“Tuberculosis (TB): Symptoms, Causes, and Management Strategies”

Understanding Tuberculosis (TB)

Tuberculosis (TB) is a contagious infection that primarily affects the lungs, but it can also impact other parts of the body, such as the brain and spine. It is caused by a bacterium called Mycobacterium tuberculosis. While TB was a leading cause of death in the past, it can now be cured with antibiotics. However, treatment requires several months. This article aims to provide a clear understanding of TB for Indian patients.

Types of Tuberculosis

1. Latent TB
In this condition, the TB germs are present in the body, but the immune system prevents them from spreading. Latent TB usually does not cause symptoms, and it is not contagious. However, it can become active in the future. If you are at high risk for reactivation, your doctor may prescribe medications to prevent active TB.

2. Active TB
Active TB occurs when the TB bacteria multiply and make you sick. It is contagious, and most cases of active TB in adults stem from a previous latent TB infection. Active TB can also be drug-resistant, meaning some medications may not effectively treat it.

Signs and Symptoms of TB

Latent TB does not present any symptoms. A skin or blood test can help determine if you have latent TB.

Signs of active TB disease may include:

• Persistent cough lasting more than 3 weeks
• Chest pain
• Coughing up blood
• Fatigue
• Night sweats
• Chills
• Fever
• Loss of appetite
• Weight loss

If you experience any of these symptoms, it is important to see a doctor for testing. Seek immediate medical help if you have chest pain.

Causes and Risk Factors

TB is caused by bacteria that spread through the air, similar to a cold or flu. You can contract TB by coming into contact with people who have active TB. Certain factors can increase your risk of getting TB, including:

• Close contact with someone who has active TB
• Living in or traveling to areas where TB is common
• Belonging to a high-risk group, such as individuals with HIV, those who have been in jail or prison, people who are homeless, and individuals who inject drugs
• Working or living in healthcare settings like hospitals or nursing homes
• Being a healthcare worker for patients at high risk of TB
• Smoking
• Having certain medical conditions or being on specific medications that weaken the immune system

Transmission of Tuberculosis

TB is not easily transmitted. It usually requires prolonged exposure to someone with a high amount of TB bacteria in their lungs. The most common sources of transmission are close contacts, such as co-workers, friends, and family members. TB germs do not thrive on surfaces, so you cannot get infected by shaking hands or sharing food or drinks with someone who has TB.

Tests and Diagnosis

1. Skin Test
Also known as the Mantoux tuberculin skin test, a small amount of fluid is injected into your lower arm. After 2 or 3 days, the healthcare provider checks for any swelling at the injection site. A positive result indicates the presence of TB bacteria, but false positives can occur, especially if you have received the BCG vaccine or have a very recent infection.

2. Blood Test
Interferon-gamma release assays (IGRAs) measure your body’s response when TB proteins are mixed with a small amount of your blood. These tests do not determine whether your infection is latent or active. Additional tests such as chest X-rays or CT scans, and Acid-fast bacillus (AFB) tests may be performed to confirm the diagnosis.

Treatment of Tuberculosis

Treatment for TB depends on the type of infection:

1. Latent TB
If you have latent TB, your doctor may prescribe medications to kill the bacteria and prevent the infection from becoming active. Medications such as isoniazid, rifapentine, or rifampin are typically used, and the treatment duration can last up to 9 months.

2. Active TB
Active TB requires a combination of medications, including ethambutol, isoniazid, pyrazinamide, and rifampin. The treatment duration for active TB is usually 6 to 12 months.

If you have drug-resistant TB, your doctor may recommend different medications and a longer treatment duration, up to 30 months. It is crucial to complete the entire course of treatment, even if you start feeling better, to prevent drug resistance.

Medication Side Effects

TB medications can have side effects. Common side effects of isoniazid include numbness and tingling in the hands and feet, upset stomach, loss of appetite, and weakness. Ethambutol may cause chills, joint pain, upset stomach, and confusion. Pyrazinamide can result in lack of energy, nausea, joint pain, and loss of appetite. Rifampin may cause a skin rash, upset stomach, diarrhea, and loss of appetite.

Complications of Tuberculosis

Tuberculosis can lead to various complications, including:

• Joint and lung damage
• Infections or damage to the bones, spinal cord, brain, or lymph nodes
• Problems with the liver or kidneys
• Inflammation of the tissues around the heart

Prevention of Tuberculosis

To prevent the spread of TB:

• Take all prescribed medications for latent TB to prevent it from becoming active and contagious.
• If you have active TB, limit contact with others, cover your mouth when coughing or sneezing, and wear a surgical mask during the initial weeks of treatment.
• When traveling to areas where TB is common, avoid crowded places with sick individuals.

Tuberculosis Vaccine

The BCG vaccine is administered to children in countries where TB is common. However, it is not widely used in the United States and does not always guarantee protection against TB. It is recommended mainly for children living with someone who has an active TB infection with a highly drug-resistant strain or those unable to take antibiotics. Other vaccines are currently under development and testing.

Outlook for Tuberculosis

The outlook for TB depends on factors such as overall health, severity of the infection, and adherence to treatment. In the United States, treatment is successful in over 95% of cases.

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