What is Tuberculosis?

Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis infection. Tuberculosis bacteria may invade various organs throughout the body, but mainly invade the lungs, known as tuberculosis.

Basic Information

English name

tuberculosis

Visiting department

Infectious Diseases

Common locations

lung

Common causes

Mycobacterium tuberculosis

Common symptoms

Low fever, fatigue, cough, hemoptysis, etc.

Contagious

Have

way for spreading

Respiratory transmission from person to person

Causes of TB

Primary

When the human body's resistance decreases, the tuberculosis bacteria that invade the human body for the first time through the respiratory tract or digestive tract often form primary lesions in the lungs or intestinal wall.

2. Blood type spread

When the body's resistance is reduced, a large number of tuberculosis bacteria invade the blood circulation at one time or multiple times in a very short period of time. At this time, as the body's allergic reaction increases, it can cause vascular permeability to increase.

3. Following hairstyle

Refers to the re-ignition of potential lesions left in the lungs during a primary infection or reinfection of Mycobacterium tuberculosis.

Clinical manifestations of tuberculosis

Invasion varies in different parts. Early or mild pulmonary tuberculosis can be ignored without any symptoms or mild symptoms. If the disease is in the active stage, the following symptoms can occur:

Mostly the body temperature rises in the afternoon, usually between 37 and 38 ° C. Patients are often accompanied by general weakness or weight loss, night sweats, and women can cause irregular menstruation or menopause.

Tuberculosis of the lungs

Cough and sputum are the most common early symptoms of tuberculosis, with blood or small blood clots in the sputum.

2. Stomach tuberculosis

The clinical manifestations are very inconsistent, some are asymptomatic or mild, and some are similar to chronic gastritis, gastric cancer, and most like ulcer disease. Patients have upper abdominal discomfort or pain, often accompanied by acid reflux, and abdominal pain has nothing to do with eating. The vomiting manifested by pyloric obstruction is mainly in the afternoon and evening. The vomit is the food that is fed. It does not contain bile. The occult blood can be negative. In addition to stomach symptoms, it can also be accompanied by systemic tuberculosis symptoms, such as fatigue, weight loss, fever in the afternoon, night sweats, and so on. On physical examination, the upper abdomen may sometimes touch irregular masses. When there is a pyloric obstruction, the stomach type, peristaltic wave, and tremor sound can be seen in the upper abdomen.

3. Tuberculosis

The most common symptoms are fever and fatigue. Other symptoms include loss of appetite, nausea, vomiting, bloating, and diarrhea. Fever is mostly in the afternoon, sometimes accompanied by chills and night sweats; those with low fever and those with relaxation type, high fever can reach 39 to 41 . People with tuberculosis can have recurrent fever for a long time.

4. Intestinal tuberculosis

The clinical manifestations are not obvious in the early stage, and most of them have slow onset and long course of disease. If they coexist with parenteral tuberculosis, their clinical manifestations can be covered and ignored. As a result, active parenteral tuberculosis, for example, shows significant gastrointestinal symptoms.

Tuberculosis examination

Smear test

The patient's sputum or other body fluids are made into smears, and the yin and positive of the patient are detected under a microscope.

2.X-ray inspection

Not only can tuberculosis be detected early, but also the location, scope, nature, development and effect of the lesion can be diagnosed.

3. Tuberculin test

(1) Positive means tuberculosis infection, but not necessarily sick. Those who have a positive skin test at a dilution level often indicate active tuberculosis in the body.

(2) Negative indicates no TB infection. However, the following situations should still be ruled out. After tuberculosis infection, it takes 4 to 8 weeks to fully establish the allergic reaction; therefore, in the early stage of the allergic reaction, the adiponectin test can be negative. In patients with immunosuppressive agents such as glucocorticoids, malnutrition, and measles, whooping cough patients can temporarily disappear. Severe tuberculosis and all kinds of critically ill patients have no response to the adiponectin. Others: For example, patients with lymphoid immune system defects (leukemia, sarcoidosis) and the elderly also often have negative response.

4. Lymphocyte culture + gamma interferon release test

It is more sensitive and specific than the tuberculin test (PPD) skin test. It is not affected by previous BCG injections, but it cannot distinguish between recessive infection or active tuberculosis.

5. Molecular biology methods

PCR-TB.

TB diagnosis

The diagnosis can be confirmed based on the etiology, clinical manifestations and laboratory tests.

TB treatment

Before determining treatment principles and choosing a therapy, the type of TB and the progress and good condition of the lesion at the current stage should be determined, and the presence of active TB outside the lungs should be checked. At the same time follow the following treatment principles:

1. There are many bacteria in early lesions, and the drug is easy to work;

2. Appropriate dosage can not only exert the maximum bactericidal or bacteriostatic effect, but also be easily tolerated by the patient, and the toxicity is not large;

3. The combined use can prevent the development of drug resistance. The combined use can also select drugs for bacteria of various metabolic states and bacteria inside and outside the cell, which has achieved the purpose of strengthening the efficacy;

4. Medication cannot be discontinued randomly. Intermittent therapy has specific requirements on dosage and interval, and there is a certain pattern of usage. It is not intermittent therapy;

5. The whole course of chemotherapy should be adhered to, in order to eliminate the persistent bacteria and prevent recurrence, the whole course is not necessarily a long course.

Only by following the above five principles, early, moderate, joint, regular, and whole course, can we ensure thorough treatment.