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Tuberculosis

Tuberculosis

Tuberculosis or TB is an infectious disease caused by the bacterium Mycobacterium tuberculosis. Today tuberculosis is a global pandemic that spreads due to poor health services, crowded living conditions, poverty, drug-resistant strains and the spread of HIV. This disease primarily affects the lungs. But it can also affect the bones, joints, lymphatic system, circulatory system or central nervous system. Persons with HIV infection or medical conditions such as diabetes are at added risk to contracting TB. Tuberculosis affects persons who are malnourished and IV drug users. Tuberculosis spreads on contact with an infected person.

A person may be infected with TB or suffer from TB disease. The patients suffering from tuberculosis infection may not be aware of it. On the other hand, a person suffering from TB disease is severely affected adn can spread the infection. Symptoms of pulmonary tuberculosis include persistent cough lasting a long time and fatigue. The patient suffering from TB experiences weight loss and loss of appetite. There might be pain on breathing and coughing. The symptoms of tuberculosis affecting other organs differ.

The TB skin test is the diagnostic tool to check for tuberculosis infection. The Mantoux test involves placement of testing material just below the top layer of the skin on the arm. It is observed after about 3 days to check for any bump. Chest xray and mucus analysis are also used to detect tuberculosis.

Treatment for TB depends on whether a person has TB disease or only TB infection. Preventive therapy is given to a person infected with TB. This is often a daily dose of isoniazid. Those with TB disease are treated with rifampin or ethambutol. TB disease must be carefully monitored and treated, lest it become fatal. Multidrug-resistant TB or MDR-TB is a strain of TB that is not affected by the TB drugs, isoniazid and rifampin. When the initial treatment is partial or incomplete, the bacteria become resistant. To treat multidrug resistant TB, second-line drugs are used. The treatment usually lasts for a couple of years. Regular checkups are essential to check the progress of the disease. TB medication may bring about side effects such as loss of appetite, nausea, tenderness in the abdomen and blurred vision.

Mantoux test

The Mantoux test or tuberculin sensitivity test is a diagnostic test for tuberculosis. This test, also known as Piquet Test is endorsed by the American Thoracic Society and Centers for Disease Control and Prevention (CDC). The other diagostic tests for tuberculosis are Tine test and Heaf test. Since the Mantoux test makes use of purified protein derivatives (PPD), it is also referred to as PPD test. This tuberculosiss test does not indicate how long the infection has been festering or if it is in the active stage. This tuberculosis test is prescribed for persons who have abnormal chest x-rays or symptoms such as weight loss and persistent cough for many months. A Mantoux test is not recommended for those suffering from any skin conditions or allergy. Women who are pregnant or breastfeeding must not be subjected to the Mantoux test.

This PPD test involves injecting a dose of TB antigens into the top layer of skin on the forearm. The dose includes 10 Tuberculin units (0.2 ml) as this exposes the person to enough bacteria to mount an immune reaction in the skin. A little bump (wheal) is noticed under the skin. This area is then observed for any reaction in then next 48 - 72 hours. Reactions such as fever or swollen lymph nodes in the armpit must be brought to the notice of health professionals immediately. The results of this test must be interpreted carefully. A positive result indicates tuberculosis. There may be cases of false positives or false negative results. The signifance of the Mantoux test on those vaccinated with BCG is still controversial.

Chest x ray

Chest x-ray is a regular diagnostic test that throws light on the condition of the lungs, heart and chest wall. Chest x-ray reveals possible lung cancer, emphysema, heart failure and pnemonia. Heart irregularities and CHF may be visible on a chest x-ray. Any pleural effusions may be detected through a chest x-ray. The patient must wear loose fitting gown and remove any metal objects from clothing. In most cases, chest x-ray of frontal or posteroanterior view is taken. The patient has to take a deep breath so as to ensure a good quality chest x-ray image. There is no discomfort. Pregnant women must not undergo chest x-ray. But some conditions may not be easily diagnosed with a chest xray, such as pulmonary embolism or some cancers. In such cases, CT scan of chest is used for further clarification. Abnormal findings on chest xrays can range from pnemonia and tuberculosis to lung tumor or collapsed lung. Osteoporosis or fracture of ribs or spine can be detected.