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Tuberculosis is an infectious disease that primarily affects the respiratory system and includes symptoms of sickness or weakness, fever, and more.
Tuberculosis (TB) is one of the top 10 causes of death worldwide. TB is an infectious disease that primarily affects the respiratory system, but it can also affect gastrointestinal, musculoskeletal, nervous, and other systems.
The most common type of TB is pulmonary TB, also known as TB of the lungs.
Symptoms of pulmonary TB include:
- Coughing that lasts for more than two weeks with or without fever
- Fever, especially an increase in body temperature in the evening
- Presence of blood in the sputum
- Chest pain
- Loss of appetite
- Loss of weight
- Chronic fatigue
- Night sweats and chills
TB may occasionally affect other organs, such as the bones and stomach, and presents with common symptoms such as fever, weight loss, and appetite loss, as well as some specific symptoms related to the organ system involved:
- Back pain and neurological complications such as paraplegia (paralysis of the lower limbs) that can result from bone TB that involves the spine
- Nausea, vomiting, diarrhea, and malabsorption that involves the gastrointestinal system
- Kidney involvement can cause blood in the urine, which can lead to kidney failure
- Seizures, headaches, neurological abnormalities, and other symptoms that can result from an infection of brain involvement
Inhaled TB bacteria settle in the lungs.
People with strong immune systems are usually able to combat bacteria and prevent the bacterium from multiplying by the immune system that contains the bacterial colony in a membrane built by cells (tubers). These structures have the potential to burst if the immunity goes down due to any cause, leaving scarring in the lungs.
Bacteria can enter the bloodstream seeding the blood and organs with them.
5 types of tuberculosis
Tuberculosis (TB) is classified into five types based on the type of infection:
- Latent TB:
- Latent TB is asymptomatic because the body's immune system keeps the infection at bay.
- Latent TB occurs when a person carries the bacteria but does not develop symptoms.
- However, there is a chance that the latent infection will reactivate later in life when the body's immune defenses weaken, leading to active disease.
- Active TB:
- Active TB is a condition in which the bacteria are active and cause symptoms. Active TB is divided into two types: pulmonary TB and systemic TB.
- Although TB is primarily a lung disease (pulmonary TB), it can affect other systems. Systemic TB occurs when active TB is present in other parts of the body.
- Disseminated TB or miliary TB:
- Miliary TB is a rare form of active TB that occurs when TB bacteria enter the bloodstream.
- In this form, the bacteria quickly spread throughout the body in tiny nodules, affecting multiple organs at the same time.
- This type of TB can be fatal.
- Multidrug-resistant TB (MDR TB):
- This type of TB is caused by bacteria that are resistant to at least two of the most commonly used and potent anti-TB drugs.
- Extensively drug-resistant TB (XDR TB):
- This is a rare form of TB in which the bacteria are resistant to more than two anti-TB drugs.
TB has the potential to cause serious complications, particularly in people with human immunodeficiency virus and compromised immunity.
If TB is not treated, it can worsen and cause:
- Miliary TB or disseminated TB
- Fluids, air, or pus in the lungs
- Acute respiratory distress syndrome or fluid buildup in the lungs
- Paraplegia or paralysis of the lower body due to TB of the spine
- TB arthritis of the hips or knees
- Infertility in men and women (TB of reproductive organs)
- Seizures and growth retardation (TB of the brain)
- MDR TB and XDR TB
What are the main causes of tuberculosis?
Mycobacterium tuberculosis is the bacterium that causes tuberculosis (TB). It spreads when someone with active TB in their lungs coughs or sneezes and someone else inhales the expelled droplets that contain TB bacteria.
To be infected, one would have to be in contact with it for an extended period. Not everyone who has TB is contagious.
The risk of TB is high in people who:
- Live in, come from, or have spent time in a TB-infested country or region.
- Are in close contact with an infected person for an extended period.
- Live in a crowded environment.
- Have an immunosuppressing condition such as human immunodeficiency virus.
- Took chemotherapy and biological agent treatments that weaken the immune system.
- Are in poor health or with a poor diet because of a bad lifestyle or other issues such as drug abuse and alcoholism.
What are the treatment options for tuberculosis?
To confirm a suspected case of tuberculosis (TB), the doctor orders laboratory tests and imaging studies in addition to a detailed history and physical examination.
Following confirmation, the doctor may discuss various treatment options based on the person’s age and severity of signs and symptoms. The type of TB infection determines the treatment.
Combination therapy is required for the treatment of active TB with a typical regimen including:
- Isoniazid
- Rifampin (also known as rifampicin, Rifadin, or Rimactane)
- Pyrazinamide
- Myambutol (ethambutol)
Depending on the type of TB, treatment may include the following:
- Latent TB:
- Medications for latent TB must be taken for six to nine months, as prescribed by a doctor.
- Active TB:
- Antibiotics are the primary treatment option for people with TB. The treatment method usually entails taking these drugs for several months.
- To effectively treat TB, these medications are usually given in combination as part of a regimen.
- These drugs either kill or inhibit the growth of bacteria that cause TB.
- Even if the symptoms improve, the treatment must be continued for six to eight months to ensure complete recovery and prevent the development of drug resistance.
- Multidrug-resistant TB (MDR TB) and extensively drug-resistant TB (XDR TB):
- Drug resistance is a risk of TB bacteria. Some people do not respond to first-line therapy and develop MDR TB.
- Bacterial strains that are resistant to the majority of available drugs cause a severe form of TB known as XDR TB.
- MDR and XDR TB treatment options include higher dosing of first-line drugs and a combination of other oral medications and injections.
- MDR TB treatment typically lasts 18 months, whereas XDR TB treatment lasts 24 months.
Supportive care
This includes the use of medications to alleviate symptoms such as fever, cough, and pain.
Some of the most common classes of drugs used in the supportive care of TB include:
- Anti-fever and analgesic medications (used to treat fever and pain)
- Nutrition and protein-rich food
- Antitussives (help reduce coughing)
- Vitamin B supplements are given in conjunction with antitubercular medications to help combat neurological side effects such as nerve pain and neuropathies caused by antitubercular medications
- Antacids (used to treat gastrointestinal symptoms)
- Allopurinol and febuxostat, which reduce uric acid levels (hyperuricemia is a known side effect of TB medications)
Vaccines for TB
- In countries where TB is prevalent, babies are immunized against the disease with the Bacillus Calmette–Guerin vaccine at birth.
The best way to avoid TB is to keep your distance from people who may be infected. Furthermore, to reduce your risk of picking up bacteria, practice good hygiene such as washing your hands frequently and using hand sanitizer after touching public surfaces.
- TB that is not drug-resistant is almost always cured if the person follows treatment regimens and antibiotics are started before the major parts of the lung are destroyed.
- People infected with drug-resistant TB strains may have a lower risk of being cured, depending on which drugs they are resistant to and how much lung damage they have before starting effective treatment.
- More than half of people with active TB will die within five years if they do not receive proper treatment.
