What is Tuberculosis?
Tuberculosis is a severe infection that mainly affects your lungs. Tuberculosis bacteria are spread by tiny drops of bacteria released into the atmosphere through coughs and sneezes.
Tuberculosis was once rare in developed countries. However, it began to increase in 1985 partly due to the emergence of HIV, which causes AIDS. HIV can weaken a person’s immune system not to fight TB germs. Due to more robust control programs in the United States, tuberculosis rates began to decline in 1993. It is still a problem.
Many tuberculosis varieties resist most of the drugs used to treat it. To treat active tuberculosis, patients must take multiple medications over several months.
Symptoms of Tuberculosis
Your body may catch tuberculosis-causing bacteria, but your immune system can usually prevent you from getting sick. Doctors make this distinction between:
- Latent TB– Although you have a TB-related infection, the bacteria infecting your body are not active and cause no symptoms. Latent TB (also known as inactive TB or TB infections) is not contagious. Latent TB can become active TB. Therefore, you must get treatment.
- Active TB– This condition, also known as TB disease, makes you sick and can spread to others. It can happen weeks or even years after the TB bacteria has been infected.
Symptoms of active TB include the following:
- Three or more weeks of coughing
- Sneezing blood or mucus
- Pain in the chest, breathing difficulties, or coughing
- Unintentional weight loss
- Night sweats
- Appetite loss
Tuberculosis may also affect other parts of your body, such as the spine and brain. Symptoms and signs of TB outside your lungs can vary depending on the organ involved. Tuberculosis of your spine could cause back pain. Tuberculosis may also cause blood in the urine.
When to consult a doctor
Consult your doctor if you experience a fever, persistent cough, unexplained weight gain, night sweats, or severe sensitivity to light. These symptoms are usually signs of TB, but other conditions can also cause them. If you suspect you have been exposed to TB, you should consult your doctor immediately.
The Centers for Disease Control and Prevention recommends screening for latent TB infection in people at higher risk for developing tuberculosis. This includes:
- Use IV drugs
- Contact with infected persons
Causes of Tuberculosis
Tuberculosis can be caused by bacteria spreading through microscopic droplets in the air. Tuberculosis can occur when an untreated active form of the disease spreads by coughs, talks, sneezes, and laughs.
Tuberculosis can be contagious, but it is not easy to catch. Tuberculosis is more likely to be contacted by someone you know than someone who lives or works near you. People with active TB that have received appropriate treatment for at most two weeks are usually no longer contagious.
HIV and Tuberculosis
Tuberculosis has seen an increase in cases since the 1980s due to the spread of HIV (the virus that causes AIDS). HIV suppresses the immune system making it more challenging to fight TB bacteria. HIV-positive people are more likely to develop TB from latent to active disease and are at greater risk than those who aren’t.
Due to the rise in drug-resistant strains, tuberculosis is still a significant killer. Some TB germs are now able to survive despite being given medications. This can be partly due to people not following the instructions or failing to complete their treatment.
Tuberculosis can develop when an antibiotic does not kill all the bacteria it targets. The remaining bacteria become resistant to the drug and sometimes other antibiotics. Some TB bacteria are resistant to commonly used antibiotics, including isoniazid (Rifadin, Rimactane) and rifampin.
Some TB strains are also resistant to less common drugs, including the fluoroquinolones and injectable medicines like amikacin (Capastat). These medications are used to treat infections resistant to more common drugs.
Risk Factors of Tuberculosis
Tuberculosis can happen to anyone, but certain factors can increase your chances of contracting it.
- A weak immune system
- Healthy immune systems can fight TB bacteria with great success. Many conditions can affect your immune system.
- Grave kidney disease
- Certain cancers
- Chemotherapy is a cancer treatment.
- Prevent rejection of transplanted organs with drugs
- Some drugs can treat Crohn’s disease, rheumatoid, and psoriasis.
- Low body weight or malnutrition
- Very young or very old
- Living or traveling in certain regions
If you are a resident of, emigrate to, or travel to high tuberculosis incidence areas, your chances of contracting tuberculosis are higher. These areas include:
- Eastern Europe
- Latin America
- Consuming substances. Excessive alcohol or IV drug use can weaken your immune system, making you more susceptible to tuberculosis.
- Tobacco use. Tobacco smoking dramatically increases your risk of contracting TB and eventually dying.
- Work in health care. Your chances of being exposed to TB bacteria are increased if you have regular contact with sick people. Your risk of getting TB bacteria is significantly reduced by wearing a mask and washing your hands frequently.
- Working or living in a residential care facility. Due to poor ventilation and overcrowding, people who live in or work in residential care facilities, homeless shelters, psychiatric hospitals, or nursing homes are at greater risk of contracting tuberculosis.
- Living with someone with TB is a risky proposition. Your risk of contracting TB from close contact with someone else is increased.
Complications of TB
Tuberculosis can prove fatal if it is not treated. While the active disease most commonly affects your lungs, it can also affect other parts of your body.
- Spinal pain– Tuberculosis can cause back pain and stiffness.
- Joint damage– Tuberculosis-related arthritis (tuberculous joint disease) typically affects the knees and hips.
