Infiltrative form of tuberculosis. Public health measures
Determining the activity of the tuberculosis process has become especially great importance on modern stage phthisiology. Due to widespread use mass fluorographic examinations reveal a significant number of people who are found to have anatomical changes in lung tissue in the absence of severe intoxication or other clinical manifestations. In such cases, it is necessary to resolve the issue of clinical activity such changes, since sometimes there is an asymptomatic course of tuberculosis, which at a certain stage can only manifest itself as morphological changes. Establishing activity (or, more precisely, inactivity) is also necessary when the process subsides, when, as a result of the treatment, the X-ray picture indicates the transition of the process to the compaction phase, the symptoms of intoxication disappear, and the dispensary doctor has to decide on the onset of a clinical cure.
The greatest difficulties in determining activity are encountered in identifying the so-called minor forms of tuberculosis, which are characterized by low prevalence (within 1-2 segments), lack of decay and, in most cases, low symptoms. The diagnostic difficulties that arise in this case are partly due to the lack of clarity of the very concept of tuberculosis activity and the lack of unity of views on this issue. F. A. Mikhailov (1971) believes that anyone should be considered active tuberculosis process, in which the tendency to progression of the disease persists to any extent and is reflected in the functional state of the body and clinical manifestations defeats. It is usually considered active to be a dynamic process, capable of evolution and progression, which requires constant dispensary observation(according to the corresponding accounting group) and complex treatment. However, in practice, the idea of tuberculosis activity does not always fully fit into such formulations.
When solving this issue, two types of errors are observed. Sometimes due to the lack of pronounced clinical symptoms the doctor can view the initial phase of the disease, which, as a result, is not treated in a timely manner and is correctly assessed only at a later stage, when the results of therapy may be less effective. And vice versa, often a carrier of old quiescent pulmonary changes is mistakenly diagnosed with an active form of tuberculosis and subjected to treatment, sometimes quite long, by being sent to a hospital. Such unjustified separation from family and work has a negative psychological impact.
For correct definition process activity it is recommended to use all available methods studies - clinical, radiological, laboratory, as well as trial treatment with chemotherapy drugs. The most reliable signs of activity are the detection of mycobacteria and the establishment of the dynamics of specific changes during repeated x-ray examination. However, in small forms, obtaining reliable signs requires a long time - mycobacterium tuberculosis in these cases can be detected only after several weeks as a result of culture, and to establish radiological dynamics it is necessary to carry out trial treatment for several months. In this regard, it is important to identify other signs, the combination of which also has a certain meaning.
Data clinical observation. Clinical symptoms in minor forms of tuberculosis they are usually mild and not specific. Low-grade fever is often observed, increased fatigue, weight loss, loss of appetite and other intoxication phenomena. Sometimes there is a cough with sputum production, and scanty moist rales are heard. There are also changes in the blood ( slight increase ESR, increase in the number of leukocytes and the percentage of band neutrophils). However, the mentioned symptoms may become significant in the simultaneous presence of specific changes on the radiograph and tomograms.
X-ray examination. Along with ordinary photographs, it is also recommended to make tomograms, which sometimes reveal decay, even in minor forms of tuberculosis.
M.A. Ginzburg (1977) offers the following classification of radiological signs of tuberculosis activity:
- 1) direct signs indicating the obvious activity of the process can be established with a single study: unclear contours of the lesion, decay, lymphangitis, pleurisy;
- 2) indirect signs of activity: polymorphism of foci, large encysted round foci, “path” to the root, paired stripes of compacted walls of the draining bronchus;
- 3) undoubted signs of activity, established when dynamic observation and expressed in change X-ray picture in a retrospective analysis of fluorograms and radiographs and in a short trial therapy.
Of decisive importance is the detection of dynamics during repeated x-ray examination. Practice confirms the possibility of establishing activity by comparing x-rays and fluorograms produced in the past during mass examinations. In this case, two options are possible. In some cases, there are no pathological shadows on last year’s fluorogram, which indicates the activity and relative freshness of the changes detected in the image. Sometimes pathological changes are also noted on the previous fluorogram, but comparison with the image allows us to identify dynamics in the form of progression (increase in the number or size of lesions) or, conversely, involution (resorption) of lesions.
X-ray dynamics are very expressive with a sufficiently long trial antibacterial treatment. It is expressed in the resorption of the infiltrate, a decrease in the size of the lesions, their fragmentation, and the disappearance of lymphangitis. The stability of the X-ray picture speaks in favor of the inactivity of changes, but the absence of dynamics convincingly indicates the inactivity of the process only with normal clinical and laboratory parameters.
Detection of Mycobacterium tuberculosis is one of the most reliable signs process activity. To search for them, you should use all available methods - bacterioscopy, flotation, sowing. In minor forms of tuberculosis, mycobacteria can be found using conventional research methods only in rare cases, much more often with repeated cultures of sputum or lavage water of the trachea and bronchi. In most cases, the discovery of mycobacteria during these processes is one-time, but this is enough to confirm the activity of the process (taking into account other manifestations).
Specific reactivity. When determining activity, tuberculin tests are of auxiliary importance. It is noteworthy to establish the variation of the tuberculin reaction in individuals young, as well as hyperergic sensitivity.
Subcutaneous tissue plays a more significant role tuberculin reaction(Koch test). Before performing the Koch test, it is recommended to establish the sensitivity of the subject, which is determined by the concentration of injected tuberculin and is carried out using a graduated skin test. For subcutaneous test the following doses are recommended: for normergy - 20 TE, for hyperergy - 10 TE, and for hypergia, a more significant dose can be used - up to 100 TE. Local reaction It matters only when the infiltrate size is greater than 20 mm. The appearance of tuberculosis after 24 and 48 hours speaks in favor of the activity of tuberculosis general reaction(increase in body temperature, bad feeling, accelerated ESR, change in hemogram, increase in the number of neutrophils and band cells, decrease in the number of lymphocytes). Currently, a focal reaction (the appearance of cough and sputum, chest pain, wheezing) is rarely observed. The presence of a general or focal reaction with high probability indicates the activity of the process and is a sufficient basis for prescribing a trial treatment. The Koch test is recommended to be used before starting chemotherapy, which may distort the test result.
