Tuberculosis is an infectious disease caused by pathogenic bacteria. A disappointing diagnosis may come as a complete surprise to a person, but it is important to understand that the disease is treatable. The defeat of the bronchi with tuberculosis does not always occur and is considered to be a complication rather than a primary disease. What is this pathology and how to deal with it is described in the article below.
Disease characteristics
Tuberculosis has been known for a very long time, during the course of the disease, a person’s respiratory system is affected. This is a chronic infection that can also affect the genitourinary system, bones and joints, lymph nodes or organs of vision.
Bacteria that cause the development of the disease are considered extremely resistant, can exist for a long time outside the body, not dying from environmental influences. However, it was revealed that under the influence of direct sunlight, microorganisms die, which allows the use of artificial ultraviolet in the treatment of the disease.
The bronchi often suffer from a lesion of Koch’s coli against the background of the development of basic pulmonary tuberculosis or lymph nodes. However, there are cases of primary lesion. Tuberculosis of the bronchi has a number of specific features that you need to pay attention to:
- The disease is equally dangerous for men and women. Age does not affect the possibility of infection.
- Statistics confirm that childhood vaccination reduces the risk of contracting tuberculosis by about 2.5 times.
- Over 15% of cases are diagnosed as a complication of pulmonary tuberculosis.
- It is believed that people suffering from other forms of the disease are at risk, the chance of re-infection is an order of magnitude higher.
Doctors agree that early diagnosis plays a large role in further treatment and prognosis for recovery. Among the signs of bronchial tuberculosis, they separately focus on the formation of ulcers and fistulas in the tissues, which complicates the course of the disease.
Epidemiology of the disease
Medical statistics suggest that bronchial tuberculosis is quite common, it is diagnosed in 10% of cases in patients with various forms of intrathoracic disease.
Lesions of the larynx, oropharynx or trachea are much less common. Such studies force medicine to pay vigilant attention to the problem.
How is the disease transmitted?
Important information is on how tuberculosis is transmitted. Such knowledge allows a person to independently assess the degree of risk to which he could be exposed in everyday life. A careful approach to this issue will prompt you to consult a doctor in time for an examination.
It is proved that tuberculosis of the bronchi, trachea and upper respiratory tract very rarely develops independently, without affecting the lungs. Based on these data, it can be concluded that the disease is most often associated with external factors (infection). Based on clinical studies and pathological features, the methods of transmission and occurrence of bronchial tuberculosis are specific:
- Contact method. In this case, the disease grows in the bronchi from the already affected lymph nodes, trachea and other organs. The infection is transmitted through the tissues of nearby diseased organs.
- Bronchogenic or bronchial method. Pathogenic microorganisms enter the bronchi from sputum, which passes through them during coughing attacks.
- Hematogenous method. It is considered the most common method of secondary infection with tuberculosis. It enters the bronchi through the bloodstream from other affected organs.
- Lymphagenic way. Microorganisms reach the bronchi through the lymph, which moves along the lymphatic paths from the affected lymph nodes (most often the chest nodes).
As mentioned above, people who have not been vaccinated and who have a weakened immune system are exposed to tuberculosis of the bronchi and trachea. A great influence on the development of the disease is exerted by a person’s lifestyle and living conditions.
Types of bronchial tuberculosis
This type of pathology is usually divided into several types, on which the overall clinical picture of the disease depends. Each type of disease has characteristic features:
- Infiltrative tuberculosis of the bronchi. This form of the disease is characterized by the absence of active secretion of bacteria with sputum, and the lumen of the bronchi remains almost unchanged. Most often, it affects individual parts of the bronchi, which at the same time become denser and thicker, and an infiltrate forms on their surface.
- An ulcerative form of pathology. The disease is local in nature, affecting the mouth of the bronchi. In advanced cases, it meets a severe course of the disease, which is accompanied by the formation of ulcers and bleeding. This species is characterized by the presence of pathogenic microorganisms in the excreted sputum.
- Fistulous tuberculosis of the bronchi. With this disease, the bronchi are severely injured, their walls are extremely thin, which leads to the formation of fistulas on their surface. Often a rupture of the lymph node leads to a similar form of the disease, and a constant deformation of the bronchial tissue leads to bronchogenic cirrhosis of the lungs.
Doctors separately pay attention to the fact that the symptoms of bronchial tuberculosis depend on the form in which the pathology proceeds. This fact has a great influence on the primary, and even more so, on the early diagnosis of the disease.
Symptoms of the disease
The considered type of tuberculosis is considered a very insidious disease, since in most cases it is not accompanied by vivid symptoms. Moreover, the disease has a chronic nature, that is, it develops in the body for a long time without proper medical supervision and treatment.
Medical statistics indicate that no more than 2% of all cases of bronchial lesions occur in acute form and have vivid symptoms. The localization of the infection, the degree of tissue damage and the form of the disease have a great influence on the symptoms of bronchial tuberculosis.
Doctors recommend paying attention to a number of characteristic signs:
- Constant bouts of coughing. At the same time, it is almost impossible to cope with it, conventional medicines do not help. The nature of the cough is barking, and the degree of its intensity increases significantly in the supine position.
- Frequent and pronounced shortness of breath, which accompanies a person even at the slightest exertion.
- With tuberculosis of the bronchi and trachea, the patient's breathing is accompanied by a loud whistling sound. This symptom can be heard without resorting to special medical instruments.
- Coughing fits are accompanied by the release of profuse sputum, which has a viscous consistency. Depending on the type of disease in the sputum, disseminated blood (with an ulcerative form) or particles of calcium salts (with a fistulous form) can be observed.
