1. Definition of Tubercullosis
Tuberculosis, MTB, or TB (short for tubercle bacillus) is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis typically attacks the lungs, but can also affect other parts of the body. It is spread through the air when people who have an active TB infection cough, sneeze, or otherwise transmit respiratory fluids through the air. Most infections are asymptomatic and latent, but about one in ten latent infections eventually progresses to active disease which, if left untreated, kills more than 50% of those so infected. 2. Types of Tubercolosis
Primary Tuberculosis Pneumonia
This uncommon type of TB presents as pneumonia and is very infectious. Patients have a high fever and productive cough. It occurs most often in extremely young children and the elderly. It is also seen in patients with immune suppression, such as HIV-infected and AIDS patients, and in patients on long term corticosteroid therapy. Tuberculosis Pleurisy
This usually develops soon after initial infection. A granuloma located at the edge of the lung ruptures into the pleural space, the space between the lungs and the chest wall. Usually, a couple of tablespoons of fluid can be found in the pleural space. Once the bacteria invade the space, the amount of fluid increases dramatically and compresses the lung, causing shortness of breath (dyspnea) and sharp chest pain that worsens with a deep breath (pleurisy). A chest x-ray shows significant amounts of fluid. Mild- or low-grade fever commonly is present. Tuberculosis pleurisy generally resolves without treatment; however, two-thirds of patients with tuberculosis pleurisy develop active pulmonary TB within 5 years. Cavitary TB
Cavitary TB involves the upper lobes of the lung. The bacteria cause progressive lung destruction by forming cavities, or enlarged air spaces. This type of TB occurs in reactivation disease. The upper lobes of the lung are affected because they are highly oxygenated (an environment in which M. tuberculosis thrives). Cavitary TB can, rarely, occur soon after primary infection. Symptoms include productive cough, night sweats, fever, weight loss, and weakness. There may be hemoptysis (coughing up blood). Patients with cavitary TB are highly contagious. Occasionally, disease spreads into the pleural space and causes TB empyema (pus in the pleural fluid).
Miliary TB is disseminated TB. "Miliary" describes the appearance on chest x-ray of very small nodules throughout the lungs that look like millet seeds. Miliary TB can occur shortly after primary infection. The patient becomes acutely ill with high fever and is in danger of dying. The disease also may lead to chronic illness and slow decline. Symptoms may include fever, night sweats, and weight loss. It can be difficult to diagnose because the initial chest x-ray may be normal. Patients who are immunosuppressed and children who have been exposed to the bacteria are at high risk for developing miliary TB. Laryngeal TB
TB can infect the larynx, or the vocal chord area. It is extremely infectious.
4. BCG - the current vaccine for tuberculosis
Bacille Calmette Guerin (BCG) is the current vaccine for tuberculosis. It was first used in 1921. BCG is the only vaccine available today for protection against tuberculosis. It is most effective in protecting children from the disease. 5. TB Signs and Symptoms
Patients with tuberculosis may present without symptoms or may present in an extremely debilitated state. Symptom-free TB may be detected during routine screening. Symptoms of tuberculosis may include malaise, weight loss, and night sweats. Most patients with TB have pulmonary disease; extrapulmonary disease usually is seen in immunocompromised patients. TB in patients infected with HIV may present atypically. These patients have a higher risk for developing multidrug-resistant TB (MDR-TB)...
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