Tuberculosis (TB)
Tuberculosis (TB): Symptoms, Diagnosis, and Management
Tuberculosis (TB) is a chronic, infectious disease caused by the bacterium Mycobacterium tuberculosis, primarily affecting the lungs but potentially involving other organs. Below is a detailed overview of its key aspects, supported by current evidence.
Symptoms
Symptoms of active TB disease include:
- Persistent cough lasting more than three weeks.
- Chest pain or discomfort.
- Coughing up blood or mucus (sputum).
- Fatigue, weakness, or feeling unwell.
- Loss of appetite and unintentional weight loss.
- Fever, chills, and night sweats.
Latent TB: No symptoms; individuals are not contagious but can develop active TB if untreated.
Causes and Risk Factors
Primary Cause:
- Mycobacterium tuberculosis: Spread through inhalation of droplets containing the bacteria, often in crowded environments.
- HIV/AIDS: Significantly increases susceptibility to TB.
- Malnutrition: Impairs immune function.
- Poor living conditions: Overcrowding and poor ventilation facilitate transmission.
- Previous TB exposure: Increases risk of reactivation.
Diagnosis
Physical Examination:
- Lung auscultation: Listening for abnormal sounds.
- Lymph node examination: Checking for swelling.
TB Tests:
- Tuberculin skin test (TST): Measures immune response to TB proteins.
- Interferon-gamma release assay (IGRA): Blood test detecting immune response.
Imaging and Sputum Tests:
- Chest X-ray: Identifies lung abnormalities.
- Sputum smear and culture: Confirms active TB by detecting bacteria.
- Nucleic acid amplification tests (NAATs): Rapidly diagnose TB using sputum samples.
Treatment
Active TB:
- Antibiotic regimen: Typically involves isoniazid, rifampin, pyrazinamide, and ethambutol for at least 6 months.
- Drug-resistant TB: Requires specialized treatment regimens.
Latent TB:
- Isoniazid monotherapy or rifampin for 3–9 months to prevent progression to active TB.
Complications
- Extrapulmonary TB: Involves organs like the spine, kidneys, or brain, leading to specific symptoms (e.g., back pain, confusion).
- Drug resistance: Emergence of strains resistant to standard antibiotics complicates treatment.
- TB meningitis: A severe form affecting the brain and spinal cord.
Conclusion
TB is a treatable disease but requires early diagnosis and adherence to antibiotic regimens to prevent complications and transmission. Regular screening in high-risk populations is crucial for controlling TB globally.
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