Pulmonary tuberculosis in humans is caused by a virus. Four-component treatment regimen for tuberculosis. According to clinical forms, tuberculosis infection is divided into

Tuberculosis is a dangerous and, unfortunately, widespread disease throughout the world. The mortality rate from this disease is higher than from any other infectious lesion of the body - these statistics are provided by the World Health Organization. What are the causes of tuberculosis? What factors contribute to the development of the disease, and why does infection with Mycobacterium tuberculosis not always lead to the development of the disease?

When considering the causes of tuberculosis, you need to pay attention to both the causative agent of the disease and the factors contributing to the development of the disease.

It is known that the causative agent of the disease is Mycobacterium tuberculosis (MBT), or Koch's bacillus (named after the German scientist who first discovered the tuberculosis bacillus). Mycobacteria are highly resistant to external factors, due to which they are able to remain viable for a long time. Cannot withstand boiling and ultraviolet rays.

1. Airborne, the most common route. In this case, mycobacteria enter the environment with droplets of saliva from a person suffering from an open form of tuberculosis.
2. Contact and everyday life is through household items.
3. Alimentary route - in this case, the tuberculosis bacillus is introduced into the body through food. This infection is less common, since in most cases mycobacteria cannot withstand an acidic environment gastrointestinal tract and die.
4. Hematogenous route - through the blood. Such infection can occur through an open wound, and in this way the infection spreads from the lungs to other human organs and systems.
5. Intrauterine - a pregnant woman with tuberculosis infection can infect the child through the placenta.

It is important to know that not only mycobacteria, but also mycobacteria of bovine tuberculosis, and in rare cases, avian tuberculosis, pose a danger to humans. This increases the risk of infection through nutritional routes in people who eat animal products without careful processing.

And yet, the mere entry of Koch's bacillus into the body is not enough for the development of tuberculosis. Indeed, according to statistics, almost 100% of the adult population in Russia are infected with these mycobacteria, but in most cases such infection has absolutely no effect on human health and quality of life. In healthy people with high level immune system, the body independently and successfully copes with pathogenic bacteria.

The main condition for the development of tuberculosis is weakening of the immune system caused by for various reasons.

Understanding the cause of the development of tuberculosis allows you to correctly build a course of treatment and reduce the risk of secondary forms of the disease.

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• Congratulations! The likelihood that you will develop tuberculosis is close to zero.

  But don’t forget to also take care of your body and undergo regular medical examinations and you won’t be afraid of any disease!
  We also recommend that you read the article on.

• There is reason to think.

  It is impossible to say with certainty that you have tuberculosis, but there is such a possibility; if it is not Koch bacilli, then there is clearly something wrong with your health. We recommend that you undergo a medical examination immediately. We also recommend that you read the article on detecting tuberculosis in the early stages.

• Contact a specialist urgently!

  The likelihood that you are affected by Koch bacilli is very high, but it is not possible to make a diagnosis remotely. You should immediately contact qualified specialist and undergo a medical examination! We also strongly recommend that you read the article on detecting tuberculosis in the early stages.

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Does your lifestyle involve heavy physical activity?

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   How often do you take a tuberculosis test (eg Mantoux)?

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   Do you carefully observe personal hygiene (shower, hands before eating and after walking, etc.)?

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   Do you take care of your immunity?

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   Have any of your relatives or family members had tuberculosis?

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   Do you live or work in an unfavorable environment (gas, smoke, chemical emissions from enterprises)?

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   How often are you in damp, dusty or moldy environments?

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   How old are you?

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   What gender are you?

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   Have you experienced Lately feeling very tired for no particular reason?

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    Have you been feeling physically or mentally unwell lately?

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    Have you noticed a weak appetite lately?

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    Have you been watching yourself lately? a sharp decline with a healthy, plentiful diet?

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    Have you recently felt an increase in body temperature? long time?

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    Are you having trouble sleeping lately?

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    Have you noticed increased sweating lately?

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    Have you noticed yourself looking unhealthy lately?

Provoking factors and risk groups

Factors that provoke the disease are:

• low social and living conditions;
• bad habits such as smoking, alcohol abuse, drug addiction;
• poor nutrition low in proteins and vitamins;
• prolonged stress leading to exhaustion of the body;
• HIV infection;
• decreased immunity due to chronic diseases and a number of other factors.

• people who have long-term contact with people infected with tuberculosis (relatives of the patient living with him). It must be remembered that patients with a closed form of the disease do not pose a danger to others;
• health care and correctional workers;
• people with chronic or acute diseases that have a protracted course (especially for lung diseases);
• patients with diabetes mellitus, diseases of the gastrointestinal tract (stomach ulcer and duodenum);
• people who have already had tuberculosis and undergone treatment;
• AIDS/HIV infected people and patients.

Once the tuberculosis bacillus enters the human body, it will remain there forever. But strong immunity will not allow the disease to develop, and the person may not even know about the infection until the end of his days.

However, when entering the body with a weakened immune system, mycobacteria do not receive adequate resistance and begin to actively multiply, forming lesions. In this case, a primary tuberculosis infection develops.

This phenomenon can occur years or even decades after infection. Therefore, great importance should be given to regular examination of the population in order to timely diagnose the likely development of the disease.

Since the disease is widespread and very dangerous, great attention is paid to preventing infection and spread of the disease. It is recommended that both children and adults be tested annually, and those at high risk even more frequently.

• immunological;
• laboratory;
• instrumental.

The most common method for diagnosing tuberculosis in children is the Mantoux test. It is given annually as part of the national vaccination schedule for children with one year old and until adulthood. The essence of the method is the subcutaneous injection of tuberculin. After three days, the reaction obtained on the skin is assessed, the result is recorded in medical card. If a positive result appears or if the papule grows from year to year, the patient is sent for a consultation with a phthisiatrician for further examination.

