Many have heard of tuberculosis, but few are aware of the real danger of this formidable 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 occur in an asymptomatic form, and the absence of treatment leads to serious complications.
Summary of the disease
To date, the pathogenesis of tuberculosis has been fully studied. This is a dangerous and highly contagious disease caused by infectious pathogens from the genus Mycobacteria.
Several types of microorganisms are known to cause disease in humans. These include:
- human, occurs most often, it accounts for 92% of all recorded cases;
- bovine, leads to the disease much less often, they suffer from about 5%;
- intermediate, mainly distributed in South Africa, in Russia, the disease is detected in 3% of patients;
- murine and avian, occurs only in individuals with a history of immunodeficiency.
Few people know that the anatomy of tuberculosis is not limited to the respiratory system. The bacillus also affects:
- bones;
- gastrointestinal tract;
- genitourinary system;
- brain.
Regardless of localization, the disease is extremely dangerous and inevitably leads to death in the absence of treatment.
The disease has a long incubation period. The first symptoms may appear after 3 months - 1 year after the introduction of the infectious agent.
Statistics
Medical professionals around the world are seriously concerned about the rapid spread of the disease. Russia ranks 22nd in the list of countries.
Previously, the majority of those infected were people serving sentences in prisons. But since the beginning of the 90s, an outbreak of incidence began, and the bacillus began to spread en masse.
Every day new cases of tuberculosis were diagnosed among wealthy families, most of the cases were children.
In the organization of health care, 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, specialists have implemented a set of preventive measures that can help stabilize the situation a little and achieve a reduction in morbidity and mortality. These included:
- vaccination of newborns in the hospital;
- Tracking new infections through the Mantoux test (in children) and fluorography (in adults).
The tuberculosis bacillus is extremely resistant to environmental changes, therefore, for a long time it remains in a viable state in water, land, etc. If the basic rules of personal hygiene are not followed, the risk of getting sick is quite high.
Characteristic signs
The primary pathogenesis is based on the penetration of the pathogen bacillus into the body. Such people do not get sick right away; accordingly, there are no complaints.
With a weakened immune system, you may experience:
- a slight increase in body temperature;
- increased heart rate;
- heavy sweating at night;
- blush combined with unnatural pallor of the skin;
- weakness, dizziness;
- cough;
- separation of sputum with an admixture of blood.
Deterioration of the general condition occurs against the background of poisoning by microbial toxins. The larger the number, the more pronounced the symptoms.
The first signs of tuberculosis in patients with a strong immune system may be minor or even absent.
The most severe course and rapid progression is observed in people with health problems.
If the microorganism is affected:
- Bone tissue - severe pain in all joints and stiffness of movements are observed.
- Brain - there is nausea, vomiting, severe headache and muscle pain.
- Urinary system - the patient constantly feels an overflow of the bladder. In the later stages, the appearance of blood in the urine is noted.
- Gastrointestinal tract (GIT) - there is constant discomfort in the abdomen, nausea, scarlet streaks in the stool.
- Skin - on its surface are formed nodules filled with pus, 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 identify it, modern diagnostic methods are used.
Risk groups
It has long been proven by medicine that the pathogenesis of tuberculosis directly depends on the state of the body's defense system.
No one is safe from infection, but the highest risk group includes people:
- with HIV and AIDS;
- prisoners;
- suffering from various chronic diseases (ulcers of the digestive system, diabetes mellitus, etc.);
- having bad habits;
- younger age;
- Neglecting personal hygiene
- regularly in contact with the infected;
- during pregnancy;
- experiencing regular stress;
- lacking essential vitamins and minerals;
- living in ecologically unfavorable areas;
- from low-income families;
- without a specific place of residence.
With the activation of the pathological process, the pathogenesis of tuberculosis is characterized by increased infectivity.
Forms
The duration of treatment, the prognosis of the likelihood of infection of other people, depends on the type of infection. The following phases of tuberculosis are distinguished:
- Open. It is observed with lung damage. If the analysis of sputum confirmed the presence of pathogens in it, the person is contagious.
- Closed. With a negative result, the patient is not a carrier of the disease.
If the stick first entered the body, they talk about the primary form, in the opposite case, the secondary one.
In addition, the ailment may differ in the nature of the lesion:
- miliary;
- disseminated;
- infiltrative;
- limited;
- cheesy;
- fibrocavernous;
- tuberculous;
- cavernous;
- cirrhotic;
- tuberculous pleurisy.
The course of the disease in childhood and pregnancy
The etiology of tuberculosis indicates that people with a weak immune system are most susceptible to infection. Such a violation can 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 it is, the more likely the penetration of a malicious wand.
After infection, the disease proceeds exactly the same as in adults, but in a more severe form. It 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 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;
- severe destructive;
- disseminated.
Such pathogens easily overcome the placental barrier, leading to severe violations in the fetus.
After making an accurate diagnosis, the patient is under the control of a gynecologist and a TB doctor.
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.
Survey
After the first suspicious signs appear, patients rarely visit a doctor, but in vain. Not only tuberculosis, but also other terrible diseases can hide behind a mask of harmless fatigue.
