signs, symptoms and treatment of pulmonary tb

Let's begin with sign and symptoms of tb, as we all know tubertuberculosis is prevalent in most parts of the world specially in developing nations like India, so it becomes requisite to know the symtoms of tb and start the necessary treatment and when to reach a doctor.

Here we are just limiting our discussion to pulmonary(lung)  tb only. There is a vast difference between the infection of tb and the disease itself. So if you are infected with tb or your tuberculin test is positive, this is not a sign to start Anti Tubercular Theraphy.
Primary disease occurs after infection only if the reparative process fails. Also the estimated lifete risk of developing tb after infection is just 10 percent ...

Symptoms of tb (clinical manifestation to decide when to reach to a doctor) :

1 - Firstly in all cases of infections the initial symptom is fever, an unexplained fever for 2 to 3 weeks  (mainly this symptom resembles the INFLUENZA like illness

2-night sweats

3anorexia i.e,loss of apetite

4-resultant weight loss (there is a particular criteria to define weight loss, for instance if you have lost 10 kg in last 6 months without any extra workout then you should be cautious)  actually this in not a general rule for everyone so percentage of weight loss will be a defining criteria

5-if you have dry cough

6-sometimes hepatomegaly may be seen if there has occurred miliary tb (enlargement of liver)

Some extrapulmonary menifestations of tb

Diagnosis of tuberculosis 

An unexplained cough for more than 2 to 3 weeks, especially in the regions where tuberculosis is prominent gives a definite reason to go for a chest X-ray done 

Further a direct microscopy of smear is done

(ZN staining is mostly employed) 

Montoux is also done in some cases

Definitive diagnosis of tb requires CULTURE

There are also new strategies for the rapid confirmation of tuberculosis and at really cheap costs such as NAT (Nucleic Acid Amplification test) 

Drug sensitivity test is one of the essential that should never be missed. There is a large no of population having resistance to rifampcin and prescribing tjem such drug will not only lead to wastage of that drug but also can lead to resistance to other drugs

TREATMENT OF TUBERCULOSIS 

It should be kept in mind that tb is totally different from other types of simple day to day bacterial infecions. So your mind should be prepared for a long course of treatment with a definite dose of particular drugs.Also stopping the treatment in the middle or leaving the doses may lead to a more dangerous form of tb MDR (multiple drug resistance ) tb or an XDR tb, where there will be increased no of drugs for increase duration and also the chances of having a good prognosis are also reduced. 

WHO has recommended a course of 6 months of treatment for new case of smear positive tb, with 2 months of intensive phase and a 4 month of continuous phase

It must be kept in mind that there are different types of tb and treatments of all types vary, here we are just limiting our discussion to new case of PULMONARY TUBERCULOSIS. 

Here are some drugs that ur doctor 😷 may prescribe to you:-

Rifampcin

Isoniazid

Ethambutol

Pyrazinamide

Streptomycin

In caseyou have reached to MDR tb then there will be addition of other drugs including injectables like kanamycin and fluoroquonolones like levofloxacin  ciprociproflo, ofloxacin etc and many others

TUBERCULOSIS CONTROL PROGRAMS 

WHO only decided in 2015 to initiate some programs to reduce the incidence of tuberctuberc worldwide.

Detection of latent tb, DOTS (directly observed therapy) , TB and HIV /AIIDS, programs for MDR and XDR cases and many more. 

TO CONCLUDE :-

IF YOU SUSPECT THAT YOU HAVE THE TB SYMPTOMS THEN DON'T HIDE, GO TO A DOCTOR 😷 AND START YOUR TREATMENT AS EARLY AS POSSIBLE 🙆. Don't wait, and save other lives by not spreading the disease

Thank you

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