- Meningitis is swelling of the brain’s membranes (meningitis). It can lead to a persistent or intermittent headache for several weeks and possibly mental changes.
- Kidney or liver problems– Your kidneys and liver filter out waste and impurities from the bloodstream. These organs may be affected by tuberculosis.
- Heart disorders– Tuberculosis can occasionally infect your heart tissue. This causes inflammation and fluid accumulations that may affect your heart’s ability to pump efficiently. This condition, known as cardiac tamponade, can lead to death.
How to Prevent Tuberculosis
Your doctor may recommend taking medication to lower your chances of contracting active tuberculosis if you are positive for latent TB. Only active TB can be contagious.
- Protect your family members and friends– It usually takes a few weeks to get rid of active TB. These tips will help you keep your family and friends healthy.
- Stay at home– Do not go to school, work, or share a bed with others during the first few weeks.
- Ventilate the space– Tuberculosis germs are more likely to spread in closed areas where the air isn’t moving. Open the windows and blow outside air if it isn’t too cold.
- Cover your mouth– Cover your mouth with a tissue whenever you cough, laugh or sneeze. Place the tissue in a bag and seal it.
- Use a mask on your face– The risk of transmitting the disease to others may be reduced by wearing a mask during treatment.
Complete your medication
This is the best way to protect yourself and your family from tuberculosis. If you discontinue treatment or skip dosages, TB bacteria can develop mutations that make it possible to survive even the most potent TB drugs. These drug-resistant strains can be deadly and are more challenging to treat.
Infants are often vaccinated with the Bacille Calmette Guerin (BCG) vaccine in countries with higher rates of tuberculosis. Because it’s not very effective in adults, the BCG vaccine is not recommended for general use in America. Numerous new TB vaccines have been developed and are currently being tested.
Diagnosis of Tuberculosis
Your doctor will perform a physical exam to check for any swelling in your lymph nodes and listen to your lungs when you breathe.
A skin test is the most common way to diagnose tuberculosis. However, blood tests are becoming more popular. You will be given a small amount of tuberculin injected under your skin. The needle should only feel a slight pinch. A health professional will examine your arm within 48 to 72 hours for any swelling around the injection site. If you have a stiff, raised bump on your arm, you will likely have a TB infection. The test results will be significantly based on the size of the node.
Sometimes results can be misleading.
It’s not perfect. Sometimes it can indicate that someone has TB even though they don’t have it. Sometimes, it can suggest that someone doesn’t have TB even though they do.
False-positive results can occur if you have been recently vaccinated with the Bacille Calmette-Guerin vaccine (BCG). Although this tuberculosis vaccine has not been used in the United States, it is used widely in countries with high TB rates. False-negative results can also occur.
A blood test can confirm or exclude active or latent tuberculosis. These tests assess your immune system’s response to TB bacteria. The tests only require one office visit. A blood test may be necessary if you have a positive response to the skin test or are at high risk for TB infection.
A positive skin test will likely prompt your doctor to order a chest radiograph or CT scan. It might reveal white spots in your lungs that your immune system has protected against TB bacteria. Or it could indicate changes in your lung function due to active tuberculosis.
Your doctor may request a sample of your sputum if your chest X-ray shows signs of tuberculosis. This is the mucus you cough up when you cough. These samples will be tested for TB bacteria.
To test for drug-resistant strains, TB can be tested using sputum samples. This allows your doctor to choose the most effective medications. These tests can take up to eight weeks to complete.
Treatment of Tuberculosis
Your doctor may recommend medication if you have latent TB. Active tuberculosis requires taking antibiotics for at least 6 to 9 months. Your age, general health, resistance to drugs, and the location of the infection will all impact how long and what medications you choose.
The most common Tuberculosis drugs
Latent tuberculosis can be treated with one or two types. Multiple drugs may be required to treat active tuberculosis. This is especially true if the strain is resistant to drug treatment. The following are the most commonly used drugs to treat tuberculosis:
- Rifampin (Rifadin, Rimactane)
- Ethambutol (Myambutol)
- A combination of fluoroquinolones (antibiotics) and injectable drugs, such as amikacin (Capastat), can be used to treat drug-resistant TB. These medications are usually administered for between 20 and 30 months. These medications are not effective for all types of TB.
To counter drug resistance, some drugs may be added to the therapy.
- Bedaquiline (Sirturo)
- Linezolid (Zyvox)
Medication side effects
Although side effects from TB drugs are rare, they can be severe and potentially dangerous. Your liver can be affected by all tuberculosis drugs. If you experience any of these symptoms, consult your doctor immediately.
- Nausea or vomiting
- Appetite loss
- Jaundice is a yellowish color that you apply to your skin.
- Dark urine
- Bleeding or bruising is not difficult
- Blurred vision
It is vital to complete treatment. You might feel less contagious after a few weeks. Do not stop taking your TB medications. You must complete the entire course of treatment and follow the instructions given by your doctor.
If you stop treatment too soon or skip doses, bacteria can become resistant to the drugs. This can lead to TB, which is more dangerous and difficult for patients to treat.
Directly observed therapy (DOT) can help patients stick with their treatment plan. You can have your medication delivered by a health care worker, so you don’t need to remember how to take it.