Tuberculosis (TB) : Meaning, Symptoms and Treatment
Tuberculosis (abbreviated as TB) is a serious contagious disease that is caused by Mycobacterium tuberculosis.
Tuberculosis (TB) usually affects the lungs however, the bacteria can attack any other part of the body as well, including the lungs, abdomen, kidney and spine.
TB is a concern in most developing countries but also in developed countries.
This article discusses the symptoms, causes and treatment of Tuberculosis (TB).
What is Tuberculosis?
Tuberculosis (TB) is spread by inhaling tiny droplets of bacteria.
When a person with TB coughs or sneezes, they release these bacteria carrying droplets.
Over time, the bacteria have become resistant to drugs.
Therefore, a combination of drugs is required to treat active TB for an extensive time.
Tuberculosis (TB) Facts
In TB, Small nodules called tubercles grown in tissues of your lungs or other organs.
About 1.4 million people lost their lives to TB in 2019.
It is considered one of the top 10 causes of death according to World Health Organization.
Around 10 million people got TB in 2019 worldwide. Among which 1.2 million were children.
According to Centers for Disease Control and Prevention, 8000 plus cases of TB were in the Unted States alone.
However, TB is curable and treatable.
Tuberculosis diagnosis and treatment has saved 60 million lives since 2000.
Types of TB
You may have the TB bacteria however, still not have a serious illness.
Your immune system prevents you from getting TB despite the presence of Mycobacterium tuberculosis.
Therefore you do have the infection, but the bacteria are inactive and do not show any sign or symptom.
Latent TB infection is inactive TB, however, it can get active.
Therefore, treatment is still required to prevent it from becoming active. It is also not contagious.
Active Tuberculosis (TB) will make you ill and also spreads to other people.
However, it is likely that the symptoms do not appear for a while in active TB disease..
They can appear a few weeks after the infection or even months and years later.
Only active TB shows symptoms. These symptoms include:
- Extensive cough lasting more than 3 weeks and sometimes has blood
- Weight loss and losing appetite
- Fever and chills
- Pain in chest
- Night sweats
- Breathlessness and pain while breathing and coughing
Tuberculosis (TB) infections that affect the lungs cause a heavy cough that lasts longer than 3 weeks.
This cough usually has thick bloody phlegm.
However, TB also rarely infects other organs. These include lymph nodes, abdomen, kidney, nervous system and joints.
They have different symptoms such as consistently swollen glands, confusion, seizures, headache, pain alongside no movement in the joint.
Moreover, the symptoms differ according to the affected organ.
For instance, TB in the spine might result in back pain, TB in the abdomen will give abdominal pain and TB in the kidneys might release blood in the urine.
People who have a weak immune system are more likely to get affected in other parts than the lungs.
Tuberculosis is caused by a bacteria and spreads when a person with the disease releases microscopic droplets containing bacteria and another person inhales them.However, Tuberculosis (TB) is not as contagious as the flu.
You need to be in close proximity and spend lots of hours with an infected person to get TB.
People are more likely to get infected by their family members or colleagues not from a short interaction with a stranger. Moreover, everyone infected is not infectious.
Small children and people who have TB of other organs, do not spread TB.
TB is more common in AIDS patients.
HIV is a virus that causes AIDS. HIV weakens the immune system therefore, HIV patients are more at risk of getting TB.
In fact, people with HIV are more likely to turn Latent TB into Active TB.
Therefore with the increase of HIV since the 1980s, TB has also been on a rise.
Moreover, another reason behind the continuous spread of TB is the drug-resistant bacteria strains.
Bacteria develop drug resistance when the antibiotic does not kill all the present bacteria. Or if people do not complete the entire course of antibiotics.
So, the bacteria that survive, develop resistance to that drug and antibiotic.
Some of the Mycobacterium tuberculosis strains have developed resistance towards isoniazid which is used as the most common treatment.
However, some have even developed resistance to less frequently used antibiotics such as fluoroquinolones.
Therefore, these resistant strains pose a threat to effective treatment and that is why TB keeps spreading.
Who Is at Risk?
Certain factors and conditions can increase your risk of Tuberculosis (TB). These include:
Weak Immune System
Good immunity can effectively fight TB and may not even let it become active.
However, if you have a weak immune system, you can suffer severely.
Conditions like HIV, cancer, diabetes, Kidney disease can weaken the immune system.
Moreover, drugs used to treat psoriasis and rheumatoid arthritis, chemotherapy, old age, malnutrition and young age can also weaken your immunity, increasing the risk of TB.
Traveling to High-Risk Areas
Certain areas have more cases of TB and have more resistant bacterium strains.
Therefore, living and traveling to these areas poses a risk to you.
These places are Asia, Russia, Latin America, Africa, Eastern Europe and the Caribbean Islands.
Excessive alcohol consumption and the use of IV drugs will weaken the immune system, hence making you more susceptible to TB.
Moreover, tobacco greatly increases your risk of TB and also causes death due to TB.
Socio economic factors
If you have a low income, you may not be able to afford health care.
Therefore, you may not be able to diagnose TB timely and that can lead to complications.