Another diagnostic method is the diaskintest, which is also based on a skin reaction, but this test will show a positive result only in the presence of active mycobacterium tuberculosis.

For the adult population, the main method for diagnosing tuberculosis is fluorographic examination. It must be carried out every two years, in some cases (in regions with a tense epidemiological situation and for people at high risk) - annually.

If the doctor has doubts based on the results of fluorography, the patient is sent for additional examination for an X-ray of the lungs.

In addition to the methods listed above, laboratory tests of biomaterials: blood, sputum, urine, feces and others are widely used to diagnose tuberculosis.

• tracheobronchoscopy - examination of the trachea and bronchi;
• bronchoscopic lavage - collection of lavage fluid;
• pleuroscopy - examination of the pleural cavity.

If the presence of tuberculosis is confirmed, for precise setting Diagnosis uses several methods simultaneously.

If diagnostic measures were not carried out on time, or after the detection of primary MBT infection, the child was not preventive actions, then primary tuberculosis infection can manifest itself in the following forms:

1. Tuberculosis intoxication. It develops against the background of the spread of tubercle bacilli throughout the child’s body. To diagnose the disease, the results of the Mantoux reaction are used over time, that is, over several years. Tuberculosis intoxication is characterized by pathological changes in the lymph nodes, disorders of the central nervous system(the child becomes irritable, it is noted fast fatiguability, deterioration in sleep quality). It is possible that body temperature may rise to subfebrile levels (37.0 0 C-37.5 0 C). In this case, there will be no foci of infection either in the lungs or in any other organs, since this is the only form of tuberculosis infection that has no localization.
2. Primary tuberculosis complex. It manifests itself in the form of a localized focus of inflammation in the lung, formed at the site of sedimentation of Mycobacterium tuberculosis. The diagnosis is made when additional examination child after establishing the fact of MBT infection using an x-ray of the lungs. In case of complications of the disease, an increase in lung damage of varying severity and spread of infection to other organs and systems is possible. Transition to the chronic form of tuberculosis is possible.
3. Tuberculosis of the intrathoracic lymph nodes. In this case, Koch's bacillus is localized only in the lymph nodes, without affecting the lungs. The lesion can be of a small form, then it can be detected only by the results of a thorough x-ray examination, or it can become severe, becoming the cause of the development of miliary tuberculosis - very dangerous form diseases.
4. Miliary tuberculosis. Most often develops in young children. In this severe form of the disease, foci of tuberculous lesions are found not only in the lungs, but throughout almost the entire body. There can be three options for the development of miliary tuberculosis: typhoid - with high fever, convulsive syndrome, loss of consciousness; pulmonary - characterized by breathing problems and cardiac dysfunction; meningeal - when signs of tuberculous meningitis predominate. The disease is detected by performing an X-ray of the lungs, which reveals multiple lesions organ.
5. Tuberculous meningitis.

It is one of the complication options for primary tuberculosis and has an unfavorable prognosis. The causative agents of the disease enter the meninges through the blood or lymph from the foci primary lesion, most often from the lungs.

Signs of the development of tuberculosis brain damage are increasing.

• behavioral changes, lethargy, irritability;
• fatigue, frequent mood swings;
• low-grade fever and gastrointestinal disorders - vomiting and constipation;
• headaches - in the first stages they appear briefly, and then take on a long-term character.

• severe headaches;
• stiff neck ( meningeal syndrome) - head thrown back;
• intolerance to light, loud sounds;
• visual impairment.

The disease is severe and requires immediate treatment. If medical assistance is not provided initial stage illness, there is a high probability of developing severe consequences; children often develop hydrocephalus, paralysis, and blindness. And if there is no treatment at all, then the patient will die.

Thus, if the diagnosis reveals that a child or adult is infected with mycobacterium tuberculosis, do not panic - if there are no aggravating factors, the body will most likely cope with the problem itself, preventing the development of the disease.

But it is also unacceptable to let the situation take its course! It is important to follow all doctor’s recommendations so as not to miss a possible disease.

Patients who have once had tuberculosis are at risk of developing secondary forms of the disease, which can affect the respiratory system, but can also be extrapulmonary in nature.

1. Focal pulmonary tuberculosis. This is the most common form of secondary tuberculosis; it is diagnosed in half of newly ill patients. The cause may be lesions in the lungs during a primary infection, activated under the influence of any factors.

The disease is not accompanied by significant symptoms, with the exception of general fatigue and a slight increase in temperature. Focal pulmonary tuberculosis is diagnosed by x-ray, the results are confirmed by the results of a blood test.

When successful treatment secondary lesions dissolve. If the disease becomes chronic, scars and adhesions form on the lungs. If treatment does not bring results, then complications of the disease can lead to decay of lung tissue.

1. Disseminated pulmonary tuberculosis. It is characterized by the spread of Koch's bacillus throughout the body with blood flow from foci located in the lungs. The lesions can be both activated primary ones and newly formed ones.

The course of the disease occurs in acute, subacute and chronic form.

Miliary tuberculosis is a type of acute disseminated pulmonary tuberculosis.

The subacute form resembles ARVI with symptoms; an x-ray of the lungs is required for an accurate diagnosis. Without proper treatment, the disease becomes chronic with the formation of numerous lesions in the lungs.

Chronic disseminated tuberculosis is accompanied by debilitating symptoms, characterized by shortness of breath, moist cough, hemoptysis. There are disruptions in the functioning of the cardiovascular system.