Immunological tests. Research by M. M. Averbakh, A. E. Rabukhin and others (1977) proved the possibility of combined use of subcutaneous administration of tuberculin and delayed-type hypersensitivity tests in vitro to detect latent activity of tuberculosis. After determining the immunological parameters, the patient is injected with tuberculin (20 TU PPD-L) under the skin, and after 48 hours the test is repeated. For this purpose, 2 delayed-type hypersensitivity tests are used in vivo- the reaction of blast transformation of lymphocytes and the reaction of inhibition of leukocyte migration from capillaries. According to the mentioned authors, with the help of the blast transformation reaction of lymphocytes in combination with a subcutaneous injection of tuberculin, it is possible to detect latent activity in 79.5%, and with the help of the reaction of inhibition of leukocyte migration from capillaries in combination with subcutaneous injection tuberculin can reveal the hidden activity of the process in 92.3% of cases. Tuberculin provocation tests can provide significant assistance in solving important clinical problem- identifying the hidden activity of the tuberculosis process without the use of trial treatment.
Trial treatment. In cases where all of the above methods do not provide an accurate answer to the question about the activity of the tuberculosis process, they resort to a trial course of chemotherapy. If during the trial treatment no positive x-ray changes or other signs indicating improvement are observed, then tuberculosis activity is excluded.
The most valuable drug for trial treatment is isoniazid. It is recommended to carry out trial treatment on an outpatient basis under the supervision of a dispensary. But if necessary, use more complex methods research or if there is a suspicion that the subject is taking medications carelessly, as well as when poor tolerance, old age, the presence of concomitant diseases, as well as if the patient lives in a hostel or has close contact with children, it is necessary to place him in a hospital at the dispensary (until the results of culture for mycobacteria are received, i.e. for an average period up to 3 months). At this time, the subject must be in the zero registration group, and then, depending on the results of the trial treatment, transferred to group I or VIIB or deregistered. Sometimes, during the first month of trial treatment, symptoms of intoxication and physical manifestations of the local process (cough, sputum, wheezing) do not disappear, and examination of sputum or rinsing water for nonspecific flora reveals positive result. In these cases, drugs that affect the flora are recommended, and positive effect after 1-2 weeks of such treatment indicates the nonspecific nature of the changes in the lungs.
Tuberculosis is considered one of the most common diseases of mankind. In many countries, its scale has long reached the epidemic threshold and, unfortunately, is not decreasing, despite active preventive work.
The risk of “picking up” a dangerous bacteria exists even in seemingly familiar and harmless conditions - on the way to work and home, in a store and other public places.
No one can guarantee that a healthy person will not be surrounded by a person suffering from tuberculosis. Although there is no need to panic - not all forms are dangerous to others.
Doctors divided tuberculosis into categories:
All these diseases can exist in the human body without showing themselves for years, or they can develop at lightning speed, also affecting others.
Disease activityDepending on whether the patient secretes mycobacteria, as well as on the intensity of the manifestations of the disease, I diagnose the following forms:
It is the ability to release a dangerous bacillus into the environment through a cough that makes a person with tuberculosis dangerous to others, or an active carrier.
This applies not only to pulmonary forms; tuberculosis of the genitourinary system, skin and lymph nodes, and fistulous forms of bone tuberculosis are also particularly contagious. But the main route of infection is still aerogenic.
The state of the immune system is of great importance - after all, it determines whether a person who has been in contact with a sick person will get sick. The mechanism of development of active and passive forms of the disease is almost the same; the main difference is the individual perception of infection by the body.
Before symptoms appear, the disease goes through several stages:
Since most people have a fairly strong immune system, at stage 3 high resistance is formed, which makes it possible to stop the development of the disease. The number of bacteria in the body decreases and reproduction stops. The tuberculin skin test remains positive. In the primary foci of infection, minimal residual manifestations may remain, which can be associated with fairly high natural resistance and mass BCG vaccination.
In this case, the bacteria preserved in the outbreak act as a tuberculosis antigen necessary to maintain specific immunity. Such a person does not pose a danger to others in terms of infection, since he is not an “excretor,” that is, we are talking about a passive form of tuberculosis.
However, at the same time, this situation creates a risk for reactivation of tuberculosis under certain conditions, so regular fluorographic examination and monitoring by a doctor is necessary.
In some cases, phase 3 of the disease develops differently. With a negative modification of the development of the disease, the body’s immune response is not strong enough. Most often this happens in:
If protective forces the body is not able to implement effective protection, then the initial focus increases, which means that the activity of tuberculosis is high. Under such circumstances, an active form of tuberculosis is diagnosed. The patient acts as a “bacteria excretor” and creates a risk of infection, therefore he needs isolation and a course of treatment.
Differentiation of two formsAs a result of clinical trials It has been established that a fairly specific picture is observed a couple of weeks after the formation of an area of inflammation in the body. Active and inactive forms have a lot of differences in manifestations, diagnostic results, and treatment.
Clinical pictureSymptoms of the disease in initial period may be different and depend on the intensity of the primary damage to the lung tissue, its extent and associated complications.
Tuberculosis is often found by chance during mass screening fluorography, although detailed analysis Anamnesis reveals that symptoms were still present, but patients attribute them to overwork or a cold.
Depending on whether the patient develops an active or passive form of tuberculosis, their symptoms also differ:
X-ray examination plays an important role in diagnosing the active form of the disease. The photographs reveal dark spots in the lungs, a path of inflamed lymphatic duct with darkening of dilated lymph nodes at the roots of the lungs.
But a significant drawback is the fact that thanks to mass X-ray examinations, most cases can be detected only 1–3 years after the onset of the disease. In other words, pathological changes are detected only after the implementation of its “black role” in the spread of Koch’s bacillus in the population.
