Pulmonary tuberculosis is the most common type of tuberculosis. This infectious disease, which develops when the body is weak, has no biological strength to defend itself. This may be due to poor conditions or an unhygienic lifestyle - excessive work, stress, lack of sleep, stimulants. The most characteristic symptom of pulmonary tuberculosis is a chronic cough that lasts more than 3 weeks.

Pulmonary tuberculosisused to be a common disease - before the introduction of universal vaccination, people from all walks of society fell into consumption, despite the fact that it was called "the disease of poverty". Currently, in Poland, the most cases are recorded in the following voivodships: Lubelskie, Łódzkie, Mazowieckie, Świętokrzyskie and Śląskie. In the countryside, people get sick more often than in cities, and men who lead a more debilitating lifestyle twice as often as women.

It is known that children between 10 and 15 years of age, elderly, malnourished people (due to poverty or the constant use of slimming diets) and consuming little diversified meals, diabetics, ulcers, smokers, and the homeless are more often infected, as well as people who abuse alcohol and are addicted to drugs.

Risk of tuberculosis

Tuberculosis is an infectious disease caused by Gram-positive bacteriaMycobacterium tuberculosis , also known as bacilli or mycobacteria (also Koch bacilli - after their discoverer, Robert Koch, who eats first described in 1882).

Bacteria entering the lungs does not mean you get sick. Mycobacteria, which enter the alveoli, may die immediately under the influence of our immune system or remain alive, but not reproduce - and thus survive in our body for many years, without doing us any harm. However, once the bacteria enter the body, the risk of developing the disease is life-long. The greatest probability of developing the disease occurs in the first and second years of infection. The disease develops in about 10 percent. infected.

Tuberculosis infection

Infection occurs through droplets (through inhaled air), less frequently through the ingestion (eg milk from sick cows) or through touch. When mycobacteria are extremely viable (we were infected by a sick person at the peak stage of the disease), the body does not always cope with the invasion. Mycobacteria learnbecause they produce substances that protect them against the immune system.

Mycobacteria multiply and destroy successive parts of the lungs or get to other organs with the blood and destroy their cells.

Having got into the lungs, they penetrate into the cells that make up the alveoli. There they grow until their walls are torn apart. Damaged follicles calcify quickly, forming lumpy (hence the name tuberculosis) swellings and eventually die. This part of the lungs is no longer involved in breathing.

Tuberculosis: diagnosis

Compulsory free 35mm x-rays were an effective method of preventing tuberculosis. They were discontinued in the 1970s when it turned out that the devices emitted harmful radiation. Today I get a full-size x-ray of the lungs. When suspecting the so-called fresh infection (in patients who have not been vaccinated or have first contact with a tuberculosis patient) the x-ray is repeated after 1-3 months. When the X-ray image is inconclusive, the doctor will refer the patient to computed tomography or magnetic resonance imaging.

Other tests confirming tuberculosis:

  • Bronchoscopy

This is a lung probing, during which a sample of the secretion is taken and submitted for bacteriological examination under a microscope. This allows you to identify the presence of mycobacteria. During bronchoscopy, the doctor may also take a piece of lung tissue to determine if there are any bacterial outbreaks in them.

  • Tuberculin test

If redness appears 72 hours after the injection of live bacteria under the skin, the reaction is considered negative, i.e. we do not get sick. Sometimes, after six weeks, a 6-mm flat lump, which can be felt with a finger, forms in this area. This means that the injected bacteria activated the dormant ones in the body. The result is tuberculosis. Tuberculin test can also confirm lack of resistance to germs.

Tuberculosis early symptoms

The most characteristic symptom of tuberculosis (which always attacks the lungs first, but then can also spread to other organs) is a cough lasting more than three weeks - initially dry, then with expectoration of sputum. The cough gets worse over time. An infected person feels weak, constantly tired, and drowsy for no reason. He sweats at night, has a slightly elevated temperature, which rises significantly after a few weeks or months. Unjustified weight loss and chest pains (sometimes, especially in men over fifty, mistaken for coronary artery disease) should attract attention. A sign of infection may be delayed recovery from bronchitis or pneumonia. Only inin the acute stage of tuberculosis, the patient is spitting blood.

In 10 percent In cases, the disease develops without symptoms and is detected by chance, e.g. during periodic examinations. In some patients, flu-like symptoms disappear spontaneously (only prolonged enlargement of the lymph nodes remains). Self-healing may occur after a few months. Evidence of a history of tuberculosis are lung calcifications and the so-called recesses in the lymph nodes.

How to protect yourself from tuberculosis?

The greatest danger are the so-called mycobacterial patients, i.e. spreading tuberculosis germs in their saliva when coughing, sneezing, laughing and talking. Therefore, the most effective way to avoid contamination is to be careful when dealing with other people. If someone around us is coughing, move as far as possible or go to another room. If possible, ventilate the room.

Let's not buy dairy and meat in the bazaar, especially from unknown producers. Although tuberculosis in cattle has been brought under control in Poland, not all breeders submit their meat and milk for veterinary examination.