1. Infiltrative tuberculosis. The infiltrate represents localized inflammation in the lungs. If it is located in the thickness lung tissue, it is detected only on an x-ray. If the lesion is small, the disease is asymptomatic. But if a significant part of the lung is affected, then specific symptoms tuberculosis manifest themselves clearly. Competent treatment may lead to resorption of infiltrates or their compaction.
2. Caseous pneumonia. With this form of tuberculosis, decay of the lung tissue is observed. The disease is severe, the patient is bedridden and is unable to care for himself. This stage is accompanied copious discharge sputum, a significant increase in temperature, severe weakness. By this point, the patient is losing a lot of weight.

It is impossible to achieve complete healing of the patient at this stage. There is a possibility of turning caseous pneumonia into pulmonary cirrhosis.

1. Pulmonary tuberculoma. Tuberculoma is a capsular inflammatory formation. It is practically not amenable to antibacterial therapy, therefore it is recommended for treatment operative method(removal of tuberculoma surgically).
2. Fibrous-cavernous pulmonary tuberculosis. It occurs as a consequence of other forms of the disease. It combines both the formation of new tuberculosis foci and the spread of Koch's bacillus from activated scars and cavities. Therapy is difficult and recovery is almost impossible.
3. Cirrhotic pulmonary tuberculosis. This condition occurs as a result of treatment of disseminated and infiltrative types, as well as fibrous-cavernous tuberculosis. Numerous scars in the lungs resulting from therapy for these forms of tuberculosis lead to deformation of the bronchi and pulmonary vessels. Patients suffer from severe shortness of breath, a constant cough with sputum production, and can sometimes be accompanied by hemoptysis. Cirrhotic tuberculosis is incurable, changes in the body are irreversible. Treatment is symptomatic and is limited to alleviating the patient’s condition.
4. Tuberculous pleurisy. This is a lesion of the pleura by Mycobacterium tuberculosis. The disease is more often diagnosed in children and young people. Usually the development of the disease occurs gradually, but in some cases it is acute. The disease is characterized by symptoms specific to tuberculosis, and diagnosis is difficult. Install accurate diagnosis is possible only based on the results of a pleural puncture study.

Extrapulmonary forms of secondary forms of tuberculosis include tuberculous lesions various organs person, which may be focal or destructive in nature. Affects the kidneys, genitourinary system, skin, musculoskeletal system(bones, joints, spine), central nervous system.

All of these forms of tuberculosis are fraught with serious consequences, so people who have once had the disease need to especially closely monitor their health and monitor for any suspicious symptoms.

Complications of the disease

To the most dangerous complications pulmonary tuberculosis include pulmonary hemorrhage and sudden pneumothorax.

• extensive damage to the lungs, when in addition to the lung tissue, blood vessels are also affected;
• frequent exacerbations of the disease;
• liver damage due to antibacterial drugs; used in the treatment of tuberculosis;
• a number of external factors: changes in atmospheric pressure and air temperature, exposure to alcohol and others.

Pulmonary hemorrhage can be fatal for the patient.

Spontaneous pneumothorax occurs when lung tissue ruptures, and pleural cavity air enters, and with it the infection.

The complication is caused by excessive physical exertion or severe cough. At the same time, there is a high risk of developing empyema - inflammation of the pleura.

Treatment of tuberculosis is a complex and very lengthy process, which is based on long-term antibacterial therapy.

1. Highly effective drugs: Isoniazid and Rifampicin.
2. Medications with average effectiveness: Treptomycin and Ethambutol, Prothionamide and Etonamide and a number of other drugs.
3. Drugs with low effectiveness - Tibon, Paraaminosalicylate.

Treatment of tuberculosis involves the simultaneous use of several antibiotics. This is due to the fact that Mycobacterium tuberculosis is able to adapt quite quickly and develop resistance to the drug. This same property of the causative agent of tuberculosis determines the need for such long-term treatment.

The course of antibacterial therapy, the composition of drugs and the duration of their use are chosen strictly individually for each patient. In this case, the attending physician takes into account the form of tuberculosis, stage of development, age and general condition of the patient. In addition, it is very important to constantly monitor the patient’s condition at all stages of the fight against the disease in order to verify the effectiveness of the therapy and adjust the course in time. Therefore, treatment of patients with tuberculosis is carried out strictly in a hospital setting under round-the-clock supervision of doctors.

In addition to anti-tuberculosis drugs, the patient is prescribed maintenance therapy, which includes taking vitamins, drugs that enhance immunity, and sometimes it becomes necessary to take hormonal drugs. Drugs are also prescribed for symptomatic treatment: antipyretic, painkillers, detoxification drugs.

The fight against tuberculosis is a complex and lengthy matter, and drug treatment is only part of an integrated approach. The quality of nutrition, physiotherapy, physical therapy, and a healthy lifestyle also play an important role.

Thus, the diet for all patients with tuberculosis should be high in calories, food rich in animal proteins and vitamins.

• meat of all types;
• milk and dairy products;
• eggs;
• fish;
• cereals;
• vegetables, fruits and herbs.

Animal proteins replenish the body's needs during intoxication that accompanies the disease, and also increase the level of immunity.

Also, in the treatment of tuberculosis, physiotherapy (electrophoresis, UHF, laser therapy) is widely used to resolve tuberculosis lesions.

Climatotherapy is also an indispensable assistant in the fight against the disease. Clean air and sun rays increase the body's overall resistance pathogenic bacteria, improve sleep quality, help improve appetite. Mountain, sea and lowland climates have a particularly beneficial effect. Also traditionally, the air of coniferous forests is recommended for the treatment of lung diseases.