Treatment and complicationsTreatment active phase tuberculosis is aimed at stopping the release of mycobacteria and healing the affected areas with maximum restoration of organ function and involves several components:
With properly selected therapy, rapid regression of symptoms occurs. However, the scarring process in the lungs and lymph nodes occurs slowly, so even if symptoms disappear, this course of treatment should last at least 6 months.
Calcium salts are deposited at the site of the lesion, forming the so-called.
Small calcifications also remain in the lymph nodes of the roots of the lungs. Such changes remain for life and do not harm health. But tuberculosis bacteria can persist in them, activating under favorable conditions.
If treatment is not thorough enough, areas of necrosis remain, which are a source of intoxication and chronicity of the process. Some complications can be life-threatening:
Inactive tuberculosis requires regular monitoring and general strengthening measures to maintain the immune system and prevent reactive infection.
Vladislav
Experienced breathing problems. I don’t know how to correctly describe this state, but in my own words, it feels like I can’t breathe full breasts(there is no feeling of saturation with air, as if I want to yawn, but I can’t).
Against this background, I went and had a fluorography done. Fluorography conclusion:
“In the projection of the C1-2 segments on the left, a group of medium-density foci can be seen. There is also a moderate vascular deformation.
For the rest of the length, the pulmonary fields are transparent, the pulmonary pattern is not changed. The roots are structural, not expanded.
The median shadow is of normal configuration, not expanded, not displaced.
The diaphragm is located usually, with a clear, even contour. Sinuses are free.
It is recommended to compare with previous studies, consult a phthisiologist, and, if indicated, conduct an MSCT examination."
Immediately, out of fear, I did MSCT. MSCT conclusion:
"On a series of CT scans of organs chest the airiness of both lungs is preserved. The trachea, main, lobar and segmental bronchi are passable, the lumen is not narrowed, the walls are not thickened. The pulmonary pattern is somewhat strengthened, deformed in S1-2 on the left due to the zone of fibrous changes in the peribronchial, subpleural location, minimally dilated bronchi (like bronchiectasis), with single calcifications up to 3 mm in diameter. There are moderate pleuroapical adhesions in the apical parts of the lungs. Lymphatic nodes of the mediastinum are of acceptable size. The pleural layers are not thickened, fluid in pleural cavities and there is no pericardial cavity. Heart in the crossbar normal sizes, the main vessels are not changed.
Conclusion: Post-inflammatory changes in S1-2 on the left are more likely of a specific nature."
With all this in mind, I went to the PTD at my place of residence. Where did I get a Diaskintest, which turned out to be positive, 20 mm papule.
Against this background, I was prescribed test therapy for two months, eremphat + pyrazinamide + isoniazid. With subsequent CT scan.
I also tested sputum, including GeneXpert, but it contained more drool than sputum, because... she doesn't stand out. Everything is negative.
I also took a general blood test and biochemistry, everything was normal, only minor changes in the leukemia. formula. I also handed over blood PCR for tuberculosis, it is also negative.
Now, after a month of treatment, I began to cough intermittently, it felt as if my throat was tickling and I wanted to cough, for which I was prescribed to wash my nose, isofra and lysobact (it didn’t seem to help much in 3 days). Every day in the late afternoon the temperature rises to 36.9, on average a little more. And there is a burning sensation on the skin of the back and, in general, on the whole body, strange tingling sensations.
What is the probability that it is still tuberculosis? What does “Post-inflammatory changes in S1-2 on the left are more likely of a specific nature” mean? Can tuberculosis progress during treatment? Considering that the CT scan was done in September, how much could its picture have changed before today?
The question is closed
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Good afternoon. What makes you think that it’s worse for you? According to MRI, there are signs of an infiltrative process in the lungs and pleurisy suffered previously. But there is also bronchiectasis; this pulmonary pathology is not associated with tuberculosis. Flow pulmonary process according to the type of asthmatic or chronic obstructive process - this is the process - exacerbation - that most likely causes your "coughing". The MRI can be repeated after three months - just right. Positive dynamics will be visible. Yes, temperature 36.9 is normal. A cough and muscle pain may also be associated with a viral infection that is currently circulating. Get well.
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Pediatrician, Allergist-Immunologist, Therapist
Hello, specific character, means tuberculosis or other etiology, characteristic. maybe if treatment does not help or there is resistance to antibiotics or an open resistant form. Also get tested for herpes viruses and atypical microorganisms. If all cultures are negative for tuberculosis, look for other organisms. Blood ELISA for EBV CMV HSV Toxoplasma mycoplasma and respiratory chlamydia.
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Gynecologist, Mammologist, Obstetrician
Hello!
All these diagnoses are presumptive in any case you received from tuberculosis good treatment the rest could be the result of an infection in the lungs, so today you just need to monitor your immunity good drug which helps get rid of cough - non-tuberculosis cough. - try the immunostimulant ismigen, it may help you!
Be healthy!
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Therapist
Hello. When they write non-specific, it means oncology or suspicion; if specific, it means any bacterial, tuberculosis, or viral infection. Your results are negative, but the Diaskin test is positive; therefore, according to the standard, you should receive treatment, so the doctor prescribed treatment for you, your treatment is good, there is no need to worry. After treatment, check again and everything will be fine.
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Tatyana, I am more worried about the cough that has appeared and the temperature, which, as I understand it, is quite normal. But before, it was always 36.6. AND strange sensations tingling and burning in the body, I don’t really understand what it is.Well, I’m worried that suddenly it’s all active tuberculosis, and it’s resistant to treatment.
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Orthopedist, Traumatologist
What is the probability that it is still tuberculosis? - There was tuberculosis, but it is not there now, although you will be infected all your life. This is also indicated by the CT report.
Can tuberculosis progress during treatment? He can progress whenever he wants, but now you have no progress data. With active tuberculosis, the picture may change in one direction or another over such a period of time. For you it will not change in any way and will remain the same.