Health care workers are more at risk of getting TB because they are in close contact with TB patients.
People living in Nursing homes, prisons and shelter homes have a greater risk of TB.
There is a greater chance of the disease with less ventilation and overcrowding.
Moreover, living with someone infected will cause a greater risk to you as well.
TB can get fatal if not treated promptly.
If it is left untreated then it will spread from the lungs to other body parts.
Spinal pain and Joint pain result from TB affecting the spine, knees and hips.
Untreated TB can also lead to meningitis. Meningitis can cause a constant headache and may even cause disorientation.
The functions of the liver and kidneys can become impaired like filtering waste out of the body if TB affects the liver and kidneys.
Rarely a severe heart complication called cardiac tamponade may result.
TB may affect the tissues around the heart. This causes a fluid build-up and inflammation in the tissues which do not let the heart pump blood properly.
This is a serious complication that can get fatal.
Your doctor will firstly check for the sound of your lungs while breathing.Moreover, they will carry out a skin test to check swollen lymph nodes. However, that may not be enough so they will carry out a blood test as well, especially for Latent TB.
Extrapulmonary TB and Pulmonary TB have different diagnostic tests.
Pulmonary Tuberculosis (TB) Tests
As the name suggests, Pulmonary Tuberculosis affects lungs.
You will usually require more than one test to diagnose Pulmonary TB.
Your doctor will suggest a chest X-ray. This can show changes in your lungs, especially the appearance that indicates TB.
Moreover, you will also send a sample of your phlegm for a lab test. The sample can determine the presence of TB bacteria in your phlegm.
Extrapulmonary Tuberculosis (TB)
This TB is found outside the lungs and in other organs of the body.
You will have to undergo several tests to identify TB bacteria.
- Endoscopy and laparoscopy
- An ultra sound or imaging scans
- Blood test
- Urine test
- lumbar puncture
These tests are carried out for the affected body part.
For instance, a lumbar puncture will be carried out to check for TB bacteria in the brain and spine. Whereas urine test will be done for kidneys.
Latent Tuberculosis (TB) Test
The Mantoux test or tuberculin skin test checks for Latent TB.
A substance called PPD is injected into the forearm skin.
If you develop a red bump and your lymph nodes swell, you probably have Latent TB.
However, the skin test may not be that accurate. You could just have an allergic reaction.
Hence, you will get a blood test, interferon gamma release assay (IGRA).
This test confirms the presence of Latent TB bacteria.
After diagnosis, your doctor will prepare a treatment plan.
Tuberculosis (TB) Treatment
Unlike other bacterial infections, Tuberculosis treatment takes a long time.You may be required to take six to nine months of antibiotic treatment.
However, the duration can differ according to the severity of the disease, previous health conditions, age, antibiotic resistance and the organ infected.
Antibiotic treatment is the only way to treat TB as of yet.
You may require either one or two antibiotics for Latent TB.
However, Active TB treatment requires a combination of antibiotics. The number also depends on the bacterium’s resistance to the drug.
The most common drugs are Rifampin, Pyrazinamide and Isoniazid.
If you are resistant to these you may be given a combination of fluoroquinolones medicines alongside injectable medicines.
This treatment can last up to 20 to 30 months.
Though, you may also get a dose of BCG vaccine if your doctor sees fit.
Side Effects of Tuberculosis Medications
TB medicines can be harsh on the liver.
Serious side effects rarely occur but they can be indicating severe complications.
Therefore, consult your doctor if you lose your appetite, have nausea, your skin turns pale indicating jaundice, you have a fever that lasts longer than 3 days and your urine is dark.
Completing antibiotic course
While it should be given, some people may still not complete their antibiotic course.
You will feel better after a few weeks of treatment. You will also no longer be contagious.
However, that does not mean that all bacteria have been killed.
Stopping treatment right there or skipping doses will allow the bacteria to grow resistant to your current medications.
This can pose a threat to your health and worsen your TB.
Moreover, your next treatment will be even more extensive and you will require more time to heal.
Therefore, complete your antibiotic course because drug-resistant bacteria are already on a rise.
Currently, the only vaccine for TB is the BCG vaccine.
However, it is not effective for adults and is only given to children.
If you have TB then you can take a few preventive steps to stop the spread to your family.
- Isolate a little by staying home
TB is contagious for a few weeks. Hence, do not go to your regular places like work or school and also limit contact with your family members.
- Keep your mouth covered
Since TB does not spread because of a one-time interaction, stop the spread to the people you live with.
Cover your mouth with a tissue or mask when around people and dispose of it immediately.
Do this especially in the first three weeks of diagnosis.
- Ventilate your room
The bacteria can spread more rapidly in closed spaces. Therefore, ventilate your room, open the windows and use an exhaust fan to blow the air inside to the outside.
We now do have treatment for Tuberculosis, a disease that was once fatal.
However, even with advanced treatments, it can still get fatal.
This could happen if you leave TB untreated or do not complete your antibiotic course.
Do not do that! Consult your doctor immediately if you have similar signs or symptoms.
Delay can also worsen your condition.