What is Lung Tuberculosis?
The tuberculosis lung is known to affect the whole world. The microorganism that causes the disease is known as Mycobacterium tuberculosis or Koch’s bacillus. The disease mainly affects the lungs, but it can affect other organs, such as the kidneys, intestines, nervous system, skin, bones, joints, ovaries and ganglia.
Although the disease affects all parts of the world, the least developed countries are the most affected. China, India, Brazil, Philippines, Nigeria, Pakistan and others have the highest incidence of the disease.
In Brazil, the numbers are worrying, despite the fact that the disease decreases annually. Tuberculosis here is treated as a public health problem, with deep social roots. Every year, about 70,000 cases of tuberculosis are diagnosed, and 4,600 people die from this disease in Brazil.
Tuberculosis has been the leading cause of death for many years and the people who suffered the most from the disease were the poorest. For a time that number decreased, but in the 1980s, tuberculosis came back strongly after the emergence of AIDS . Notification of the disease is mandatory, which means that the doctor must inform the health department of contamination.
The disease is caused by Mycobacterium tuberculosis and is transmitted through the air, through droplets from sneezing, coughing or talking to people already infected, thus, healthy people breathing the contaminated air inhales the bacteria that lodges in the lung. After being released into the air, the bacteria can last for several hours, as long as there is no contact with sunlight.
If the person who came into contact with the bacteria is in good health, the body absorbs the bacteria and it will stay in the body for a while (latent period).
Although the disease is passed from person to person, there are some factors that facilitate the contamination of tuberculosis. The spread of the bacteria depends on people’s living conditions, the level of agglomeration, housing, food and work. All of these factors influence the proliferation of the disease.
The contagion of the disease depends on some factors, such as:
- Environmental conditions;
- Extension of the disease (people with lung injuries are more susceptible to the disease);
- Exposure time between the patient and the healthy person.
Tuberculous primary infection
When you inhale droplets that contain the bacilli of the disease, they may lodge in your throat and nose, where it is impossible for the infection to happen. But if the bacilli reach the alveoli, inflammation occurs quickly.
When bacilli reach the body without causing disease, it means that the immune system is under control.
The small majority of cases of primary infection (5%) develop causing the disease. The disease can develop within five years after the first infection.
Post primary tuberculosis
Once the person is infected, the development of the disease can occur at any stage of life. The disease can arise when the body cannot take it and the immune system cannot control the bacilli, causing them to multiply quickly.
Sputum smear microscopy is positive and the main source of infection of the disease.
It is necessary to perform all tests so that the treatment is done as quickly as possible so that there is no transmission of the disease to other people. There are some factors that contribute to the stability of the disease in the body, such as poor diet, poor hygiene, alcoholism , smoking or any other activity that lowers the immune system.
Although the disease is only transmitted by inhaling the microorganism of the Koch bacillus, there are some conditions that facilitate the conditions for the emergence of tuberculosis. Are they:
- Advanced age;
- Use of illicit drugs;
- AIDS / HIV infection;
- Chronic renal failure;
- Drugs indicated to treat psoriasis, Crohn’s disease and rheumatoid arthritis;
- Live or travel to countries with little development.
The lack of access to basic care, whether medical or related to sanitation, can greatly influence the increased risk of tuberculosis. Smoking is also a risk factor for the disease, it is believed that 20% of tuberculosis cases are related to cigarette consumption.
With the increase in the number of AIDS and HIV cases , tuberculosis has also become more vulnerable because of patients having low immunity. HIV-positive patients are believed to be up to 30 times more likely to contract the disease than people who do not have the HIV virus.
Tuberculosis has also become resistant to some drugs, such as rifampicin and isoniazid. This occurred thanks to bacterial strains, which occur when the antibiotic is not able to kill all bacteria, causing them to become resistant to the antibiotic itself and also to others.
Although the disease is well known, only 10% of patients develop symptoms of tuberculosis. The other 90% are inactivated, becoming unable to provoke or transmit the signs of the disease. The disease can arise later if immunity falls, causing the bacteria to proliferate.
The main symptoms of tuberculosis are:
A fever is a symptom of various diseases common, but TB is a major one. The fever usually exceeds 38 ° C and appears only at the end of the day.