The drugs prescribed to you are very toxic. They may tingle and itch.
Stop with this treatment already...
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Neurologist, Psychologist
Good evening, Vladislav. According to the described CT picture, you have previously suffered from tuberculosis, and for a long time, this is indicated by changes in the form of calcifications (an old lesion). This is what the phrase means - post-inflammatory changes of a specific nature. You were prescribed adequate treatment, so tuberculosis cannot progress during treatment, and there is no evidence of progression. Sputum is normal, blood is normal, PCR is normal. Now about Diaskin... Your CT scan revealed changes like bronchiectasis, which can also cause cough and fever, and this does not mean at all that these are manifestations of tuberculosis. And Diaskin shows those people who are suspected of being infected with tuberculosis or who are suffering from it. Also, Diaskintest requires special conditions carrying out. It should not be used: for acute and exacerbation chronic diseases, after a recent exacerbation of allergies, with skin diseases. Therefore, if at the time of taking Diaskin you had an exacerbation, for example chronic bronchitis or bronchiectasis, then Diaskin could give false positive result. Almost 3 months have already passed since the last CT scan, we can already do a repeat one, but it seems to me that the picture will not change, since, again, there are recent changes in lung tissue it wasn’t in September, that’s all already happened before carried over changes, perhaps years ago. I wish you good health and all the best.
Active tuberculosis is the secondary type complex illness, which has been known for a very long time. It begins to develop in the presence of bacteria and can be transmitted from person to person through the air. The lungs are affected, but further illness harms the entire body.
Infected patients may be virus carriers. But research has revealed that only one in 10 such patients suffers from the development of a secondary infection. This is what is called the active form. It develops over a long period of time if the immune system is weakened.
What are the differences between active and inactive forms of tuberculosis?
- from one person to another, through bacterial excretion;
- through airborne droplets;
- when sneezing or coughing.
The possibility of developing an infection increases as the patient develops HIV. In this case, the immune system deteriorates and the body lacks resistance to the bacteria that have entered it. Tuberculosis begins to progress.
How is the disease treated?
Medicines are prescribed after the examination; there can be several types. The duration of treatment is usually long. It is necessary to choose products that belong to the group of antibiotics. They must completely destroy the infection.
The state of human immunity plays a major role in the development of tuberculosis bacteria.
If it is strong, then the infection that enters the body will not be able to develop and will die. In this case, the person will not get sick. Doctors classify two forms of tuberculosis.
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- Congratulations! The likelihood that you will develop tuberculosis is close to zero.
But don’t forget to also take care of your body and undergo regular medical examinations and you won’t be afraid of any disease!
We also recommend that you read the article on. - There is reason to think.
It is impossible to say with certainty that you have tuberculosis, but there is such a possibility; if it is not Koch bacilli, then there is clearly something wrong with your health. We recommend that you undergo a medical examination immediately. We also recommend that you read the article on identifying tuberculosis on early stages.
- Contact a specialist urgently!
The likelihood that you are affected by Koch bacilli is very high, but it is not possible to make a diagnosis remotely. You should immediately contact a qualified specialist and undergo a medical examination! We also strongly recommend that you read the article on identifying tuberculosis in the early stages.
Task 1 of 17
1 .Does your lifestyle involve heavy physical activity?
Task 2 of 17
2 .How often do you take a tuberculosis test (eg Mantoux)?
Task 3 of 17
3 .Do you carefully observe personal hygiene (shower, hands before eating and after walking, etc.)?
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4 .Do you take care of your immunity?
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5 .Have any of your relatives or family members had tuberculosis?
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6 .Do you live or work in an unfavorable environment (gas, smoke, chemical emissions from enterprises)?
Task 7 of 17
7 .How often are you in damp, dusty or moldy environments?
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8 .How old are you?
Task 9 of 17
9 .What gender are you?
Task 10 of 17
10 .Have you recently experienced a feeling severe fatigue for no particular reason?
Task 11 of 17
11 .Have you been feeling physically or mentally unwell lately?
Task 12 of 17
12 .Have you noticed a weak appetite lately?
Task 13 of 17
13 .Have you been watching yourself lately? a sharp decline with a healthy, plentiful diet?
Task 14 of 17
14 .Have you recently felt an increase in body temperature? long time?
Task 15 of 17
15 .Are you having trouble sleeping lately?
Task 16 of 17
16 .Have you noticed yourself lately? increased sweating?
Task 17 of 17
17 .Have you noticed yourself looking unhealthy lately?
Experts identify active or latent forms of tuberculosis.
Characteristics latent form diseases:- no symptoms of the disease appear;
- the virus in the body is in a state of sleep;
- there is a real danger of developing the disease in the presence of favorable conditions.
It follows from this that the patient carries the virus and can infect others, but does not himself suffer from the development of tuberculosis. Many people do not even realize that there is a very dangerous disease in their body. According to doctors, a third of the entire population are carriers of the tuberculosis virus.
With the development of an active form of tuberculosis, the patient develops characteristic features:
The timing of the onset of active tuberculosis varies from patient to patient. It may take months or years, but symptoms will begin to become noticeable within a few weeks.
The form of tuberculosis does not depend on the patient’s age or place of residence. Of course, young patients or older people may find it more difficult to tolerate this disease. The lungs are immediately affected, and only then the disease affects many other parts of the body.
What is active tuberculosis? When an infection enters the body, an inflammatory process begins. Initially, characteristic granulomas occur, which contribute to the formation of tubercles. They may fall apart. It is necessary to find out the location of the source of infection.
Active pulmonary tuberculosis is transmitted in several ways:
- through the air, through saliva. A healthy person inhales it, and the bacteria settle in the body;
- entry into the body through the digestive organs;
- when touching a sick person. The infection can enter through the conjunctiva of the eye in a small child or adult;
- if the expectant mother suffers from tuberculosis and the placenta is infected, unborn child becomes infected in the womb.