Even a slight deterioration in well-being without signs of acute respiratory infections, but with elevated body temperature should be an occasion to visit a doctor.
An 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 to general tests (blood and urine) and other necessary studies, this may be:
- Fluorography. It is carried out once a year, starting from the age of 15. It allows to detect pulmonary tuberculosis and other pathologies of the respiratory system. Included in the list of compulsory examinations for employment, before leaving for the army, etc. If the result of fluorography is controversial, then an additional x-ray is taken.
- Mantoux test. Many mistakenly confuse it with vaccination. This is a special type of diagnosis of tuberculosis. It is carried out for all babies aged 1 year to 14-15 years, sometimes up to 17. A substance - tuberculin is introduced under the skin with a small needle. It contains the vital products of pathogenic sticks. After such contact, a “button” should appear. To evaluate the result, its diameter is measured.
- Enzyme-linked immunosorbent assay (ELISA). Allows you to determine the presence of a microorganism in the blood at the time of the study.
- Zill-Nielsen sputum analysis. It is carried out for all patients with prolonged cough. Sputum is stained with a special solution to determine the presence of pathogenic bacilli.
- Bacteriological sowing. It allows you to find out exactly which wand provoked the disease. Sowing ripens 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, they additionally carry out:
- X-ray
- MRI or CT of the affected area;
- Encephalogram, etc.
The pathogenesis of tuberculosis has very similar features with many other diseases, such as cancer, so it is not always possible to immediately suspect it.
Treatment
The selection of therapy mainly depends on the pathogenesis and clinic of tuberculosis. It is carried out under the supervision of TB doctors and takes a long period. In most cases, this is 2 years, slightly less often 3-4.
The choice of drug regimen depends on many factors. As a rule, the doctor makes this decision based on:
- patient condition;
- his age and gender;
- survey results, etc.
The main goals of treatment:
- make the patient non-infectious;
- stimulate the healing of damaged tissues;
- restore health.
A positive result can be achieved using the following drugs:
- Paraaminosalicylic acid.
- "Streptomycin".
- Kanamycin.
- "Rifampicin".
- Ftivazid.
- Pyrazinamide.
- Ethionamide.
Basically apply 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, so phthisiologists often prescribe a pathogenetic treatment for the natural process of tissue repair. This includes a range of activities to achieve good results. These include the reception:
- anti-inflammatory drugs;
- immunomodulators;
- enzymes;
- B vitamins;
- sorbents;
- preparations for the protection and restoration of 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, one cannot do without such methods. When lung damage is carried out:
- Lobectomy
- Resection.
- Bilobectomy
- Pulmonectomy
- Cavernectomy.
- Pneumothorax.
Given the pathogenesis of extrapulmonary tuberculosis , surgery can also be applied to it.
When complications from the infected gastrointestinal tract occur, a planned or emergency operation is prescribed to eliminate the consequences.
CNS tuberculosis is treated mainly with conservative drugs. If they do not help, proceed to the removal of pathological foci. These are very complex procedures that can lead to irreversible consequences.
Purulent skin granulomas can also be operated on.
The main purpose of such measures is to eliminate the consequences of the disease and, if possible, restore the functioning of the affected systems.
What to do in order not to get 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 and your loved ones:
- Vaccination. They make such a vaccine at the request of their parents, but do not refuse it. It allows you to develop a stable immunity in the baby against infection, which becomes the strongest after reaching 1 year. As a result, the child does not develop tuberculosis or tolerates it in a mild form.
- Regular examination. It allows you to identify the disease in the early stages, conduct effective treatment and prevent infection of a large number of individuals. This includes the Mantoux test and fluorography.
Some groups of patients are shown prophylactic chemotherapy courses, these are:
- Having weak immunity and chronic lung diseases, gastrointestinal tract, central nervous system.
- Living in the same room with the infected.
- Having changes in the airways against the background of tuberculosis.
- Children with poor Mantoux test results.
In addition to medical measures, there are a number of recommendations that can reduce the risk of developing the disease. To do this, you must:
- exercise regularly;
- eat healthy food;
- deal with addictions;
- wash hands thoroughly before eating and after visiting public places;
- limit contact with a sick person;
- it is good to sanitize the room in which the infected person is located;
- regularly take vitamins and drugs containing omega-3 polyunsaturated acids.
All TB doctors know one little secret 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 so the bacillus has practically no chance to penetrate the body.
Complications
The negative consequences of tuberculosis are noted on themselves by persons who addict to a visit to the doctor and neglect the diagnosis. A neglected form can threaten a person:
- heart and respiratory failure;
- bleeding from affected organs;
- the formation of ulcers, fistulas;
- impaired renal and hepatic function;
- the development of granulomas throughout the body;
- amyloidosis;
- pneumothorax;
- deterioration of motor function;
- paralysis;
- sepsis
- gangrene;
- necrosis;
- coma;
- fatal.
When complications occur, the prognosis of 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 can be manifested by a prolonged cough that cannot be 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 case of a transition to a neglected form, the risk of developing complications is inevitable, leading inevitably to painful death.