Tuberculosis (TB) is a chronic granulomatous, infectious, airborne, respiratory droplets disease caused by mycobacterium tuberculosis bacteria. It can be life-threatening when not diagnosed and treated on time.
Tuberculosis disease has an affinity for the lungs, so it affects the lungs the most. Still, it can affect other major organs and structures such as the brain, bones (spine), kidneys, the genitals, and the skin.
Mycobacterium is spread when an infected person sneezes, speaks, spits, or coughs, the droplets from the cough or sneeze can be caught by the people nearby, especially in the same household with the infected person.
Today, Mayor Boss decided to tell you about tuberculosis symptoms, risk factors, and treatment. So straight away, Let’s get started.
Tuberculosis signs and symptoms according to types and organs affected:
Pulmonary tuberculosis disease is tuberculosis of the lungs. It is the most common type of tuberculosis, and it presents with:
- Chronic productive cough of more than 6 weeks, which can be accompanied by blood (hemoptysis)
- Chest pain
- Shortness of breath
- Low-grade fever with drenching night sweat (seen in all types of TB)
- Significant weight loss (seen in all types of TB)
- Generalized body weakness (seen in all types of TB)
- Loss of appetite (seen in all types of TB)
- Swollen axillary lymph nodes
Tuberculosis of the spine (pott’s disease) and joints
Pott’s disease, also formally called tuberculosis spondylitis, is tuberculosis of the spine, the areas of spine mostly affected are the lower thoracic and upper lumbar vertebrae. Its manifestations are:
- Severe back pain and tenderness
- Stiffness of the knee, hip, sternoclavicular and sacroiliac joints
- Involuntary muscle spasm
- Cold Abscess.
- Paralysis/paraplegia (muscle weakness, reduced sensation, inability to control bladder)
- Prominent spinal deformities (Kyphosis is the most common spine deformity in TB).
- Paresthesia (pins and needles, the feeling of walking on foam)
Tuberculosis of the Lymph Node
Tuberculosis of the lymph node also called tuberculous lymphadenitis or collar stud abscess. It presents with:
- Painless swelling of one or more of the lymph nodes.
- Swelling is located on the sides of the neck.
Tuberculosis of the Brain
Tuberculosis of the brain, also known as tuberculous meningitis. It presents with:
- Loss of memory.
- Neck stiffness
- Photophobia (sensitivity to bright light)
- Severe headache.
Tuberculosis of the Skin (Cutaneous TB)
- A firm, painless ulcerative lesion on the skin that takes years to heal and leaves scars on the skin (scrofuloderma).
- Recurrent nodules lump on the back of the legs (tuberculids)
- Pinpoint red confluence of rashes(macules, papules, pustules, papulo-vesicles).
Tuberculosis of the Kidneys (Renal TB)
- Flank, back and suprapubic pain
- Hematuria (blood in urine)
- Nocturia( frequent urination at night)
- Polyuria( increased frequency and amount of urine)
Tuberculosis Risk Factors
Factors that expose people to Mycobacterium tuberculosis are:
- Having contact with an infected person for a minimum duration of 20 hours within a given time frame (that’s about 4 hours a day for 5 days)
- Immunosuppressive persons: examples are: HIV positive persons, Diabetes mellitus patients, Malignancies (cancer patients), People on immunosuppressive drugs, Rheumatoid arthritis and Systemic lupus erythematosus
- Chronic alcoholism
- Nutritional deficiencies(malnutrition, low body weight)
- Intravenous drugs abusers
- Occupations, for example, working in the health sector
- Being a smoker
- Older adults or infants
Diagnosis of Tuberculosis
- Tuberculin skin test (Mantoux test)
- Microscopy examination of sputum for Acid-fast bacilli (AFB), as well as Culture and sensitivity. (Other bodily fluids that can be used for investigation are pharyngeal secretions, early morning gastric washing, bronchial washing, pleural fluid)
- Excision biopsy of lymph node
- X-ray of the lungs and spine
- Bone scan(scintigraphy)
- CT of spine
- Bone biopsy
- Liver function test before commencing treatment
Treatment of Tuberculosis
Tuberculosis disease can be treated by taking medication, such as:
- The first line drugs recommended for tuberculosis treatments are Rifampicin, Isoniazid, Pyrazinamide, Ethambutol, and Streptomycin.
- The second line drugs include: fluoroquinolones (Levofloxacin, ciprofloxacin, ofloxacin, moxifloxacin), Thioamides (ethionamide), Cycloserine, Aminoglycosides (kanamycin, amikacin, capreomycin)
- Third line drugs: macrolides(clarithromycin), arginine, rifabutin, linezolid, thiacetazone.