The human respiratory system is protected by mucus, which can glue together bacteria that have penetrated it. But, if the patient suffers from chronic bronchitis or tracheitis, the possibility of infection increases significantly.
The movement of harmful microorganisms through the digestive system and their absorption into the body occurs quickly in the presence of damage to the intestinal walls.
With good body resistance, the immune system is able to cope with tuberculosis on its own. But residual effects still remain. How will they behave?
When conducting sputum tests, it is not always possible to identify tuberculosis bacteria. Therefore, the patient may not know about his infection for a long time and be considered a healthy person. But at this moment he poses a danger to the people around him.
The absence of risk of infection cannot be guaranteed under any circumstances, even in a closed form. They can only be reduced to a minimum. Experts say that approximately 30% of people who communicate with patients with active tuberculosis become infected with tuberculosis. Of course, this happens with prolonged and fairly close contact.
The main way bacteria spread is through already sick people. They must follow safety precautions to avoid causing the spread of a complex disease.
Tuberculosis manifests itself gradually, but a characteristic cough immediately begins. What are the characteristics of a cough due to tuberculosis?
- duration of cough for at least 20 days;
- sputum is released, most often with a cough;
- painful sensations in the chest and when coughing.
In this case, you need to go to a tuberculosis clinic and undergo special tests.
With prolonged development, the disease spreads to:
If this happens, the symptoms will be slightly different. Pain will be felt at the location of the affected organ. In some cases bleeding will be noticeable in urine.
How do you get infected with tuberculosis?Infiltrative tuberculosis develops very quickly when communicating with a patient, with an active form of tuberculosis. At this moment, the sick person may sneeze or cough. Along with his exhalation, a certain amount of saliva should be released, which will contain the tuberculosis bacterium.
The main causes of tuberculosis infection:- frequent communication or living with a patient with active tuberculosis;
- you need to be quite close to him or communicate frequently;
- a patient with tuberculosis is not being treated and does not take any medications.
To prevent the infection from progressing, the body’s immunity must be maintained. When undergoing a course of treatment, a patient with an active form of tuberculosis does not pose a danger to others when taking medications for 14 days.
Almost anyone can become infected, but there are certain groups that are at risk. This may be due to many factors. Which people can get TB?
A person's lifestyle can influence their risk of developing active TB. Which bad habits cause the development of tuberculosis?
- human consumption of any psychotropic drugs;
- alcohol, especially in large quantities;
- nicotine consumption.
In these cases, the body experiences greater stress and cannot resist bacteria. At this moment, tuberculosis bacteria begin to multiply rapidly and infect the human lungs.
Separately allocate medical workers who encounter infected patients. They must follow certain rules to prevent germs from developing.
People serving sentences in prison are at risk. The employees of these institutions are in the same situation. There is a certain microclimate that promotes the accumulation of harmful microorganisms. This is due to being indoors quite large quantity people, irregular ventilation, lack of wet cleaning.
Attention must also be paid to patients diagnosed with HIV. They should try to avoid any infection, and the entry of tuberculosis bacteria into their body is generally unacceptable. In this case, death is almost impossible to avoid.
Very often people suffer from active tuberculosis who cannot afford drug treatment. These are patients who have meager incomes or live without any means at all. They usually do not have a permanent place of residence.
Complications of active TBWithout proper treatment, the disease progresses and causes complications. They can cause such harm to the body that it will be impossible to cure. On which organs does active tuberculosis cause complications?
Experts have learned to determine the type of tuberculosis infection. There are strains that are not affected by the drug. These are products developed many years ago.
The bacteria regenerated and grew stronger, adapting to the treatment used. They develop a kind of immunity. For this purpose, new antibiotics are being invented that should destroy harmful microorganisms.
Disease activityTuberculosis is a life-threatening disease. Its shape depends on the type of bacteria.
Experts distinguish:- MBT+, active form;
- MBT-, inactive form.
The active form of the disease is considered very harmful to the environment. Regardless of where the disease spreads. What are the forms of active tuberculosis?
Most often, tuberculosis is transmitted through the air. The possibility of developing an infection occurs in several stages and depends on the state of the immune system.
What happens to the infection?
- it enters the body;
- begins to reproduce;
- formation of the immune response to the ongoing process in the body.
The progression of the disease can be stopped at the very beginning if the patient good immunity. The reproduction of bacteria stops, but a positive reaction to a test for tuberculosis remains. The remaining pathogenic bacteria are anti-agents that are capable of developing a protective reaction of the body against tuberculosis.
Such patients need to be registered with a TB specialist and undergo regular fluorography.
Immunity does not work:
When bad defensive reaction tuberculosis begins to develop rapidly. The form of the disease becomes active. The patient is dangerous to others and requires protection in communication. The situation is corrected with the help of treatment.
Identification of the diseaseWhen a person goes to a medical facility, he undergoes an initial examination. What does the doctor pay attention to?
- examines the lymph nodes, determines whether they are enlarged;
- listens to the lungs.
If necessary, the doctor can prescribe any tests or examination methods. At this point, the individual characteristics of the person and the presence of chronic diseases are taken into account. Then a decision is made on treatment for tuberculosis.
Treatment of tuberculosis takes a long time. The infection is difficult to completely defeat. Even with an inactive form of tuberculosis. Antibiotics are taken for six months. In complex cases, this period increases to 9 months or more. What are the criteria for choosing drugs and methods?
- patient's age;
- the presence of complex diseases and the general state of human health;
- the type of bacteria that develops in the body;
- form of the disease;
- place where bacteria spread.
The effect of using medications depends on the form of the disease. When treating the latent form, it can transform into active tuberculosis. Subsequently, the secondary form of the disease is treated. It is important to complete the entire course, only in this case can one hope for recovery, regardless of the presence of symptoms and signs of tuberculosis.
Danger when incomplete treatment lies in the possibility of a secondary manifestation of the disease if not all harmful microorganisms have been destroyed.