To restore motor activity, in cases where the disease has caused complications in the form of partial paralysis, as well as to increase the tone of the body as a whole, physical therapy is widely used for all patients with tuberculosis. It is connected not at an early stage of the disease (at this time patients are advised to go to bed), but when the threat of complications has passed.

Treatment of tuberculosis with folk remedies can be an addition to the main treatment, but in no case should you try to resist the disease on your own, relying only on this method. Defeat tuberculosis exclusively folk recipes it is forbidden!

For herbal medicine, plants and herbs are used that have a restorative, tonic, and anti-inflammatory effect on the body. Propolis is also very popular.

Both during treatment and after recovery, you need to carefully monitor your health. Healthy image life, proper nutrition, refusal bad habits, adequate physical activity, walks fresh air, positive emotions and lack of long-term stressful situations - the necessary conditions to maintain health, which will help to avoid re-development diseases.

Quiz: How susceptible are you to tuberculosis?

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Time is over

• Congratulations! Are you OK.

  The probability of getting tuberculosis in your case is no more than 5%. You are a completely healthy person. Continue to monitor your immunity in the same way and no diseases will bother you.

• There is reason to think.

  Everything is not so bad for you; in your case, the probability of getting tuberculosis is about 20%. We recommend that you take better care of your immunity, living conditions and personal hygiene, and you should also try to minimize the amount of stress.

• The situation clearly requires intervention.

  In your case, everything is not as good as we would like. The probability of infection with Koch bacilli is about 50%. You should immediately contact a specialist if you experience first symptoms of tuberculosis! It is also better to monitor your immunity, living conditions and personal hygiene, and you should also try to minimize the amount of stress.

The disease tuberculosis has been known to mankind under the name consumption since ancient times. The disease was first described by the physician Hippocrates, who believed that it was a genetic disease. Another ancient doctor, Avicenna, found that the disease can be transmitted from one person to another. In the 19th century, the German scientist Robert Koch proved infectious nature disease by discovering the mycobacterium that caused the disease. The causative agent of the disease, Koch's bacillus, is named after its discoverer. The scientist received the Nobel Prize for his discovery.

Tuberculosis in our time is still one of the most common diseases in all countries of the world. According to WHO, many cases of tuberculosis infection are registered annually in the world - about 9 million. In Russia, 120,000 people become ill with tuberculosis every year. The mortality rate from infection in Russia is higher than in European countries.

So what is tuberculosis? How does a person become infected with tuberculosis, and is this disease always dangerous? What treatment is effective and can tuberculosis be completely cured? Let's look at these questions in detail.

What kind of disease is tuberculosis?

The causative agent of tuberculosis is mycobacterium (Mycobacterium tuberculosis). Tuberculosis is an infectious disease. The most common route of transmission of tuberculosis is airborne. The tuberculosis bacillus is transmitted through contact during talking, sneezing, singing or coughing, as well as through household items. The immune system of a healthy person copes with the infection by destroying the Koch bacillus in the respiratory tract. Too massive an infection or frequent contact with a sick person can cause illness even in a healthy person. In people with a weakened immune system, its cells are not able to destroy mycobacteria.

The incubation period of pulmonary tuberculosis is from 3 to 12 weeks. Symptoms of the disease during the incubation period include a mild cough, weakness, and a slight increase in temperature. During this period, the disease is not contagious. However, the absence of pronounced symptoms of the incubation period explains why tuberculosis is dangerous for the infected person. After all, mild symptoms do not attract much attention; they can be mistaken for a respiratory disease. If the disease cannot be recognized at this stage, it becomes pulmonary. The main cause of tuberculosis is a low level of quality of life. Crowding of people contributes to the spread of the disease, especially in prisons. Decreased immunity or concomitant diabetes promotes infection and its progression.

The first signs of tuberculosis

Signs of pulmonary tuberculosis in the early stages vary depending on the form, stage and localization of the process. In 88% of cases, the infection takes a pulmonary form.

Symptoms of pulmonary tuberculosis at an early stage of its development:

• cough with phlegm for 2–3 weeks;
• periodically elevated temperature up to 37.3 °C;
• night sweats;
• sudden weight loss;
• presence of blood in sputum;
• general weakness and loss of strength;
• chest pain.

The initial manifestations of tuberculosis infection can be mistaken for any other disease. It is in the initial stage that the patient is dangerous to others. If the patient does not consult a doctor in a timely manner, the tuberculosis infection will progress and spread in the body. That is why it is so important to undergo annual fluorography, which will promptly identify the source of the disease.

Forms of tuberculosis according to clinical course

There are primary and secondary tuberculosis. Primary develops as a result of infection with Koch's bacillus in an uninfected person. The process most often affects children and adolescents. The manifestation of the disease in old age means activation of tuberculosis of the lymph nodes suffered in childhood.

In children, tuberculosis occurs in the form of the primary tuberculosis complex. In infancy, the process affects a lobe or even a segment of the lung. Symptoms of pneumonia include cough, fever up to 40.0 °C and chest pain. In older children, the lesions in the lung are not so extensive. The disease in the lungs is characterized by an increase in cervical and axillary lymph nodes.

The primary complex consists of 4 stages of disease development.

1. Stage I - pneumonic form. X-ray shows a small lesion in the lung, enlarged lymph nodes in the root of the lung.
2. Stage II of resorption. During this period, the inflammatory infiltrate in the lungs and lymph nodes decreases.
3. Next stage Stage III, it is manifested by compaction of residual foci in the lung tissue and lymph nodes. In these places, the X-ray image shows small pinpoint pockets of lime deposits.
4. In stage IV, calcification of the former infiltrate occurs in the pulmonary and lymphatic tissue. Such calcified areas are called Ghon lesions and are detected by fluorography.

