Tuberculosis(TB) is a contagious infection and one of the top 10 causes of death worldwide. It is caused by bacteria called <em>Mycobacterium tuberculosis</em>, which primarily affects the lungs and may also spread to other parts of the body such as the bones, spinal cord, kidneys and fallopian tubes. It may spread from an infected person to a healthy person through tiny droplets that is released into the air through cough and sneeze. According to World health organization (WHO), more than 10 million adults and 1 million children were affected with TB in the year 2015. Tuberculosis can be fatal if it is left untreated.
Types of Tuberculosis
The two main kinds of tuberculosis infections are:
Latent TB: It is a type of tuberculosis in which the bacteria is present in the body but is in a dormant state. They do not cause any symptoms and are not contagious. Latent TB can become active.
Active TB: In this type, the tuberculous bacteria is in its active form, causes symptoms and is extremely contagious.
Signs and Symptoms
The signs and symptoms of tuberculosis include:
Fever and chills
Fatigue
Chest pain
Loss of appetite
Profuse sweating during night
Persistent cough
Swollen lymph nodes
Coughing up blood or mucus
Unexplained weight loss
Tuberculosis may also affect other parts of the body and the signs and symptoms may vary depending on the organs involved. Symptoms such as severe back pain may develop when tuberculosis affects the spine or blood in the urine may develop due to tuberculosis in the kidneys.
Diagnosis
The doctor would first assess lung sounds (using a stethoscope) to check for congestion or inflammation in the lungs. The following diagnostic tests are useful for the confirmation of tuberculosis.
Complete blood picture: This test helps in determining general health of the patient. detecting whether infection is present in the blood. Increased levels of white blood cells in blood indicates infection.
AFB(Acid Fast Bacilli) smear and culture is a rapid and the most common test performed to detect Mycobacterium tuberculosis.. The sample is taken on a thin glass slide and a smear is made. This is stained and studied under a microscope. AFB cultures help in identifying the presence of active Mycobacterium, or other bacteria which may produce TB-like symptoms.
Bacterial sputum test is performed to identify the cause of lower respiratory tract infections. Three sputum samples, are collected on three consecutive days and is sent to the laboratory for further evaluation. The results help in determining the presence and severity of infection. Complete Blood test is performed to determine the health status of the individual. Some amount of blood is drawn from the vein and sent to the laboratory. The test results determine the presence of the disease-causing bacteria based on the number, size and shape of the blood cells. Blood test also helps in ruling out the other causes of tuberculosis.
Tuberculin skin test is performed to check for any previous exposure to tuberculosis. This test is done by injecting a small amount of TB antigen on the top of the skin in the inner forearm. The formation of a hard bump at the site of injection may confirm the presence of tuberculosis.
Interferon gamma release assay (IGRA) is a blood test performed to check the presence of latent tuberculosis infection and identifies the person who is at a risk of developing active tuberculosis. This test helps in differentiating between the latent and active tuberculosis infection.
Imaging tests such as chest x-ray, MRI, CT scan, chest photofluorography are performed to confirm the location of infection and determine the spread of infection.
Treatment
The duration of treatment for TB is long as the tuberculous bacteria takes a long time to leave the system than any other bacterial infection. The doctor may prescribe a course of antibiotics for the treatment for tuberculosis. The dosage and the duration of treatment depend on the age, overall health, severity of the condition and the possible resistance to the drug.
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Reference
Tuberculosis. http://www.who.int/mediacentre/factsheets/fs104/en/. Accessed on 25-10-2017
Tuberculosis: Causes, Symptoms, and Treatments. https://www.medicalnewstoday.com/articles/8856.php. Accessed on 25-10-2017
Tuberculosis. https://medlineplus.gov/tuberculosis.html#cat_92. Accessed on 25-10-2017
TB Screening Tests. https://labtestsonline.org/understanding/analytes/tb-skin/tab/test. Accessed on 25-10-2017
Treatment for Tuberculosis. https://www.webmd.com/lung/understanding-tuberculosis-treatment#1. Accessed on 25-10-2017
Tuberculosis. https://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-causes/syc-20351250. Accessed on 25-10-2017
Tuberculosis (TB). https://www.medicinenet.com/tuberculosis_tb_facts/article.htm. Accessed on 25-10-2017
Bacterial Sputum Culture. http://www.tuberculosisjournal.com/. Accessed on 25-10-2017
Interferon-gamma release assays for diagnosis of latent tuberculosis infection. https://www.uptodate.com/contents/interferon-gamma-release-assays-for-diagnosis-of-latent-tuberculosis-infection. Accessed on 25-10-2017