How is active tuberculosis treated?The phthisiatrician prescribes medication. The active form requires taking several medications.
Most often, doctors prescribe:
- Pyrazimidine;
- Isoaniside;
- Ethambutol;
- Rifampicin.
Additionally, Vitamin D is used, which has a beneficial effect on the treatment of complex illnesses.
During the course of treatment, the patient may experience side effects:The positive result of the treatment becomes noticeable after a few weeks. The patient feels significant improvement. The main thing at this moment is not to stop there and not to stop treatment. Completion of reception drugs will happen when conducting an examination that does not reveal the presence harmful bacteria in organism.
Incorrect treatment provokes drug resistance of tuberculosis, and in the future it is almost impossible to select a drug that will defeat the disease.
Active tuberculosis is transmitted from humans by airborne droplets. Therefore, it is dangerous not only for the patient, but also for others. An important factor is to prevent the transition of primary tuberculosis to the secondary form.
The sick person needs to follow preventive measures so as not to infect his friends and relatives. What needs to be done for this?
- the patient is allocated a separate room to live;
- limit communication with strangers;
- don't visit places large cluster of people;
- do not travel by public transport;
- wet cleaning of the room is carried out every day;
- the room is ventilated regularly;
- when sneezing or coughing, the patient covers his mouth with a napkin or handkerchief;
- sputum is collected and thrown away in a bag;
- When communicating with family members, wear a mask, especially in the first month of treatment.
These measures will help avoid infection of people in contact with the patient.
To prevent infection with tuberculosis, people need to follow preventive measures.
To do this you need:
Prevention is also important for patients who have had tuberculosis. A healthy lifestyle will help maintain health and preserve it for many years.
Quiz: How susceptible are you to tuberculosis?Time limit: 0
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- Congratulations! Are you OK.
The probability of getting tuberculosis in your case is no more than 5%. You are completely healthy man. Continue to monitor your immunity in the same way and no diseases will bother you.
- There is reason to think.
Everything is not so bad for you; in your case, the probability of getting tuberculosis is about 20%. We recommend that you take better care of your immunity, living conditions and personal hygiene, and you should also try to minimize the amount of stress.
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Ask your question Questions and answers on: active tuberculosis is2014-11-21 06:50:04
Svetlana asks:
My father smokes and coughs a lot. Since a small child appeared in the family (he is now three months old), she forced the father to do fluorography. Fluorography conclusion from 2014: the apical segments of the left lung are reduced in size due to pneumosclerosis. In segment 1-2 dense lesions. The left apical pleura is thickened. The left root is pulled up. Conclusion: residual changes in previous respiratory tuberculosis. It turned out that the changes were discovered in him a long time ago, since 2001, and he visited a phthisiatrician and did not tell us anything about it. The phthisiatrician wrote: there is no evidence of active tuberculosis. From 2009 to 2014, I did not visit a phthisiatrician and did not undergo fluorography. Latest Research in 2007 (conclusion: focal changes in the apex of the left lung) and in 2009 (conclusion: small calcifications in the apex of the left lung). Is it possible to determine the stage of the disease and its activity using fluorography? Since they wrote to him “residual changes of previous respiratory tuberculosis,” he is not going to go to a phthisiatrician. I am very worried. Is contact with the grandfather dangerous for a child???
Ernest Danielovich Agababov answers:
Svetlana, good afternoon! A face-to-face appointment with a phthisiatrician is required to decide whether the patient requires additional examination for the presence of active tuberculosis. Without a face-to-face consultation, it is incorrect and impossible to draw any conclusions or make recommendations. Be healthy!
2014-07-18 11:16:41
Svetlana asks:
Hello, please explain my diagnosis, during routine fluorography on December 13, 2013, focal fibrous changes in the lobes were found in the image right lung, sent the following description for the tomogram: on direct tomograms, rights. lung (sections 6,7,8,9) very fibrotic changes in the right are determined. the tops of the decay cavities were not found. on the right in the lobe there is a pleuroapipelous commissure, a fibrous scar. There is no data for active tuberculosis. when they took the fluorography for 2012, the doctor said that changes were already visible then, but no one told me about this. I passed the commission and no problems arose until the next year. I want to understand whether I have tuberculosis or not, now I’m pregnant and worried about my unborn child. Please explain what my diagnosis means.
Ruslan Anatolyevich Veremeenko answers:
Hello Svetlana! On this moment there is no active tuberculosis process (taking into account the statute of limitations of 2012). Focal changes (i.e., Gon's lesions) will remain in the lung; it is dense tissue and does not dissolve.
2013-11-07 19:23:58
Milana asks:
Hello! Tell me, please, I have manifestations of genital herpes in the form of rashes. I am also undergoing treatment for active tuberculosis, the intensive phase. Can human immunoglobulin be used in this case? I was told that now any immunostimulants are contraindicated. But this is a ready-made immunoglobulin, nothing is stimulated?
Oleinik Oleg Evgenievich answers:
Good afternoon
You are absolutely right. This drug does not apply to pharmacological group and immunomodulatory drugs, because it does not have a direct immunostimulating effect. This effect manifests itself indirectly, which means that the body is not loaded and immune system in particular. At the same time, the nonspecific (innate) resistance of the body increases (which is very important for the treatment of tuberculosis): opsonization occurs, neutralization of microorganisms, including viruses, in bloodstream, and connecting to the membrane of macrophages, neutrophils and monocytes ( immune cells), immunoglobulin increases their antibody-dependent cell-mediated cytotoxicity.
Let me remind you: the main drug in the treatment of herpes will be an abnormal second-generation nucleoside (valocyclovir) at a dose 2-3 times higher than usual. As immunoglobulin therapy, you can use intravenous immunoglobulin (it contains antibodies to almost all pathogens), specific antiherpetic immunoglobulin, or make a similar one at the Hematology Research Institute by donating your own blood. Be healthy!
