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Tuberculosis

Pulmonary Tuberculosis (TB) is a potentially widespread and dangerous infectious disease that is seen throughout the world.

Tuberculosis is caused by Mycobacterium tuberculosis and in some cases it can even be lethal. This condition can lead to difficulty with the Respiratory System and in many cases, it attacks the Lungs.

TB can also affect the Nervous System, the lymphatic system, the Circulatory System, the Digestive System, Bones, Joints, skin, and others.

TB affects more than 20% of the world’s population. But more than 1/3 of the population has been affected at some point. Approximately 3 million people worldwide die each year from TB.

Some estimates state that 15 million + individuals currently have TB in the United States. Tuberculosis is seen more in the under-served, homeless, overcrowded and immunocompromised individuals.

Properly treated TB can have great outcomes

Transmission

1.)  Transmission occurs by “airborne droplets” when an infected individual coughs.

2.)  It can also be passed by spitting, sneezing, when speaking, and singing.

3.)  Transmission should occur only during active or Primary TB.

Two Main Categories

1.)   Primary Tuberculosis is when the infection is in full force and symptoms are at their worst.

–  This can also be termed Active TB

2.)  Latent Tuberculosis is when the disease is not active but hiding.

–  During this time you can not typically infect someone else.

  –  Reactivation from Latent to Primary can occur at any time – but usually does so in about 10% of individuals

–  Patients with HIV find that reactivation is much more common.

Symptoms

–  Fatigue
–  Cough
–  Weight loss
–  Night sweats
–  Coughing blood (Hemoptysis)
–  Cough
–  Breathing difficulty
–  Loss of Appetite

Risk Factors

1.)  Tuberculosis is closely linked to both Overcrowding
2.)  Also Linked to Malnutrition
3.)  Manifest largely as a Disease of Poverty
4.)  Huge increase in Risk with History of HIV
5.)  Excess Alcohol use
6.)  Increased risk with history of Diabetes

Diagnosis

–  Lab sputum analysis is essential
–  Three consecutive morning specimens are required
–  Bronchoscopy and X-ray are important

Tuberculin skin test

–  A skin test with a positive result for someone previously or currently infected with TB
–  The test will be positive if you currently have it or have had it in the past
–  There have been some, especially outside of the United States, that have been vaccinated for TB and will have a positive result.
–  The Mantoux test places a small amount of a protein just under the skin.
–  After 48-72 hours the site of injection is looked at for changes or redness.

Treatment

Medication Options Available

  –  Isoniazid
  –  Rifampin
  –  Pyrazinamide
  –  Ethambutol
  –  Steptomycin

*** Typical regimen course lasts 6-9 months and involves multiple drugs

Hospitalization is rare

If an individual is HIV-positive than complications and concerns can arise

1.)  You should contact an Expert to help

2.)  Typically longer treatment is required

Potential Treatment Complications

1.)  Some cases of resistant TB do exist and longer treatment may be an option.

2.)  Since multiple drugs are used and it can be difficult to find which drug has the resistance.