Tuberculosis is a severe bacterial infection caused by a type of mycobacterium, Koch's bacillus. It spreads easily by airborne droplets when someone who has an illness in an open form coughs or sneezes. The disease affects the lungs as well as other parts of the body. Anyone can become infected with tuberculosis, but more often it occurs in people with a weakened immune system or poor health, in children, HIV patients, and people living in cramped conditions where the disease can spread easily. Without appropriate treatment, this disease is fatal. A person with an active form of tuberculosis infects 10 to 15 people per year. Every year, 9 million new cases of the disease are diagnosed worldwide.
Diagnosis of pulmonary tuberculosis should include a physical examination, chest x-ray, microbiological examination (sputum or other appropriate sample). It may also include a tuberculin test, a surgical biopsy, and some other examination methods.
Medical checkup
It is carried out to assess the general state of health of the patient and to detect factors that may affect the manifestation of a disease. Only with its help is it impossible to diagnose pulmonary tuberculosis.
Mantoux test
A tuberculin skin test, also known as a Mantoux test, helps identify most people infected with Koch's bacillus. The substance is a purified protein derivative (PPD), which is injected under the skin of the forearm and checked after 48-72 hours. If a red scar forms around the injection site, the person may be infected, but not necessary, so he needs additional diagnosis of tuberculosis.
Fluorography
An x-ray is one of the most effective and common methods. A lot of small vesicles appear in the lungs of a person with tuberculosis, which may indicate a possible disease. However, such anomalies can also occur in HIV-infected and other immunocompromised individuals. Nevertheless, a chest x-ray is used to exclude the possibility of a disease in a person with a positive reaction to a tuberculin test and in the absence of symptoms of the disease.
CT scan
In some cases, computed tomography (CT) and magnetic resonance imaging (MRI) have proven useful in imaging tuberculosis lesions, especially in the brain and spine. Computed tomography is therefore often used to detect extrapulmonary type of disease.
Microbiological research
This is the most commonly used diagnosis of tuberculosis, which was developed in 1880 and remains virtually unchanged. With its help, only half of the examined patients can be diagnosed, and this diagnostic method is especially ineffective for children and patients with HIV co-infection. Although it is often described as a simple technology, microscopy requires a high level of training and hard work.
Bronchoscopy
If there is no sputum, samples can be obtained using a laryngeal swab and bronchoalveolar lavage.
Biopsy
Some cases require a sample that cannot be provided by sputum or bronchoscopy. In these cases, a tissue biopsy of the suspected organ should be performed.
PCR
Diagnosis of tuberculosis through microbiological studies does not guarantee a one hundred percent result. This can only be done by PCR (polymerase chain reaction) - the latest research method that detects the pathogen based on its gene information. This method helps to reliably distinguish the Kosh stick from other mycobacteria.
In general, the whole complex of diagnostic measures is aimed at timely detection of the disease, in order to prevent the further spread of tuberculosis.