Very common at night, night sweat can appear with or without the presence of fever. The symptom is also quite common in patients with tuberculosis.
Cough is the main symptom of the disease. It is only common in pulmonary tuberculosis and can last for weeks. It usually starts with a dry cough and can develop with yellow-greenish sputum.
Shortness of breath and tiredness
This symptom is common in more advanced stages of the disease, when the lung is already severely damaged. In the beginning, shortness of breath can appear only after making an effort and, over time, shortness of breath happens even with the patient at rest.
As the cough develops, bloody sputum may appear. This is known as hemoptysis.
Chest pain may arise due to the effort of the lung during a chronic cough or, otherwise, due to the injury that the lung has due to tuberculosis.
Within a few weeks, it is possible for the patient to lose 5 to 10 pounds. Lack of appetite is also a symptom of the disease.
The doctors indicated to treat tuberculosis problems are:
Pulmonologist, infectologist, general practitioner, neurologist and nephrologist.
In order for the diagnosis to be made more quickly, the patient can go with some information to assist the doctor:
- When symptoms appeared;
- If the symptoms have gradually intensified;
- If there was blood in the cough;
- If the patient has already had a tuberculosis vaccine;
- If the patient smokes.
Answering these types of questions can make the diagnosis faster.
The diagnosis is usually made by collecting pulmonary secretion. Phlegm can be collected when coughing (preferably in the morning). At least two samples on consecutive days must be taken in order for the diagnosis to be made accurately. If the microorganism Mycobacterium tuberculosis is found, the disease will be confirmed.
There is also the Mantoux test that can be done to assist the doctor in diagnosing the disease. Performing gastric aspirate, fibrobronchoscopy, lung biopsy, PCR and other exams can be done so that the diagnosis is more accurately made by the doctor.
The treatment of pulmonary tuberculosis can be done in several ways. Basically, antibiotics are used , but it is known that it takes longer than the treatment of other infections caused by bacteria.
Generally, the treatment lasts between six and nine months, depending on the patient’s age, health conditions and possible resistance of the bacterial strain, which will be indicated in the patient’s diagnosis.
There are studies that the treatment can be done in four months, if there is the interaction of several medications, which means that there is no evolution of the disease.
The drugs indicated to treat pulmonary tuberculosis are known as:
- Predsim ;
- Bromidrato de fenoterol;
- Androcortil ;
- Prednisolone .
The following drugs are distributed free of charge at health centers after laboratory confirmation of the bacterial disease. They are antibiotics, so they must be treated with care. These drugs are used together for the treatment of tuberculosis and, with the exception of rifampicin, cannot be sold in pharmacies .
- Rifampicin ;
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
If there is no treatment, the disease can become fatal. If the disease affects other organs, it can occur:
- Meningitis, which can cause headache and even mental changes;
- Back pain and muscle stiffness;
- Joint injuries caused by tuberculous arthritis, affecting knees and hips;
- Heart problems, including inflammation of the tissues that are wrapped around the heart, making it difficult to pump blood and can lead to death;
- Kidney and liver problems can arise if the organs themselves do not perform the function of properly filtering and ridding the blood of impurities.
There are two problems that usually affect those who have tuberculosis. The first are the side effects caused by the treatment of the disease: nausea, vomiting, abnormally colored urine, jaundice, loss of appetite and intense and continuous fever can become a problem for patients. If side effects occur, the specialist must closely observe and if necessary, intervene in the treatment.
Another problem that usually affects people who are undergoing treatment is that the duration is very long. Continued use of the medication can harm the patient’s health.
People living with the infected person must maintain basic hygiene care so that the risk of contracting the disease is minimal. People infected with HIV, on the other hand, have a higher risk of having the disease due to the immune system.
The best way to prevent the disease is to get the BCG vaccine. In Brazil, children are vaccinated between 1 and 4 years of age.
Doing secondary prevention with isoniazid is indicated for people living with the tuberculosis patient, whether at home or at work. This prevention, before being done, is necessary to carry out specific exams.
It is also recommended to avoid places where there is no sunlight and that is crowded with people.
The sooner the problem is diagnosed, the greater the chances of treating and curing the disease.
Tuberculosis is a disease that can affect anyone. For more people to learn about the disease, share this text with your friends and family.