2013-07-18 06:00:16
Elya asks:
Hello! Please tell me, can I have tuberculosis and how dangerous can I be to others? Somewhere from mid-April to the end of June, I dated a guy who, as it turned out, had active closed-form tuberculosis. He began treatment on May 5-6. But before treatment we had sexual intercourse. During these 2 months there were also kisses. Around mid-June, I began to notice a low-grade fever, weakness, sometimes dizziness, I can’t really say anything about the cough... it seems like sometimes I cough or just wind myself up, but I coughed before that. Finally I got to the TB doctor. I took an x-ray and they say everything is normal. IN general analysis blood everything is normal, biochemical tests showed an increase in seromucoids. Soon I will undergo the rest of the examinations (Mantoux, Diaskintest, ELISA analysis). How significant are they? Regarding other diseases - everything is excluded, only the dentist did not go through and did not go away completely neurological examination. Is it just that there is a high probability of infection and could the disease manifest itself after this period of time?.. The temperature sometimes reaches 37.2-37.3, when I am nervous and worried, mostly 36.8-37.0. Thanks in advance for your answer!
Answers:
Good afternoon, Elya! Close and prolonged contact with a patient with tuberculosis, even closed form does have a certain risk of infection. After all, it is impossible to exclude 100% the fact that your man did not secrete mycobacteria, for example, yesterday or 10 days ago - YOU do not conduct bacteriological examinations every day. In addition, it cannot be ruled out that false negative result(incorrectly collected, processed and interpreted material). Also, you can become infected with tuberculosis not only through airborne droplets and infected sputum, but bacteria can also enter the body through other media in the body (urine, purulent discharge from a wound, etc.). Therefore, you are absolutely right in deciding to go through thorough examination, and those diagnostic procedures that have already been completed and are planned in the near future are completely justified. Trust your TB doctor! And lastly, remember that a negative result obtained once immediately after contact with a patient does not mean that you do not have this pathological process. Now you must be specially registered with a TB doctor and undergo a re-examination in a year. All the best!
2010-12-07 13:14:40
Natalya asks:
Hello. I am 22 years old, doctors diagnosed active tuberculosis and prescribed a course of treatment: 4 types of tablets (pyrazinamide, rifampicin and 2 other types) and injections (tubazid and vitamin, I think B6). Tell me, please, what does ACTIVE tuberculosis mean? can I infect others? Relatives advise drinking badger fat and eating more butter, is it worth listening to their advice? I also heard about the drug Tubasit, that it can affect my mind, is that true? And I’m also interested in the question: my husband was recently released from a correctional colony, I have an assumption that I could have become infected from him, but for reasons unknown to me, he does not want to get tested, he says that he has bronchial asthma and that it is not compatible with TB, This is true? But if, after all, he is also sick, could it be that my course of treatment is useless if I live with a person who is not being treated?
Thank you in advance!!!
Vera Alexandrovna Strizh answers:
Dear Natalia! All your concerns are justified. Active means there is inflammation of the lung tissue. My husband definitely needs to get tested. For a period of intensive care or you can go to a tuberculosis clinic or hospital for the entire course of basic treatment. Bronchial asthma is not a cough, but attacks of suffocation and breathing problems. Asthmatics also suffer from tuberculosis. If your husband is sick and does not receive treatment, then he may be a source of additional infection for you. If the spouse is healthy, he should receive a short course of anti-tuberculosis therapy. Butter eat, here you go badger fat avoid. The latter is not combined with toxic anti-tuberculosis drugs. Tubazid does not lead to mental retardation! While taking it, inhibited reactions may occur, which easily disappear when taking adequate doses of B vitamins.
2010-01-22 14:18:58
Lyudmila asks:
Good afternoon My husband was confirmed to have active tuberculosis. But he was offered outpatient treatment. Is this correct? My daughter and I are not called as contacts. What should be our actions? How dangerous is it to live with him in the same apartment? Or should we still insist on hospitalization?
Nikolay Pavlovich Gordeev answers:
Hello, Lyudmila. If the daughter is small and/or the apartment is one-room, it is better to insist on hospitalization. De facto, all patients with active tuberculosis produce sputum to varying degrees and infect others. Observation of you is a timely fluorography (preferably a survey radiograph), for your daughter - a Mantoux test. Your actions, from my point of view, are hospitalization of your husband + examination of both of you as contacts. You can ask the TB doctor who treats your husband for a referral, even if he himself does not insist. The girl can be registered at the dispensary children's office and for the first 2 months, say, send him to a sanatorium (of course, according to age). A leaflet for a patient with tuberculosis, which should have been given to you at the anti-tuberculosis dispensary, will tell you how to carry out disinfection at home. Good health to you.
2010-01-19 13:59:58
Elena asks:
Hello, I had a low-grade fever for 1.5 months, X-rays (two with a three-week gap) showed nothing, I had a computed tomography scan, the result was active tuberculosis. upper lobe left lung focus 1-1.5 mm, sputum and MBT culture (-) As I understand it, I have active closed-form tuberculosis. Apart from elevated temperature, there are no other symptoms (weight loss, night sweats, fatigue, cough) I am interested in the following questions: 1. If I work, do I have to go on sick leave? After all, I can take a pill once a day and get an injection without sick leave. The closed form is practically not dangerous (30% is nothing, considering that 90% of the adult population are already infected). Moreover, , I work not in a small room, but in a huge workshop at an enterprise. I feel quite normal, and going on sick leave for 6 months means actually losing my job. I have 2 children, and I am their only breadwinner. 2. Chemoprophylaxis for my children, as I understand it, it is obligatory. But my daughter (6 years old) has congestive heart disease and cholecystitis, her liver is slightly enlarged. Is there an alternative to tubazit, since it is such a toxic drug? Is it possible with folk remedies (inhalations) essential oils eucalyptus, fir, badger fat, etc.)? I forgot to write - my daughter’s mantu (-), x-ray is normal
Vera Alexandrovna Strizh answers:
There is not enough convincing evidence to make a statement about tuberculosis. Moreover, if dense foci are detected on CT, the bacteriological method is ineffective, and in such patients other methods are used to determine the activity of the process, in particular biochemical ones (determining the amount of sialic acid, C-reactive protein, haptoglobin and other markers of activity). Biochemical methods are more effective when they are used together with tuberculin tests, in particular with subcutaneous injection of tuberculin (Koch test). It is not necessary to enter large quantities tuberculin, a dose of 20 TE PPD-L is recommended. There are also immunological methods determining process activity. If these methods do not help to establish the activity of the tuberculosis process, it is necessary to resort to the so-called test treatment, when chemotherapy is administered for 2–3 months and X-ray dynamics are studied, taking into account the patient’s subjective condition and changes in blood counts. Sometimes with focal tuberculosis, except focal changes, pleural changes are determined, which is an important indirect evidence of the activity of the process.
