Tuberculosis

Overview

Tuberculosis is a bacterial disease, that severely affects the lungs. Bacteria primarily affects the lungs but, it can also negatively impact other organs like the brain, spine, etc. The disease is accompanied by severe cough, headaches, and so on. While deaths from it are common, TB patients can be cured with proper care and treatment. So, upon noticing the symptoms, it is imperative to go for prompt diagnosis and treatment to avoid complications.

What is Tuberculosis?

Tuberculosis, also known as TB is infectious, however, it does not spread easily. Bacteria like Mycobacterium tuberculosis and others lead to the development of this condition. When the germs get into someone's body their immune system cells find and capture the germs and may destroy them. However, some germs may still survive and cause symptoms. Some forms of the bacteria that cause TB no longer respond well to antibiotic treatments, making it difficult to use this treatment option.

Types of Tuberculosis

There are two different types of TB such as inactive TB or latent TB infection and active TB disease.

Inactive TB or latent TB infection

Sometimes, TB bacteria can stay alive in a person’s body without showing symptoms or making them sick. This condition is referred to as latent TB infection or inactive TB. People with inactive TB cannot spread the germs to others. However, latent TB can turn into Active TB for some people if they have a weak immune system.

Active TB disease

Active tuberculosis is contagious and is associated with various symptoms. It is also known as TB disease and can be fatal if it is not treated promptly. People who have a weakened immune system are at an increased risk of developing this condition. The bacterium moves through the blood to other body parts such as the lungs, kidneys, spine, brain and other organs, resulting in various complications.

There are some different types of active TB such as:

Pulmonary TB disease

Pulmonary TB affects the lungs. It may be active or latent and is infectious. Most tuberculosis cases are pulmonary.

TB Lymphadenitis

TB lymphadenitis is the most common form of extrapulmonary TB, causing a painful swelling of the lymph nodes.

Skeletal TB Disease

This type of tuberculosis affects the bones, joints and spine. This TB disease mostly affects the thoracic spine, the spine’s middle section.

Miliary TB Disease

Miliary TB disease is a form of both extrapulmonary and pulmonary TB. It affects the lymphatic system, blood, bones, central nervous system or internal organs.

Genitourinary TB Disease

Genitourinary TB disease affects the urinary tract, genital, or kidneys. It is a rare disease and may cause infertility in females.

Gastrointestinal TB Disease

Gastrointestinal TB disease affects the gastrointestinal tract. TB in the intestines is rare but more common in the ileocecal area.

Liver TB

Liver TB usually affects people with immunodeficiency such as advanced HIV infection. This disease may appear as small multiple nodules on the liver during imaging tests.

TB meningitis

Tuberculous meningitis (TBM) is an infection occurring in the meninges, the membranes that cover the brain and spinal cord.

TB Peritonitis

Peritoneal tuberculosis affects the abdomen lining, known as the peritoneum. This TB disease may result in the development of ascites, a fluid buildup in the abdomen.

TB Pericarditis

Tuberculous peritonitis (TBP) affects the pericardium. It is a rare form of TB and is difficult to diagnose.

Cutaneous TB

Cutaneous TB is a rare and uncommon form of extrapulmonary TB, primarily affecting the skin.

Symptoms of Tuberculosis

Common signs and symptoms of tuberculosis are unexplained weight loss, loss of appetite, chills and fever, fatigue, getting night sweats, weakness or fatigue. Symptoms of TB disease in the lungs may include coughing up blood or sputum, a cough lasting for more than 3 weeks, and chest pain.

Causes of Tuberculosis

The Mycobacterium tuberculosis, Mycobacterium bovis, Beijing strain bacteria or germ causes tuberculosis. People with TB in their throat or, lungs spread the virus when they cough, sneeze, talk or sing. The bacteria can settle in the lungs when someone breathes it in and begins to grow. The bacteria can then multiply and spread through the body and affect different organs.

Diagnosis and Tests for Tuberculosis

Doctors usually start by checking for swollen lymph nodes and listening to someone’s breathing with a stethoscope to diagnose tuberculosis. They will likely prescribe some additional testing to determine if someone has active or latent TB.

Some of these tests are used to diagnose tuberculosis like Mantoux Tuberculin Skin Test(TST). Here, a small amount of tuberculin is injected into the skin of the forearm and is monitored for a reaction 48 to 72 hours after the injection. A positive skin test result indicates the presence of TB and there is a need for additional tests to determine to determine if it is active or latent.

There are blood tests to determine or rule out if the patient has active or latent TB. There are two blood tests approved by the Food and Drug Administration for TB- T-SPOT TB test(T-spot) and the QuantiFERON-TB Gold-In-Tube test(QFT-GIT)

Doctors may prescribe a chest X-ray or CT scan after a positive skin test. These tests produce images that may show changes in the lungs caused by active TB. Doctors sometimes collect sputum samples and test them for different strains of TB bacteria. Sputum is the mucus that comes up with cough. The sputum test results help in choosing the best course of treatment.

Tuberculosis Management and Treatment

Patients must finish their course of treatment and take the medications exactly as prescribed. If patients do not complete the entire course of medicine as prescribed, they can become sick again and potentially spread the disease to others. It is also possible if someone takes the prescribed medicines incorrectly TB germs that are still alive may become drug-resistant. It will make it harder for patients to get better next time.

Patients typically undergo two medication phases: intensive and continuation in the treatment regimen. The intensive phase is a crucial phase of the treatment. This phase is used to kill actively growing TB bacilli. It is also used to prevent the emergence of drug resistance and determine the outcome. The continuation phase is used for killing the remaining TB bacilli and reducing treatment failure and relapse.

Preventive Measures for Tuberculosis

Active tuberculosis spreads through contact with someone infected. It may help to follow some guidelines on how to not spread or contract it. Some of these are- washing hands thoroughly and often, coughing into the elbow or covering the mouth while coughing, and avoiding close contact with others. Patients should also take the prescribed medications for TB correctly. Infected persons should not go to public places and wait until their doctors think they are fit for it.

Myths and Facts Related to Tuberculosis

There are some myths surrounding tuberculosis. Here are some of them with facts to prove them wrong:

Myth 1: TB is a Genetic Disease
Fact: Earlier, people used to believe that TB is passed down from parent to child. This is, however, a myth. Since people living in the same house often develop the disease, this misconception is common.

Myth 2: TB Affects People in Low-Income Countries
Fact: TB can affect anyone from the global competition. There are some countries where it's more prevalent. India is one of eight countries that account for two-thirds of global TB cases in 2022.

Myth 3: TB is Always Fatal
Fact: TB can indeed be fatal without treatment. However, doctors can successfully treat the illness with the right treatment regimen.