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Tuberculosis is a bacterial infectious disease that develops in 10% of people. infected. It is often detected accidentally. In Poland, most cases of its form are pulmonary tuberculosis. What are the symptoms of tuberculosis and how is it treated?

Tuberculosis ( Latintuberculosis, TB,tubercule bacillus ) , which was once called the disease of the poor, it can get any of us. However, the most vulnerable to its attack are:

  • children between 10 and 15 years old,
  • elderly people,
  • malnourished people (also due to frequent use of slimming diets),
  • people with diabetes,
  • people suffering from gastric and duodenal ulcers,
  • smokers,
  • alcohol abusers,
  • drug addicts.

Thoughtuberculosisseemed to be defeated, the number of new cases of the disease has been rising again for some time. And although it can be completely cured, about 1,000 people die of it in Poland each year. This is twice as much as in the Czech Republic and Slovakia and as much as seven times more than in Norway and Sweden. That's why you have to sound the alarm.

Worth reading: Tuberculosis vaccine versus coronavirus: A new way to prevent disease

Tuberculosis: causes

Tuberculosisis an infectious disease caused by gram-positive bacteria (Mycobacterium tuberculosis) called Koch bacilli or bacilli - after their discoverer, Robert Koch. They are very resistant to antibiotics, acids and alkalis. With sufficient humidity (no light) in the soil or dust, they can survive for several years. However, mycobacteria die under the influence of sunlight, and at a temperature of 75 ° C they become harmless after 10 seconds. They reproduce quite slowly - they divide every 18-20 hours.

Sources of tuberculosis infection

The greatest threat are the so-called mycobacterial patients, i.e. bacteria exhaling with air when coughing, sneezing, laughing and talking. Less commonly, the disease is spread by food or by touch. The source of infection is also milk from sick cows.

But being infected with tuberculosis bacteria is not synonymous with getting sick. The disease develops in about 10 percent. infected. However, once the bacteria enter the body, the risk of developing the disease is life-long, and athe largest is in the first and second years after infection.

Tuberculosis: are we in danger of an epidemic?

Tuberculosis: symptoms

The symptoms of tuberculosislargely depend on which organ is affected. In 10 percent In cases, the disease develops without symptoms and is detected at random. However, it is more common that whentuberculosisattacks, weakness, a feeling of constant fatigue and sleepiness appear.

Recurrent low-grade fever and night sweats are typical. But the most characteristic symptom of tuberculosis is a persistent cough - initially dry, then with expectoration of sputum (spitting blood occurs in the acute stage of the disease).

Weight loss, not related to diet or intensive exercise, and chest pains should also pay attention. Recovery from pneumonia may also be a sign of infection. Each of these symptoms should be a signal to visit the doctor.

Tuberculosis: types

  • primary - is asymptomatic. Some patients develop flu-like symptoms that go away on their own, but often have enlarged lymph nodes. Self-healing may occur after a few months. Evidence of a history of tuberculosis will be lung calcification visible on the X-ray;
  • miliary - is one of the most severe forms of the disease. It develops as a result of the spread of mycobacteria which, along with the blood, reach all organs. The name is related to the shape of tuberculous foci (nodules) that form in individual organs and resemble millet grains. It can start with a high fever, shortness of breath, and even respiratory failure, headaches, or be tricky - with low-grade fever and rapid weight loss. The sick person has to go to the hospital;
  • postprimary is the result of activation of mycobacteria that have survived in the body while dormant. As a rule, it affects the lungs, but it can also manifest itself in other organs: the respiratory system, the genitourinary system or the nervous system, as well as in the bones, joints and the pericardium;
  • extrapulmonary - affects 5 percent infected. Most often it affects the lymph nodes (painless enlargement), the urinary system (attacks the kidneys), bones and joints (this leads to the so-called compression fractures), the pericardium (frequent pains behind the sternum and weight loss), but it also happens that it takes the form of cutaneous tuberculosis .

In Poland 95 percent cases aretuberculosislung. But the disease can affect any organ, most often the urinary system, lymph nodes, bones and joints. The most popular types are:

Pulmonary tuberculosis

Tuberculosisof the lungs tothe most common form of tuberculosis. The most characteristic symptom is a cough lasting over three weeks - initially dry, then with sputum production, weakness, fatigue, drowsiness, night sweats, slightly increased temperature, unjustified weight loss and chest pain, in the acute stage of tuberculosis the patient spits 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.