The primary tuberculosis process in children and adults often occurs in a chronic form. In this case, the active process in the lungs and lymph nodes persists for many years. This course of the disease is considered chronic tuberculosis.

Open and closed forms of tuberculosis infection

Open form of tuberculosis - what is it and how does it spread? Tuberculosis is considered to be in open form if the patient secretes mycobacteria in saliva, sputum, or secretions from other organs. Isolation of bacteria is detected by culture or microscopy of the patient's secretions. Bacteria spread through the air very quickly. When talking, the infection with saliva particles spreads over a distance of 70 cm, and when coughing it reaches up to 3 meters. The risk of infection is especially high for children and people with reduced immunity. The term “open form” is more often used in relation to patients with the pulmonary form of the disease. But the release of bacteria also occurs during an active tuberculosis process in the lymph nodes, genitourinary system and other organs.

Symptoms of open tuberculosis:

• dry cough for more than 3 weeks;
• pain in the side;
• hemoptysis;
• causeless weight loss;
• enlarged lymph nodes.

A patient in open form is dangerous to everyone around him. Knowing how easily open tuberculosis is transmitted, in case of prolonged and close contact with a patient, you need to undergo examination.

If the bacteriological method does not detect bacteria, this is a closed form of the disease. Closed form of tuberculosis - how dangerous is it? The fact is that laboratory methods Koch's bacillus is not always detected; this is due to the slow growth of mycobacteria in the culture for inoculation. This means that a patient who has no bacteria detected can practically excrete them.

Is it possible to become infected with tuberculosis from a patient with a closed form? With close and constant contact with a sick person, in 30 cases out of 100 you can become infected. In a patient with a closed form, the process in the lungs or any other organ can be activated at any time. The moment the process transitions into an open form is initially asymptomatic and is dangerous for others. In this case, closed-form tuberculosis is transmitted, like open tuberculosis, through direct contact during communication and through household items. Symptoms of the closed form of tuberculosis are practically absent. Patients with a closed form do not even feel unwell.

Types of pulmonary tuberculosis

Based on the degree of spread of tuberculosis, several clinical forms of the disease are distinguished.

Disseminated tuberculosis

Disseminated pulmonary tuberculosis is a manifestation of primary tuberculosis. It is characterized by the development of multiple lesions in the lungs. Infection in this form spreads either through the bloodstream or through lymphatic vessels and bronchi. Most often, mycobacteria begin to spread hematogenously from the mediastinal lymph nodes to other organs. The infection settles in the spleen, liver, meninges, and bones. In this case, an acute disseminated tuberculosis process develops.

The disease is manifested by high fever, severe weakness, headache, and general serious condition. Sometimes disseminated tuberculosis occurs in a chronic form, then sequential damage to other organs occurs.

The spread of infection through the lymphatic tract occurs from the bronchial lymph nodes to the lungs. With a bilateral tuberculosis process in the lungs, shortness of breath, cyanosis, and cough with sputum appear. After a prolonged course, the disease is complicated by pneumosclerosis, bronchiectasis, and pulmonary emphysema.

Generalized tuberculosis

Generalized tuberculosis develops due to the spread of infection through the hematogenous route to all organs simultaneously. The process can occur in acute or chronic form.

The reasons for the spread of infection are different. Some patients do not comply with treatment regimen. In some patients it is not possible to achieve the effect of treatment. In this category of patients, the generalization of the process occurs in waves. Each new wave of the disease is accompanied by the involvement of another organ. Clinically, a new wave of the disease is accompanied by fever, shortness of breath, cyanosis, and sweating.

Focal tuberculosis

Focal tuberculosis lung disease is manifested by small foci of inflammation in the lung tissue. The focal type of the disease is a manifestation of secondary tuberculosis and is more often detected in adults who suffered from the disease in childhood. The source of the disease is localized in the apices of the lungs. Symptoms of the disease include loss of strength, sweating, dry cough, and pain in the side. Hemoptysis does not always appear. The temperature during tuberculosis rises periodically to 37.2 °C. A fresh focal process is easily cured completely, but with inadequate treatment the disease takes on a chronic form. In some cases, the lesions level out on their own with the formation of a capsule.

Infiltrative tuberculosis

Infiltrative tuberculosis lungs occurs during primary infection and chronic form in adults. Caseous foci are formed, around which a zone of inflammation forms. The infection can spread to the entire lobe of the lung. If the infection progresses, the caseous contents melt and enter the bronchus, and the vacated cavity becomes a source of formation of new lesions. The infiltrate is accompanied by exudate. If the course is favorable, the exudate does not completely dissolve; in its place, dense strands of connective tissue. Complaints from patients with the infiltrative form depend on the extent of the process. The disease can be almost asymptomatic, but can manifest as an acute fever. Early stage tuberculosis infection is detected by fluorography. In people who have not undergone fluorography, the disease develops into a widespread form. Possible death due to pulmonary hemorrhage.

Fibrous-cavernous tuberculosis

symptom of fibrocavernous tuberculosis - weight loss

Fibrous-cavernous pulmonary tuberculosis is formed as a result of the progression of the cavernous process in the lungs. With this type of disease, the walls of caverns (empty cavities in the lung) are replaced by fibrous tissue. Fibrosis also forms around the cavities. Along with caverns, there are foci of contamination. Cavities can connect with each other to form a large cavity. The lung and bronchi are deformed and blood circulation in them is disrupted.

Symptoms of tuberculosis at the onset of the disease include weakness and weight loss. As the disease progresses, shortness of breath, cough with sputum, and temperature rise. The course of tuberculosis occurs continuously or in periodic outbreaks. It is the fibrous-cavernous form of the disease that is the cause fatal outcome. A complication of tuberculosis manifests itself in the formation pulmonary heart with respiratory failure. As the disease progresses, other organs are affected. Complications such as pulmonary hemorrhage or pneumothorax can cause death.