While tuberculosis is active, you will receive intensive treatment (the first 2-6 months) and you cannot go to work - for two reasons: 1 - this is the 30% you know, second - anti-tuberculosis drugs are toxic and require a gentle daily regimen and adequate nutrition. Make sure that the treatment is helping, that you tolerate it well, and then, together with your doctor, decide whether to return to work. About the 30%: colleagues who fall into this percentage won’t say thank you. The figures - 30% of those sick and 90% of those infected are not comparable, because... refer to different categories- sick and healthy, but infected! My daughter needs chemoprophylaxis (CP). There is an alternative to tubazide - a less toxic isophone, ftivazid, but their anti-tuberculosis activity is also lower. In order to prevent possible adverse reactions chemoprophylaxis is carried out against the background of multivitamins with minerals, hepatoprotectors and choleretic agents, beneficial bacteria and herbal immunocorrectors. Folk remedies will not kill the bacteria. Negative Mantoux and the presence of hr. cholecystitis in a child increases the risk of tuberculosis. HP is required!!!
2015-01-01 15:25:20
Anatoly asks:
A month and a half ago, as it turned out, there was contact with a patient with open tuberculosis (we were in the same room at a distance of about a meter for about half an hour), the patient was without a mask, did not cough or sneeze, but simply talked, periodically turning in my direction). At that time, I had already had a slight cold for a couple of weeks - a sore throat, a runny nose, but I was already recovering.
After three weeks without any symptoms, the temperature slightly increased for a couple of days (36.9-37). Because According to the plan, it was just time for me, I went and did a fluoro in two projections (like a contact type), the doctor said that the heart and lungs were normal.
I calmed down and the temperature did not bother me for two weeks, and I was no longer worried about anything, I felt great. After this, for two days in a row, the temperature began to rise to 37.1 in the evening. Then throughout the week, too - in the morning everything is fine, in the evening it reaches 36.9-37.0, freezing. During this week - normal during the day, in the evening up to 37.0-37.1 almost every evening.
The therapist said that it was all because of what I was experiencing, it was depression, and prescribed sedatives. If there is a desire, she suggested doing an ultrasound, visiting a cardiologist and other possible tests.
It is important for me to rule out the possibility of tuberculosis - this problem really worries me, because I don’t know if I’m sick with something, whether I could be dangerous to the people close to me with whom I communicate on a daily basis. I lead a healthy lifestyle, eat a balanced diet, without supplements.
It's been 1.5 months now since contact. Apart from the temperature every evening, slight weakness - nothing worries me. Even when swallowing hot liquids, somewhere just above the sun, but below the neck, such mildly painful irritation is heard.
Does it make sense to do an X-ray or CT scan now, and if so, which one? Should you limit active communication with people? Is it necessary to reduce this temperature?
I will be very grateful for your answer
Answered by the Medical Consultant of the website portal:
Hello! Upper limit The norm for temperature is 37.2 C; in the evening, body temperature normally rises by 0.3-0.5 C. So your fears related to body temperature are unfounded. Do fluorography regularly, once a year general examination and a medical examination with a therapist and do not create reasons for anxiety. As for the risk of contracting tuberculosis, it exists constantly. Modern man constantly communicates with people whose tuberculosis infection status is unknown. And at any moment a critical dose of mycobacteria can enter the body, which can cause a clinically significant disease. So your meeting with a patient with tuberculosis is just one of many episodes. A healthy lifestyle and regular fluorography will help prevent serious consequences. Take care of your health!
2014-02-28 23:44:44
Yana asks:
Hello! I need your professional opinion about my situation.. I am 30 years old and planning a pregnancy. A blood test showed the presence of tuberculosis bacteria in the body. According to x-ray the lungs are clean and “the bacteria is not active,” but it is in the body and I’m in the zone increased risk get sick with tuberculosis. How safe is it to plan a pregnancy in this situation if I do not undergo any treatment? What are the risks? According to some sources, there are recommendations to go preventive treatment BEFORE pregnancy. But it takes 6-9 months, which is a lot of time for me. Another question - are there any risks for the fetus if less than a month passed after my x-ray before conception? Thanks a lot!
Gritsko Marta Igorevna answers:
You must understand that x-rays are accompanied by irradiation of the body and, accordingly, the egg, so planning a pregnancy in the same month is not recommended. Regarding tuberculosis, you should consult with a phthisiatrician, who will examine you and make prescriptions based on the examinations.
Ask your question Popular articles on the topic: active tuberculosis isTuberculosis is infection, which is caused by the pathogen - Mycobacterium tuberculosis ( Mycobacterium tuberculosis), and is characterized by the formation of specific granulomas in different organs and fabrics.
Accidental contact with a carrier of the tuberculosis bacillus is safe: it is not a source of infection. But with long-term and regular communication with the owner open form It is possible to become infected with tuberculosis. Prevention will help you avoid illness.
Blood testing for tuberculosis is one of the most modern methods for diagnosing tuberculosis infection in the body. A blood test for specific antibodies to Mycobacterium tuberculosis antigens has become an integral component of complex diagnostics.
