Tuberculosis types of tuberculosis history of tuberculosis ,mode of infection diagnosis and treatment of tuberculosis.

5. TUBERCULOSIS

Tuberculosis (TB) is a bacterial infection caused by the bacterium Mycobacterium tuberculosi. TB most commonly affects the lungs, but it can affect nearly any organ in the body. There is also a class of organisms known as atypical tuberculosis. Other Mycobacterium bacteria are involved in this. These bacteria can occasionally cause an infection that looks like tuberculosis. These "atypical" mycobacteria include M. kansasii, which can cause similar clinical and pathologic symptoms. M. avium-intracellulare (MAI) is a pathogen seen in AIDS patients that is primarily found in organs of the mononuclear phagocyte system rather than the lungs.

 Tuberculosis outside the lungs can manifest itself in the following ways:

• SKELETAL TUBERCULOSIS

                                                    Tuberculosis osteomyelitis, also known as Pott's disease, primarily affects the thoracic and lumbar vertebrae, followed by the knee and hip. There is extensive necrosis and bony destruction, as well as compressed fractures with kyphosis and soft tissue extension.

• GENITALTRACT TUBERCULOSIS

                                                            Tuberculous salpingitis and endometritis are caused by granulomatous salpingitis in the fallopian tube, which can drain into the endometrial cavity and cause granulomatous endometritis with irregular menstrual bleeding and infertility. Tuberculosis affects the prostate and the epididymis in men, resulting in infertility.

• URANIARY TRACT TUBERCULOSIS

                                             WBCs are found in urine, but a negative routine bacterial culture may indicate renal tuberculosis. If the condition is not treated, the renal parenchyma deteriorates. Inflammation and ureteral stricture can result from ureteral drainage.

•  CNS TUBERCULOSIS

                                           Meningeal spread is possible, and the cerebrospinal fluid has a high protein, low glucose, and lymphocytosis. Because the base of the brain is frequently involved, various cranial nerves may be affected. A solitary granuloma, or "tuberculoma," may form and cause seizures in rare cases

• GASTROINTESTINIAL TUBERCULOSIS

                                                            This is unusual nowadays because routine milk pasteurisation has eliminated Mycobacterium bovis infections. M. tuberculosis coughed up in sputum, on the other hand, may be swallowed due to contamination. The classic lesions are circumferential ulcerations with small intestine structure and ileo-caecal involvement.

• ADERNAL TUBERCULOSIS

                             Tuberculosis usually spreads to the adrenals bilaterally, causing both adrenals to become noticeably enlarged. Addison's disease is caused by the destruction of the cortex.

•   SCROFULA    

                         Mycobacterium scrofulaceum causes uberculous lymphadenitis of the cervical nodes, which can result in a mass of firm, matted nodes just under the mandible.

Chronic draining fistulous tracts to the overlying skin are possible. This complication is possible in children.

• CARDIC TUBERCULOSIS

                                         The pericardium is the most common location for tubercular infection of the heart. As a result, granulomatous pericarditis develops, which can be hemorrhagic. Fibrosis with calcification can occur, resulting in constrictive pericarditis.

 HISTORY        

In 1882, Robert Koch isolated the tubercular bacillus and established tuberculosis as an infectious disease. Patients were isolated in sanatoria and treated in the nineteenth century due to the lack of antibiotics. Throracoplasty surgery was used to try to remove the infectious tissue. There was no effective treatment available until the first half of the twentieth century. Streptomycin was the first antibiotic used to treat tuberculosis, and isoniazid (Laniazid, Nydrazid) became available in 1952.

M. tuberculosis is a slow-growing rod-shaped bacterium. Its cell wall contains a high acidic content, making it hydrophobic and resistant to oral fluids. The cell wall absorbs a specific dye and retains a red colour, thus the name acid-fast bacilli.

MODE OF INFECTION

A person can become infected with tuberculosis bacteria by inhaling bacillus droplets from the air. When someone with tuberculosis lung infection coughs, sneezes, or spits, the bacteria enter the air. TB is not spread by simply touching an infected person's clothes or shaking their hands. Tuberculosis is primarily transmitted from person to person through infected air, particularly in closed rooms. TB caused by Mycobacterium bovis, on the other hand, is spread through the consumption of unpasteurized milk. Previously, this bacterium was a major cause of tuberculosis in children, but it now rarely causes TB because most milk is pasteurized.