Cirrhotic tuberculosis

Cirrhotic tuberculosis is a manifestation of secondary tuberculosis. At the same time, as a result of the age of the disease, there are extensive formations fibrous tissue in the lungs and pleura. Along with fibrosis, there are new foci of inflammation in the lung tissue, as well as old cavities. Cirrhosis may be localized or diffuse.

Elderly people suffer from cirrhotic tuberculosis. Symptoms of the disease include cough with sputum and shortness of breath. The temperature rises as the disease worsens. Complications occur in the form of cor pulmonale with shortness of breath and bleeding in the lungs; they cause the death of the disease. Treatment consists of a course of antibiotics with sanitation bronchial tree. When the process is localized in the lower lobe, its resection or removal of a segment of the lung is performed.

Extrapulmonary types of tuberculosis

Extrapulmonary tuberculosis develops much less frequently. Tuberculosis infection of other organs can be suspected if the disease cannot be treated for a long time. Based on the location of the disease, there are such outside pulmonary forms tuberculosis, such as:

• intestinal;
• osteoarticular;
• genitourinary;
• cutaneous

Tuberculosis of the lymph nodes often develops during primary infection. Secondary tuberculous lymphadenitis can develop when the process is activated in other organs. The infection is especially often localized in the cervical, axillary and inguinal lymph nodes. The disease is manifested by enlarged lymph nodes, fever, sweating, and weakness. The affected lymph nodes are soft, mobile on palpation, painless. In case of complications, caseous degeneration of the nodes occurs, other nodes are involved in the process, and a continuous conglomerate is formed, fused to the skin. In this case, the nodes are painful, the skin over them is inflamed, a fistula is formed, through which the products of specific inflammation of the nodes are discharged. At this stage, the patient is contagious to others. If the course is favorable, the fistulas heal and the size of the lymph nodes decreases.

Tuberculosis of the female genital organs is more susceptible to young women 20–30 years old. The disease is often erased. Its main symptom is infertility. Along with this, patients are concerned about the violation menstrual cycle. The disease is accompanied by an increase in temperature to 37.2 °C and nagging pain lower abdomen. Used to make a diagnosis X-ray examination and a method of culture of uterine secretions. The x-ray shows displacement of the uterus due to adhesive process, pipes with uneven contours. On overview photo Calcifications are found in the ovaries and tubes. Complex treatment includes several anti-tuberculosis drugs and lasts for a long time.

Diagnostics

How to diagnose tuberculosis at an early stage? Initial and effective method diagnostics is carried out in the clinic during fluorography. It is performed for each patient once a year. Fluorography for tuberculosis reveals fresh and old foci in the form of infiltration, focus or cavity.

If tuberculosis is suspected, a blood test is done. Blood counts vary greatly depending on the severity of the infection. With fresh lesions, neutrophilic leukocytosis with a shift to the left is noted. At severe form lymphocytosis and pathological granularity of neutrophils are detected. ESR values ​​are increased in the acute period of the disease.

An important method of examination for the detection of Koch bacillus is sputum culture for tuberculosis. Mycobacteria are almost always detected in culture if a cavity is visible on the x-ray. With infiltration in the lungs, Koch's bacillus is detected by culture only in 2% of cases. A 3-fold sputum culture is more informative.

A test for tuberculosis is a mandatory method for mass diagnostics. The tuberculin test () is based on the skin reaction after intradermal injection of tuberculin in various dilutions. The Mantoux test for tuberculosis is negative if there is no infiltrate on the skin. With an infiltrate of 2–4 mm, the test is doubtful. If the infiltrate is more than 5 mm, then the Mantoux test is considered positive and indicates the presence of mycobacteria in the body or anti-tuberculosis immunity after vaccination.

Treatment

Is it possible to recover from tuberculosis and how long will it take to undergo treatment? Whether the disease will be cured or not depends not only on the place of development infectious process, but also on the stage of the disease. Great importance The success of treatment depends on the body's sensitivity to anti-tuberculosis drugs. These same factors influence how long the disease will take to be treated. If the body is sensitive to anti-tuberculosis drugs, treatment is carried out continuously for 6 months. In case of drug resistance, treatment of tuberculosis continues for up to 24 months.

The modern treatment regimen for tuberculosis infection includes taking a complex of drugs that have an effect only when used simultaneously. With drug sensitivity, complete cure of the open form is achieved in 90% of cases. If treated incorrectly, an easily treatable form of infection turns into difficult-to-treat drug-resistant tuberculosis.

Complex treatment also includes physiotherapeutic methods and breathing exercises. Some patients require surgery. Rehabilitation of patients is carried out in a specialized dispensary.

Drug treatment carried out according to a 3, 4 and 5 component scheme.

The three-component regimen includes 3 drugs: Streptomycin, Isoniazid and PAS (para-aminosalicylic acid). The emergence of resistant strains of mycobacteria has led to the creation of a four-drug treatment regimen called DOTS. The scheme includes:

• "Isoniazid" or "Ftivazid";
• "Streptomycin" or "Kanamycin";
• "Ethionamide" or "Pyrazinamide";
• "Rifampicin" or "Rifabutin".

This scheme has been in use since 1980 and is used in 120 countries.

The five-component regimen consists of the same drugs, but with the addition of the antibiotic Ciprofloxacin. This regimen is more effective for drug-resistant tuberculosis.

Medical nutrition

Nutrition for pulmonary tuberculosis is aimed at restoring body weight and replenishing the lack of vitamins C, B, A and minerals.