Tuberculosis treatment

In most cases, tuberculosis can be completely cured. It currently takes 6-9 months. However, a lot depends on when the patient reports to the doctor and whether he will follow all his recommendations.

Patients with mycobacteria must be isolated from the environment and remain in the hospital. After two weeks of taking the medication, they stop spreading the bacteria, but specialists believe they should stay in the hospital for another 4-6 weeks. Only after this time you can be treated at the clinic.

In the first phase of the disease, 3-4 anti-tuberculosis drugs and antibiotics are administered simultaneously, including rifampicin - RMP (note: RMP abolishes the effects of contraceptives, so they do not protect against pregnancy).

After taking the first dose of medication, many ailments pass. Nevertheless, we must not stop the treatment and change the doses, because when we feel worse again and start taking the same measures, they will not work anymore. Then it will be necessary to administer much stronger drugs.

Supporting pharmacological treatment

Nutrition is of great importance. You must eat a diet rich in high-protein foods, fresh fruit and vegetables, and whole grains. The meals should be high-calorie, because you have to make up for the lost kilos. In order to increase the body's immunity, after consultation with the doctor, the doses of vitamins C and A are increased and the dose of selenium and zinc is taken.

Many people think that garlic is great for fighting tuberculosis. It's a fact that it increases immunity, but let's also remember that it isnatural antibiotic and may weaken or enhance the effects of synthetic antibiotics. Therefore, the garlic treatment should be discussed with your doctor.

Mycobacteria of tuberculosis die in the sun and ultraviolet rays emitted by special lamps. You can use them after consulting your doctor. Patient rooms should be ventilated frequently.

Tuberculosis of other organs

In Poland 95 percent cases arepulmonary tuberculosis . But mycobacteria can also become active in the skin, respiratory system, genitourinary system, nervous system, or in bones, lymph nodes, joints, and the pericardium.

  • Tuberculosis of the urinary system (usually kidneys) - very dangerous, because it does not give any symptoms for a long time. The first is hematuria, pain when urinating, and a burning sensation in the urethra, but this means that the mycobacteria have attacked the entire system. The end of such an infection is death from kidney failure.
  • Tuberculosis of the lymph nodes - manifested by enlargement of the lymph nodes around the neck and above the collarbones. Untreated, it leads to the softening of the nodes and the formation of cracks in damaged skin, which, after healing, leave visible scars. A biopsy will help identify this form of the disease. If you don't get the antibiotic, the tuberculosis germs will spread rapidly throughout the body.
  • Tuberculosis of bones and joints - the patient develops the so-called compression fractures of injured lumbar and lower thoracic vertebrae (in children only thoracic). Often there is a hump on the back. Cold abscesses form around tuberculous foci, because they are not accompanied by swelling, pain, redness and high temperature characteristic of inflammation. Medications are sufficient for early diagnosis, later surgical treatment is required, sometimes even amputation (of a bone fragment or the entire limb).
  • Pericardial Tuberculosis - This starts with an elevated temperature and weight loss. Pains behind the breastbone, increased heart rate, shortness of breath and swelling of the legs and arms appear fairly quickly. Therefore, this form of tuberculosis is confused with a heart attack. If it is not recognized, it may end tragically after a few years.
  • Miliary tuberculosis - this is the most dangerous form of tuberculosis. Tuberculous foci in the organs take the shape of millet grains. As breathing may become arrested, the patient must be hospitalized.
Important

The microscopic mycobacteria (0.5 x 3 µm) resemble a cylinder. They have very dense, hard walls, hence their great resistance. That is why you often have to give several antibiotics, and even combine them with drugs that soften the walls of the bacteria. Then the antibiotics can get into theminteriors and destroy them.

With sufficient environmental humidity (e.g. in soil or dust) and in the absence of light, mycobacteria can survive for several years. However, they die quickly when exposed to sunlight, and at a temperature of 75 degrees Celsius, they are harmless after 10 seconds. They reproduce - compared to other bacteria - quite slowly. Breakdown occurs every 18-20 hours.

Tuberculosis vaccinations

in Poland, since 1955, all newborns and children in the age of 2.6 and 12 have been vaccinated against tuberculosis (BCG vaccine). Vaccination is repeated in those children who do not have a clear post-vaccination scar or whose tuberculin skin test was negative (i.e. there was no trace of the test).

Note!

Parents who employ elderly people (whether from relatives or strangers) to look after their children should ask for an X-ray of the lungs. Tuberculosis is a disease that can remain dormant for years, and young children are very susceptible to infection.

Free tuberculosis treatment

Since 1999, the reimbursement of medical expenses covers everyone, including the uninsured, ie the homeless and unregistered unemployed. Each case of active tuberculosis (when the patient has mycobacteria) must be reported by the doctor to the Central Register of Tuberculosis Patients at the Institute of Tuberculosis and Lung Diseases in Warsaw.

Important

We are 25 years away from the western countries in the fight against tuberculosis. Every year in Poland about 1,000 people die of this disease, although it is completely curable. In 2000, there were 12 thousand. new cases. it is twice as much as in the Czech Republic and Slovakia, two and a half times more than in Germany and as many as seven times more than in Sweden and Norway.

Category:

Infectious diseases