PATHOLOGY

When tuberculosis bacteria are inhaled, they can multiply and cause pneumonia. Local lymph nodes associated with the lungs may become infected and enlarge as a result of the infection. The infection has the potential to spread to other parts of the body. In healthy people, the immune system can fight the infection and prevent the bacteria from spreading.

If the body can form scar tissue (fibrosis) around the TB bacteria, the infection is rendered inactive. Such a person usually has no symptoms and cannot spread TB to others. Scar tissue and lymph nodes may eventually harden as a result of the scar calcification process. However, TB bacteria can break through scar tissue if the body's immune system is compromised.

issue. The spread of bacteria can cause pneumonia to recur and TB to spread to other parts of the body. It could take months for symptoms to appear after the infection has entered the lungs. An active TB infection typically causes generalized tiredness or weakness, weight loss, fever, and night sweats. If the lung infection worsens, additional symptoms may include coughing, chest pain, coughing up sputum or blood, and shortness of breath. If the infection spreads beyond the lungs, the symptoms will vary according to the organs affected.

DIGNOSIS

TB can be diagnosed using a variety of methods, including chest X-rays, sputum analysis, and skin tests. Chest x-rays can reveal active tuberculosis pneumonia, as well as scarring (fibrosis) or hardening (calcification) of the lungs. The presence of tuberculosis bacteria can be detected by examining sputum on a slide (smear) under a microscope. A sample of the sputum can also be cultured in special incubators to help identify the tuberculosis bacteria.

TB is detected using a variety of skin tests, including tuberculin skin tests such as the Monteux test, the Tine test, and the PPD (Purified Protein Derivative) test. A small amount of purified extract from dead tuberculosis bacteria is injected under the skin in each of these tests. If a person is not infected with tuberculosis, no reaction will occur at the injection site. However, if a person has tuberculosis, a raised and reddened area will appear around the site of the test injection 48 to 72 hours after the injection.

If the tuberculosis infection was recent, the skin test may be negative because it takes 2 to 10 weeks for the skin to test positive after infection. If a person's immune system is weakened due to another illness, such as AIDS or cancer, or if he is taking medication that suppresses the immune response, such as cortisone or anti-cancer drugs, the skin test may be falsely negative.

TREATRMENT

Antibiotic treatment is recommended to treat as well as prevent dormant tuberculosis from becoming an active infection. Isoniazid is the antibiotic used for this purpose (INH). It will keep the TB from becoming active in the future if taken for 6 to 12 months. In fact, if a person with a positive skin test does not take INH, there is a 5 to 10% chance that the TB will become active in their lifetime.

Isoniazid is not recommended (contraindicated) during pregnancy or for people who have alcoholism or liver disease. Isoniazid can also cause skin rashes, tiredness, and irritability. Isoniazid liver damage is uncommon and usually reverses once the drug is stopped. However, in elderly people, the liver damage (INH hepatitis) can be fatal. It is therefore critical for the doctor to monitor a patient's liver by performing liver function tests on a regular basis during the course of INH therapy.

Active tuberculosis is treated with a combination of isoniazid, Rifampicin (Rifadin), ethambutol (Myambutol), and pyrazinamide. Drugs are frequently used during the first two months of therapy to help kill any potentially resistant bacteria strains. Based on drug sensitivity testing, the number is usually reduced to two drugs for the remainder of the treatment. Streptomycin, an injection-based antibiotic, may also be used, especially if the disease is severe. Treatment usually lasts several months, if not years. The patient's compliance is crucial to the successful treatment of tuberculosis.

Drug-resistant tuberculosis has become a major issue in some populations in recent years. In Southeast Asia, for example, INH-resistant tuberculosis is common. A more serious issue is multi-drug resistant tuberculosis, which has been observed in prison populations. Poor inmate compliance is thought to be the primary cause of the development of multi-drug resistance.

When medication fails to cure tuberculosis, lung surgery may be recommended, but it is not always necessary. In most cases, antibiotics are effective in curing the disease. Tuberculosis, on the other hand, can be fatal if not treated, so early detection is critical.

disease no .6

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