The diet for tuberculosis includes the following categories of products.

1. An increased amount of proteins is required due to their rapid breakdown. Easily digestible proteins found in dairy products, fish, poultry, veal and eggs. Meat products should be boiled, stewed, but not fried.
2. It is recommended to get healthy fats from olive, butter and vegetable oil.
3. Carbohydrates contained in any foods (cereals, legumes). Honey is recommended flour products. Easily digestible carbohydrates are found in fruits and vegetables.

Food should be high in calories and served freshly prepared. The diet consists of 4 meals a day.

Prevention

The main means of preventing tuberculosis is vaccination. But besides this, doctors recommend:

• lead a healthy and active image life, including walks in the fresh air;
• consume foods containing fats of animal origin (fish, meat, eggs);
• do not eat fast food products;
• eat vegetables and fruits to replenish the body with vitamins and minerals that support the immune system;
• In order to prevent infection, young children and elderly people should not have close contact with the sick. Even short-term contact with a sick person in an open form can cause them to become infected.

Vaccination

Prevention of tuberculosis in children and adolescents comes down to preventing infection and preventing the disease. Most effective method tuberculosis prevention is vaccination. The first vaccination against tuberculosis is carried out in the maternity hospital for newborns on days 3–7. Revaccination is done at 6–7 years of age.

What is the tuberculosis vaccine called? Newborns receive a gentle vaccine against tuberculosis BCG-M. Vaccination during revaccination is done with the BCG vaccine.

As a result, we come to the conclusion that tuberculosis is a common infection and poses a danger to everyone around us, especially to children and people with reduced immunity. Even patients with a closed form are potentially dangerous to others. Tuberculosis is dangerous due to its complications and often ends in death. Treatment of the disease requires a lot of time, patience and money. A severe and debilitating disease deprives a person of their quality of life. The best measure Prevention of the disease is vaccination.

Tuberculosis is the most dangerous disease known for a long time. Despite numerous advances in medicine, it is still not possible to prevent the development of the disease and defeat it.

It is difficult to say what causes tuberculosis. Several million people die from it every year. The pathology is infectious, the symptoms of its appearance and provoking factors will be discussed below.

Only a doctor can answer where tuberculosis comes from. The causative agent of the disease is Koch's bacillus.

Other mycobacteria can also provoke pathology:

1. Tuberculosis humanus- the most common bacteria. During examination, this type is often identified.
2. Tuberculosis africanus- found among residents of African countries.
3. Tuberculosis microti– occurs in humans only in extreme cases. The carriers are rodents.
4. Tuberculosis bovines- the most dangerous form of the disease, it was created from it BCG vaccine.

After microbacteria multiply, an immune reaction occurs. Given favorable conditions, bacteria can live up to six months.

Important! The incubation period can last up to many years, but the person is unaware that he has a serious illness.

Routes of transmission of tuberculosis

It is important not only to know what causes tuberculosis, but also how it is transmitted.

There are several ways to do this:

Unfortunately, it is easy to become infected with tuberculosis. According to health data, about two billion people have tuberculosis. The video in this article explains exactly how the disease develops.

The first symptoms of tuberculosis

At the first stage of development, it is difficult to differentiate tuberculosis from acute respiratory infections or other diseases. The person feels weakened, overwhelmed, and constantly sleepy.

Appetite disappears, mood disappears, even minor stress can cause a violent reaction. The body temperature remains at 37 - 38 degrees, the cough is paroxysmal, and is especially disturbing at night and in the morning. The first symptoms can appear both together and separately.

Symptoms progress as follows:

1. Appearance changes– the face of a sick person becomes haggard, the complexion pale. The sparkle in the eyes speaks of poor condition health. The patient rapidly loses weight; at the first stage of the disease, the symptoms are not very noticeable, but with chronic tuberculosis they are a constant concern. The diagnosis at this stage is made without difficulty.
2. Temperature. This is another sign of tuberculosis - the temperature lasts for a month, apart from it there may not be any symptoms. A person often sweats, but even this does not help reduce the temperature, since the infection constantly leads to fever. On late stage As the disease progresses, the temperature becomes febrile, that is, the thermometer shows 39 or higher.
3. Cough– the patient coughs almost constantly, initially it is dry, after which it develops into a paroxysmal cough. After some time it becomes wet, the patient at this moment experiences significant relief. Important! A cough that does not go away for three or more weeks is a reason to visit a phthisiatrician.
4. Hemoptysis– a dangerous symptom, indicating the development of an infiltrative form of tuberculosis. To make a final diagnosis, it is necessary to differentiate the disease from heart failure and a malignant tumor, since hemoptysis also occurs with these pathologies. With tuberculosis, blood is released after coughing; in rare cases, it can flow like a fountain, which indicates a rupture of the cavity. To save the life of a sick person, immediate assistance from specialists is required.
5. Chest pain- This is a rare symptom. The symptom most often occurs during the chronic or acute stage.

The photo below is an example of what a sick person looks like when tuberculosis develops.

Is it possible to cure the disease?

Tuberculosis is a pathology that requires long-term and complex treatment, it depends on the stage of development and other nuances.

Therapy may include the following:

• chemotherapy;
• reception medicines;
• surgical intervention;
• rest in sanatoriums.

First and the main objective treatment - stop the inflammatory process, this will avoid further tissue destruction, the infiltrate will resolve, mycobacteria will no longer be excreted from the sick person’s body. In other words, doctors will do everything possible to ensure that the patient is not contagious to others. This treatment takes about six months.

