Miliary tuberculosis is a serious enough disease that is often confused with typhoid fever. The disease affects various systems of internal organs, ranging from the liver to the lungs. This form of tuberculosis is diagnosed in a small number of people.
Disease Description
Miliary tuberculosis of the lungs is an acute form of the disease, characterized by the appearance of lesions simultaneously in several organs. The acute and chronic stages of the pathology are distinguished. 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. Amid extensive infection, the membranes of the brain are seriously affected.
The main causative agent of the disease are mycobacterium tuberculosis, which as a result of weakening the body's defenses penetrate the body in large quantities. Subsequently, they spread along with the blood stream.
According to experts, three men with tuberculosis account for only one woman with a similar diagnosis. Most often, pathology is diagnosed among representatives of the stronger sex, whose age varies from 20 to 40 years.
Miliary tuberculosis is considered a socially determined disease, since its prevalence in the population is determined by living conditions. Epidemic troubles are explained by active migration flows, a drop in the level of material capabilities, and an increase in the number of socially unadapted people.
Causes of the disease
The causative agents of tuberculosis are bacteria of the genus Mycobacterium. In total there are more than 70 species. They are common in water, soil, air, animals. Of particular concern to humans are only a few species that scientists conventionally 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.
The group at increased risk of developing this disease includes children who have not been vaccinated in a timely manner, people with immunodeficiency or who have been taking medications for a long time to suppress excessive activity of the body's defenses.
What signs help to recognize miliary tuberculosis?
Symptoms of this disease are not specific, they depend on the area of localization of the lesion. Common symptoms that patients usually complain about include the following:
- Weakness in the body.
- Fever.
- Temperature rise.
- Pronounced intoxication.
- Weight loss.
- Trouble breathing.
- Cyanosis of the skin.
- Excessive sweating at night.
- Dry cough.
The disease can occur in acute, chronic or acute form. Each of them has its own characteristics.
The chronic form proceeds undulating. This means that the acute phase is replaced by remission. Patients seek help from a doctor with complaints of reduced ability to work, a sharp decrease in body weight, and rapid fatigue. In some cases, hemoptysis is present.
Acute miliary tuberculosis usually proceeds in a severe form, 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 a low-grade fever and a dry cough are recorded.
The most acute form of the disease is otherwise called tuberculous sepsis. It is characterized by a rapid course. 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 of severe 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.
- Meningial. It is characterized by the presence of infectious foci in the meninges.
Establishing diagnosis
In case of unreasonable weight loss, night sweats, sensations of weakness and loss of appetite, it is recommended to seek the advice of a specialized specialist, namely a TB doctor or infectious disease specialist.
Diagnosis of miliary tuberculosis includes the following procedures:
- Complete blood count.
- Lumbar puncture.
- CT scan of the brain and chest.
- Ultrasound of the systems of internal organs.
- Chest x-ray.
- Echocardiography.
Based on the test results, the doctor can confirm or refute the diagnosis of miliary tuberculosis. Symptoms that characterize the condition of a person do not allow us to say 100% about the presence of the disease. Only instrumental diagnostics can help establish the final diagnosis.
What treatment is required?
The treatment of this disease requires a lot of effort and time. Almost the whole year, the patient is forced to take several medications. Usually prescribed Streptomycin, Isoniazid, Rifampicin, Moxifloxacin. Doctors explain this variety of medicines by the fact that each drug individually has a certain effect on the course of treatment, and in the aggregate 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 mode 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.
Surgery
Many patients with this disease are prescribed surgery, which involves excision of a part of the lung. Resection is recommended for cicatricial structures of the bronchi, patients with hemoptysis.
Perhaps the use of other methods of treatment, including combined. In especially serious cases, the removal of part of the lung or the entire organ, the application of artificial pneumothorax, and also the drainage of the cavity are usually recommended.
Forecast
Of course, the treatment of miliary tuberculosis using chemotherapy is an important stage in the fight against the disease. Before they began to actively use anti-TB drugs, the mortality rate of patients with this diagnosis was almost 100%. Timely and competent therapy today can reduce these indicators to 10%. The earlier a diagnosis is made and appropriate treatment is started, the higher the chances of a favorable prognosis. Most fatal cases with this disease are recorded in the first few weeks of patients being in a medical facility. Experts explain such sad statistics by the late start of therapy.
The probability of relapse is only 4%. If the patient follows all the doctor’s prescriptions and strictly takes the prescribed medications, the chances of re-infection are significantly reduced.
Disease complications
In the absence of timely treatment, the following complications may develop: the formation of multiple caverns in the lungs, bronchogenic dissemination, caseous pneumonia.
Preventative measures
Miliary tuberculosis is usually diagnosed in certain social strata (people with low material incomes, migrants, etc.). Men get sick several times more often and more intensively than women. At risk are people aged 20 and up to about 39 years.
Prevention of this pathology primarily implies the complete exclusion of close contact with people with signs of pulmonary diseases. It is equally important to ensure 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 exercise, starvation, work in adverse conditions.
The state should take 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 physical examination when they go to work.
Conclusion
In this article, we talked about what constitutes a disease such as miliary tuberculosis. Photos of patients with such a diagnosis can be found in specialized medical guides. This disease is diagnosed today less and less, and cases of fatal outcome are recorded less and less. Doctors warn that the timely detection of the disease helps minimize the likelihood of complications, including death.