Pulmonary TB

Pulmonary Tuberculosis

Tuberculosis is a widespread, infectious and often fatal disease of the lungs

It is caused by Mycobacterium Tuberculosis, a small, no motile aerobic bacillus

This bacillus thrives in body areas like lungs which are abundant in oxygen and blood

Any part of the body may be infected by Tuberculosis, but mostly it occurs in the lungs (pulmonary tuberculosis)

When TB develops outside lungs it is called Extra-pulmonary TB

How does it reach the lungs?

TB spreads through air via droplets during

Coughing

Sneezing

laughing

Singing

What are the high risk factors of TB?

Diabetes

Lung disease

Smoking

Certain medications having steroids

Poor nutrition

Living with TB patients

What is Latent TB?

When the immune system is strong, the bacterium remains alive but inert in encapsulated form- called ‘latent TB’

When immunity becomes low, TB becomes active

Of all Latent cases 5% to 10% develop active TB in their lives at some stage

Treatment of Pulmonary TB?

Pulmonary Tuberculosis is curable with standardized treatment. For a new or fresh case of tuberculosis the duration of treatment is six to nine months, where for the first two to three months first line TB drugs are used like.
- Rifampicin
- Isoniazid
- Ethambutol.
- Pyrazinamide
- Streptomycin.
- and for the next four months, three drugs –
  - Rifampicin
  - Isoniazid
  - Ethambutol are used.

Treatment is daily and adherence to TB treatment is critical for curing tuberculosis. If the treatment is not followed, the TB can come back or the TB bacteria can become drug resistant

Prevalence of Pulmonary TB?

Nearly one-third of the world population is believed to be infected with M. tuberculosis

New infections develop in 1% of the population every year

Nearly 9 million new cases of TB worldwide every year

Estimated deaths of 1.4 million every year

Almost 640,000 new multidrug-resistant cases (MDR) recorded all over world

The extensively drug-resistant (XDR) TB prevalent in 84 countries worldwide

What are the Symptoms of TB?

Cough with thick, cloudy sputum (sometimes haemoptysis) from lungs for more than 2 weeks

Night sweating, Chills and Fever

Fatigue; Unexplained weakness and tiredness

Unexplained weight loss

Loss of appetite

Shortness of breath and chest pain

No symptoms in almost 25% patients infected with TB

What can go wrong when TB not treated?

When full course of treatment not completed, it leads to multi-drug resistant strains (MDR or X MDR)

When not treated leads to Bleeding in lungs, Infection from other bacteria & Hole in airways of lungs

TB is fatal if not treated

The body’s immunity system is largely responsible for containing the TB infection.

If treatment is not successful, the TB infection can flare up again (relapse). People who have relapses usually have them within 6 to 12 months after treatment

Treatment Regimens in Special Situations

The treatment of TB in special situations like in pregnancy and breastfeeding, liver disorders, and renal failure ,diabetes , HIV,alcoholism etc require modified treatment regimen
- Treatment of tuberculosis is a complicated and lengthy process.
- There are over 20 drugs available for TB treatment, which are used in differing combinations for different situations
- More than 97% of people with drug susceptible TB (the non-drug resistant tb) are cured in 6 – 9 months using a combination of ‘first line’ TB drugs

The use of corticosteroids is in doubt: but they have been employed in cases of increased Intra-Ventricular pressure, due to change in consciousness, due to focal neurological findings, due to spinal block or due to tuberculous encephalopathy.

Ventricular drain shunt advised in obstructive hydrocephalus and those showing neurological deterioration

Duration of Treatment
- The optimal duration of antimicrobial therapy is unclear.

Strategies on prevention of TB?

Avoid stuffy enclosed rooms with active TB patients

Use face masks when working with untreated TB patients

Maintain strong immunity. Eat healthy foods, get ample sleep and do physical exercises

Get a Medical check-up

Get sputum analysis as advised. Mycobacterium shows up as acid-fast bacteria (AFB). The Xpert MTB/RIF test assay can detect 90% of pulmonary TB from sputum sample.

Get X-ray Chest done (usually confirmatory)

Send blood for interferon gamma test

Get HIV test (as TB common in HIV cases and vice-versa)

Get blood tests done

Pulmonary TB

Pulmonary TB

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