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Tuberculosis And Treatment

Tuberculosis And Treatment

Pulmonary tuberculosis (TB) is a bacterial infection that initially affects the lungs, but could later spread to other organs. Tuberculosis is an infection caused by the Koch bacillus and it is contagious. A healthy person could be infected if he/she is living or working in the same place with the infected person The infected person spreads the germs into the air by coughing, and others inhale them.
Diagnosis of TB
One way to diagnose TB is by performing a skin test called the intra-dermal reaction of tuberculin. The person who is suspected to have been infected with TB is considered to have developed a hypersensitivity to the TB germ. The test consists in injecting into the skin a purified protein derived from the TB germ. After more than 48 hours there will be a bump present in the skin area . If the bump is large, the test is considered to be positive, meaning that the TB infection has occurred. Though the test is negative, it should be repeated after a while, because the test is not a 100 percent accurate.

Another method of diagnosing TB is performing a thoracic X-Ray which shows where in the lungs is the infection localized and how greatly it is expanded. If the suspected person coughs, doctors take the sputum and with the help of the microscope they search for the TB germs in the sputum. This is quite an accurate method of diagnosing TB.

After diagnosing TB, doctors have to test what drugs will be most efficient against the particular type of the TB bacteria, using genetic engineering techniques like polymerase chain reaction (PCR).A new blood test is now available that can help distinguish between a prior BCG vaccine and a positive PPD due to TB infection (QuantiFERON-TB Gold). This test involves mixing the patient’s blood with substances that produce a TB-like immune response. After a period of time, the immune cells, if infected with TB, produce interferon-gamma, a protein produced by the body to defend against an infection. This test, like most, is not perfect, but with the proper clinical information can help distinguish a real TB infection from a positive reaction on the test due to a prior BCG vaccine.

Most people who develop symptoms of a TB infection have been infected in the past. But , in few cases, the disease gets active only weeks after the primary infection. The Elderly, Infants and People with weakened immune systems, on account of AIDS, chemotherapy, diabetes, or certain medications are at greater risk for active TB. The risk further increases if they, are in close proximity with people who have TB, have poor nutrition or live in crowded or unhygienic living conditions. Increase in HIV infections, number of homeless people and the appearance of drug-resistant strains of TB also increase the rate of TB infection in a population.
The initial stage of TB usually doesn’t show any signs of the disease. The symptoms of pulmonary TB include cough with mucus or blood, excessive sweating particularly at night, fatigue, fever, difficulty in breathing, chest pain, wheezing and weight loss.

The treatment for tuberculosis?
In order to check the spread of TB in other people, it has been made mandatory that every child to get a shot of the Bacillus Calmette Guerin (BCG) vaccine. This vaccine prepared out of a weakened TB germ, and it is considered to be the most effective vaccine in preventing childhood cases of TB. This vaccination is believed to be important in parts of the world where TB is quite common. When BCG has been administered, future PPD and Tine skin tests remain positive and can cause some confusion when trying to diagnose TB. It is also important to realize that even with a BCG vaccine in childhood, when exposed to the tuberculosis bacteria, an adult can still contract TB .This really questions the actual utility and effectiveness of this vaccination.

If a person comes out with a positive skin test, a normal chest X-ray, and has no symptoms it is most likely that there are only a few TB germs in an inactive state and is not contagious. Nevertheless, treatment with an antibiotic may be recommended for this person to prevent the TB becoming into an active infection. The antibiotic used for this purpose is called isoniazid (INH). A person with a positive skin test along with an abnormal chest X-ray and sputum evidencing TB bacteria has active TB and is contagious. Treatment of active pulmonary TB will always involve a combination of many drugs (usually four drugs). All of the drugs are continued until lab tests show which medicines work best. Treatment usually lasts for many months and sometimes for years. It is very important that you take the pills the way your health care provider instructed.
Successful treatment of TB is dependent largely on the compliance of the patient.

However taking isoniazid during pregnancy or for those suffering from alcoholism or liver disease is not recommended. Moreover, isoniazid has side effects which can occur infrequently. A rash can develop, and the individual can feel tired or irritable. Liver damage from isoniazid is a rarity and typically reverses once the drug is stopped. Very rarely, however, especially in older people, the liver damage (INH hepatitis) can even be fatal. It is essential that the doctor monitors the patient’s liver through blood tests during the course of INH therapy. Decreased sensation in the extremities referred to as a peripheral neuropathy is another side effect of INH . This can be avoided by taking vitamin B6 (pyridoxine), and is often prescribed along with INH.

Surgery on the lungs is the last option to help cure TB when medication has failed, though at present, surgery for TB is unusual. Treatment with appropriate antibiotics will usually cure the TB. If a person with a positive skin test does not take INH, there is about 10% lifelong risk that the TB will become active. Without treatment, however, tuberculosis can be a lethal infection. The requirement of an early diagnosis is therefore crucial. Those individuals who have been exposed to a person with TB, or suspect that they have been, should be examined by a doctor for signs of TB and screened with a TB skin test.

The goal of the treatment is to cure the infection with drugs that fight the TB bacteria. When people fail to take their TB medications as recommended, the infection becomes even more difficult to treat. The TB bacteria may become resistant to treatment, and sometimes, the drugs will be of no help to treat the infection. Hospitalization may be required in such cases for about 2 – 4 weeks to isolate from those who are healthy so that the disease does not spread until one is no longer contagious. Treatment must be followed at least 6 months constantly because interrupting the treatment could lead to spreading the disease in other organs like kidneys, intestinal tract, and lymph nodes, even leading to the death of the infected person. Normally if the treatment is followed religiously, a person can recover without problems, and be back to normal life in about 6 to 9 months period.

Tuberculosis And Treatment


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