercle bacillus, but without clinical or radiological signs of organic involvement and without evidence of the germ in cultures of patient samples (sputum, blood, urine, etc.).
  2. Tuberculous disease: when there are symptoms, radiological alterations, and above all, the bacillus has been identified in some sample of the patient.

8 million new cases appear in the world per year.

Causes of tuberculosis

An aerobic bacillus called Mycobacterium tuberculosis.

The germ is found in lung lesions of a sick individual, when he speaks or coughs, it expels aerosol particles that contain tubercle bacilli.

These aerosol particles are inhaled by another individual, thus reaching the germ to the pulmonary alveoli, there it replicates and is distributed through the lymphatic circulation to the regional nodes, from where it reaches the venous blood, spreading by hematogenous route throughout the body ( organic plantings). So far we speak of primary tuberculosis infection.

If the immune response of the infected person is effective, although some live bacilli persist in the latent state, no disease appears, but if the response is ineffective, there will be a progression towards tuberculosis disease. For this reason, it mainly affects immunosuppressed individuals.

What symptoms appear?

  • In the primary infection, low-grade fever and an unproductive cough appear.
  • In hematogenous dissemination, there are: fever , anorexia, sweating, asthenia and weight loss. Depending on the organ most affected, different clinical forms will appear:
    – Miliary TB (general condition, fever and cough)
    – Pulmonary TB (low-grade fever, night sweats, weight loss and mucopurulent and / or haemophoic sputum)
    – Meningeal TB (confusion, lethargy , cranial nerve palsy)
    – Tuberculous pleurisy (chest pain, fever, dyspnea)
    – Tuberculous adnexitis or orchitis (resulting in sterility)
    – Renal TB (voiding syndrome and sterile pyuria)
    – Tuberculous osteomyelitis, mainly affecting the vertebrae

Diagnosis of tuberculosis

The diagnosis is suspected in patients:

  • with compatible symptoms, who have had continuous contact with active tuberculosis patients.
  • who present alterations in the chest X-ray suggestive of disease.

The positive Mantoux test shows previous contact with the tubercle bacillus, that is, it diagnoses the infection but not the active disease. It is also positive in patients vaccinated with BCG and in atypical Mycobacteria infection.

Only when Mycobacterium tuberculosis is isolated and identified in patient samples (cultures, smear microscopy, PCR, etc.) can a certain diagnosis of active tuberculosis disease be established.

How is it treated?

General measures

Isolation of the smear-positive patient

Medical treatment

Treatment must be completed correctly, and always with more than one drug, to prevent any population of bacilli from becoming resistant.

The initial regimen currently recommended in children and adults, and for pulmonary and extrapulmonary forms lasts 6 months, the first two months are administered isoniazid, rifampicin and pyrazinamide, and the last four only rifampicin and isoniazid. Throughout this time it is necessary to monitor liver function tests, since some of the drugs used can damage that organ.

In special situations the treatment can last up to twelve months.

Other drugs used are ethambutol and streptomycin.

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Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of ​​Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.

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