- If the lymph nodes are affected during the disease, then the person should feel a feeling of pain and burning between the shoulder blades.
If these symptoms are found, you should immediately consult a doctor. Early diagnosis will make further treatment more effective. Experts note that the defeat of the bronchi with Koch's rods is not accompanied by the usual signs of tuberculosis. The patient can maintain the same body weight, the temperature may remain normal, therefore, there is no nighttime sweating.
Doctors agree that the diagnosis of this disease is difficult and requires a comprehensive approach. In some cases, symptoms can be mistaken for ordinary bronchitis.
Diagnostic Methods
The diagnosis of bronchial tuberculosis is difficult to make even for a very experienced doctor, this disease has its own tricks and successfully disguises itself. For this reason, they resort to differential diagnosis of bronchial tuberculosis, which eliminates false pathologies and timely establishes the disease.
The lack of a clear clinical picture leads to the fact that the list of necessary procedures is quite wide:
- Urinalysis and blood tests are definitely prescribed. This allows you to determine the overall health of the patient.
- X-ray tomography is performed. This examination allows you to establish the degree of patency of the bronchi, the level of damage to their tissues, as well as the quality of ventilation.
- Bronchoscopy, which allows you to clarify the location of the infection, or rather to establish the form of the disease.
- A biopsy of the tissues of the bronchi, which is performed at the time of bronchoscopy as prescribed by the attending physician.
- Separately, an analysis of sputum is performed. The laboratory determines the presence of pathogenic microorganisms (Koch sticks) in it.
- If the sputum excreted is insufficient, then a study is carried out for tuberculosis of the bronchial lavage water. For this, a certain amount of brine is introduced, which is suctioned off with an aspirator. The laboratory determines the presence of microorganisms in the resulting liquid.
In conjunction with the above activities, an enzyme-linked immunosorbent assay (ELISA), which determines the presence of antibodies in the blood of a person. It is rarely used as an independent method for diagnosing bronchial tuberculosis; it can determine the presence of Koch sticks, but it will not tell the localization of the disease.
Features and types of treatment
In the case of a disappointing diagnosis, the doctor should approach the treatment comprehensively. As mentioned above, the defeat of the bronchi occurs mainly with secondary infection, that is, against the background of already developing pulmonary tuberculosis.
There are a number of main activities that are carried out in the treatment of bronchial tuberculosis:
- Drug therapy is prescribed using various types of antibacterial drugs.
- Against the background of oral administration of tablets, local chemotherapy is performed. This approach is possible if the disease is clearly localized.
- In the case of widespread infection, aerosol spraying of antimicrobial drugs into the respiratory tract is prescribed.
- Regular bronchoscopy allows mechanical cleaning of the bronchi from accumulations of caseous masses.
- In severe cases of the disease and a strong narrowing of the lumen between the bronchi, laser cauterization of the affected parts is performed.
- The doctor prescribes the intake of vitamin complexes and preparations of immunomodulatory properties. This allows you to provide the body with additional, but necessary assistance in the difficult period of the disease.
The course of taking drugs on average lasts at least three months. During this time, bacteria can become resistant to the main components of drugs, which will reduce effectiveness. The patient regularly passes tests, according to which the doctor adjusts the treatment.
It is important that the patient should be in a special tuberculosis dispensary all the time during the treatment, especially if the disease is contagious. Vigilant continuous monitoring by medical personnel allows you to achieve the desired result in the shortest possible time.
With pulmonary tuberculosis and bronchi, relapses are not uncommon. Simple rules help to avoid an unwanted repetition of the disease. Twice a year, the patient is required to undergo antibiotic therapy courses. This approach is used within two years after recovery.
An important role in the patient's health is diet. The body must constantly receive a full-fledged complex of useful vitamins, which will allow you to build the necessary immune defense.
Recovery Forecasts
The patient's chances of recovery depend on the stage at which the disease was diagnosed. Early diagnosis greatly facilitates treatment and shortens its duration. It is important to remember that bronchial tuberculosis most often acts as a complication of the pulmonary form.
Determining the person’s ability to fully recover, the doctor will rely on the degree of primary damage to the respiratory tract and the severity of the complications.
As medical practice shows, about 80% of patients successfully recover. The personal responsibility of the patient plays an important role in this, it is necessary to strictly follow the doctor's recommendations in order to be cured and avoid relapse.
Specialists pay special attention to the fact that it is impossible to cure the disease on their own. The longer a person decides to visit a doctor, the less likely they are to completely get rid of the disease. If untreated, mortality can reach 50%.
The situation becomes much more complicated if a person has concomitant serious diseases (HIV, diabetes).
The consequences of bronchial tuberculosis
It is possible to recover from tuberculosis. A person can return to a full life after going through a long stage of treatment and recovery. If the patient complies with all the recommendations of the attending physician and does not neglect the indicated examinations, then there will be no consequences from the disease.
Disease prevention
Preventive measures aimed at combating the spread of tuberculosis are carried out everywhere. Medical institutions recommend regular preventive examinations, in particular, fluorography, which allows you to determine if the patient has signs of the disease.
Another important method of prevention is vaccination, the effect of which actively begins a few months after administration. Studies have found that in vaccinated people the disease proceeds in the most mild form, or infection does not occur at all.
For risk groups, chemoprophylaxis is provided.
An important role in strengthening your own body is played by lifestyle, the presence of bad habits, as well as working conditions. For the prevention of tuberculosis, it is recommended to consider these aspects especially carefully and take the necessary measures.