Tuberculosis of the urinary system (usually kidney)

Tuberculosisof the urinary system is 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

Tuberculosisof lymph nodes is 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

In the case oftuberculosisof bones and joints, 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

TuberculosisPericardium 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

Tuberculosismiliary tuberculosis 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.

Genital tuberculosis

Tuberculosisof the reproductive organs concerns the vagina, vulva, fallopian tubes and the uterine mucosa - it can be asymptomatic and detected accidentally when diagnosing infertility. There may be symptoms suggestive of inflammation of the ovaries, such as pelvic pain, vaginal discharge, menstrual disorders, abnormal bleeding, and a postmenopausal period.

Nervous system tuberculosis

Tuberculosisof the nervous system is one of the most severe forms of tuberculosis, with a high mortality rate. We talk about it when pathogenic mycobacteria enter the brain and spinal cord, where they form subcortical or on the meninges inflammatory foci (rich foci) - nodules (hence the name). The most common form of this disease is tuberculous meningitis. Occasionally, intracranial tuberculomas and tuberculosis of the spinal cord develop.

Tuberculosis: research

If the doctor suspects tuberculosis infection, he or she orders appropriate tests:

  • x-ray of the lungs - if the X-ray image is inconclusive, the patient is directed to a computed tomography; if a fresh infection is suspected, the x-ray is repeated after 1-3 months,
  • bacteriological examination of sputum collected during bronchoscopy - the sample is examined under a microscope, which allows to determine the presence of Koch mycobacteria; during bronchoscopy, the doctor may also take a piece of lung tissue to determine if there is no tuberculosis granulation tissue formation,
  • tuberculin reaction - is performed to determine the body's allergic reaction to contact with live tuberculosis sticks: bacteria are introduced under the skin and the result is read after 72 hours - if only redness appears on the forearm, the result is considered negative ( there is no tuberculosis), when a 6-mm flat lump appears with a finger - this indicates tuberculosis - this reaction usually occurs 6 weeks after infection.
You must do it

Important for parents

If you employ elderly people to look after your children (whether they are family members or strangers), you should ask for an X-ray of the lungs.Tuberculosisis a disease that can remain dormant for years, and young children are especially susceptible to infection.

Compulsory vaccinations

They have been performed in Poland since 1955. All newborns and children (without a clear post-vaccination scar and with a negative tuberculin test) must be vaccinated again.2, 6 and 12 years of age.

Lung X-ray

Unfortunately, today prophylactic x-rays of the lungs are not performed free of charge. The test can be done for a fee, but without a clear need - not more often than every 2 years.

Tuberculosis: treatment

Tuberculosis therapy must last at least six months. Patients who develop mycobacteria stay in the hospital and are isolated from their surroundings. After 2 weeks, they stop spreading bacteria, but should stay in the hospital for 2-4 weeks. After that, the treatment can be continued at the clinic. In the period when the patient has mycobacteria, he or she is given 3 or 4 drugs at the same time. Most often it ishydrazide, streptomycin, rifampicin (RMP)andpyrazinamide . Treatment of tuberculosis is free of charge. Since 1999, reimbursement of treatment costs covers also all uninsured persons.

How to support tuberculosis treatment

Proper nutrition is of utmost importance in the treatment of tuberculosis. The best diet is a balanced diet rich in fresh fruit and vegetables, high-protein products, and whole grains. Meals should be high in calories to compensate for weight loss.

To increase the body's immunity, it is also recommended to consume increased doses of vitamin C and vitamin A as well as selenium and zinc. However, each vitamin treatment must be agreed with the doctor. The patient should stay outdoors as much as possible. Mycobacteria are very sensitive to ultraviolet radiation. Therefore, exposure to the sun or exposure to special lamps reduces the spread of the disease and speeds up healing.

Anna Jarosz A journalist who has been involved in popularizing he alth education for over 40 years. Winner of many competitions for journalists dealing with medicine and he alth. She received, among others The "Golden OTIS" Trust Award in the "Media and He alth" category, St. Kamil awarded on the occasion of the World Day of the Sick, twice the "Crystal Pen" in the national competition for journalists promoting he alth, and many awards and distinctions in competitions for the "Medical Journalist of the Year" organized by the Polish Association of Journalists for He alth.

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Infectious diseases