The following treatment regimen is a three-component one. Antibiotics are prescribed: Isoniazid, Streptomycin. There are also additional therapy, which includes the following:

1. Immunostimulants - the body of a sick person will be able to overcome tuberculosis mycobacteria.
2. Sorbents are prescribed when chemotherapy is stopped.
3. Vitamin complexes.
4. Glucocorticoids are the most extreme measure in treatment, helping to eliminate the inflammatory process.

Instructions for use medicines indicated by a doctor, the course of treatment is different for each patient. In advanced cases it may be necessary surgical intervention.

The following methods are currently used:

1. Speleotomy - resection of large cavities occurs; conservative treatment methods in this case are ineffective.
2. Valvular bronchoblocking - small valves are installed, so that the mouths of the bronchi do not stick together, this provides the patient with full breathing.

In order to prevent the development of such a disease, you need to know what causes pulmonary tuberculosis. With timely treatment, the prognosis is favorable.

Despite the fact that medicine does not stand still, tuberculosis remains one of the most common and dangerous diseases. The World Health Organization has proven that up to 4 million people die from tuberculosis every year. is an infectious disease that is caused by Mycobacterium. What causes pulmonary tuberculosis? Is it possible to protect yourself from the disease?

The main causes of the development of pulmonary tuberculosis

The causative agent of tuberculosis is Koch's bacillus. The disease can be caused by several mycobacteria:

• Tuberculosis humanus is common. Quite often this type of bacteria is found in humans.
• Tuberculosis africanus typical for African countries.
• Tuberculosis microti develops extremely rarely in humans. The main carriers are small rodents.
• Tuberculosis bovines is a dangerous form of tuberculosis, and it is against this that the BCG vaccine was created.

Mycobacteria multiply intensively and cause a pronounced immune reaction. People most often become infected with tuberculosis by airborne droplets. If for mycobacteria favorable conditions, they live for about six months. Rarely, a person can become infected with tuberculosis after eating contaminated foods. Eggs and dairy products are especially dangerous.

Note! The incubation period of tuberculosis can last several years. A person does not even suspect that he is a carrier of a serious disease.

Who is at risk of getting tuberculosis?

• A person who has chronic diseases– HIV, diabetes mellitus.
• Refugees, migrants, drug addicts.
• A person who suffers from mental illness.
• Prisoners.

Symptoms during the development of pulmonary tuberculosis

Most often, pulmonary tuberculosis does not manifest itself in any way. It can be diagnosed accidentally after fluorography. The first symptoms of tuberculosis include:

• General intoxication of the body.
• Lethargy.
• Weakness.
• Constant dizziness.
• Lack of appetite.
• Sleep disturbance.
• Increased sweating at night.
• Pale skin.
• Sudden weight loss.
• Temperature is about 37.5 degrees.

When the patient goes to the doctor, he already has lymphadenopathy. If measures are not taken at the onset of the disease, symptoms appear that indicate lung damage:

• Cough with copious sputum, sometimes it may be absent.
• Painful sensations in the area chest when coughing.
• Sputum with blood.

Sometimes, in addition to the lungs, the bacterium affects bones and intestines.

Diagnosis of pulmonary tuberculosis

• It is observed that the hemoglobin level drops sharply.
• The level of leukocytes decreases.
• Microbiological diagnosis reveals mycobacterium tuberculosis in sputum.
• The bronchial lavage waters are examined; for this purpose, saline solution is injected into the bronchi; with its help, sputum production can be improved.
• Studies of sputum and pleural fluid.
• Bronchoscopy and biopsy. Pieces of bronchial tissue are taken for examination.

Genetic research methods

Main in an informative way diagnostics is PCR (polymerase chain reaction). In this case, bacterial DNA is detected in the material being tested. Additionally, tomography, fluorography, and x-rays are prescribed.

Is it possible to completely cure pulmonary tuberculosis?

The sooner you see a doctor, the better. Today, a large number of drugs for tuberculosis are offered. The doctor individually prescribes the necessary treatment regimen.

All anti-tuberculosis drugs can be divided into several groups:

• Basic drugs have a small amount of side effects. They are prescribed at the beginning of the development of the disease.
• Additional drugs are appointed to severe cases, When pulmonary tuberculosis worsens.

If Mantoux increases sharply, the doctor may prescribe preventive treatment course for about two months.

Sanatorium-resort treatment is of no small importance. This method used if a person has recovered or has tuberculosis in mild form. Sanatorium treatment is prohibited for open forms of tuberculosis, miliary tuberculosis, and also for bacterial excretion. Physical therapy and dietary nutrition help improve the condition.

What to do if tuberculosis is discovered during pregnancy?

If you have the disease, you cannot continue pregnancy. Everyone knows that during this period a woman’s immunity is reduced, so the disease can intensify, and everything will end in toxic damage to the fetus and the expectant mother.

The danger of tuberculosis

You need to understand that tuberculosis is a serious disease that can lead to various complications. Most often it results in pulmonary hemorrhage, hemoptysis, pulmonary and heart failure, pneumothorax, as well as amyloidosis.

Please note that pulmonary tuberculosis most often ends in hardening of the lung tissue, and calcifications and scars begin to appear on it. If the disease is not treated promptly, it can result in the death of the patient.

How to protect yourself from pulmonary tuberculosis?

It is important to understand that the BCG vaccine is not a panacea; it cannot provide 100% protection against tuberculosis. As statistics show, almost everyone is vaccinated, but the disease continues to develop.

The greatest importance in the prevention of pulmonary tuberculosis is played by timely identification of active bacterial excretors, their isolation and timely treatment.

In order to prevent pulmonary tuberculosis, it is necessary to constantly strengthen the immune system. First of all, pay attention to your diet - it should contain as much as possible more protein and vitamins. Also, watch your lifestyle; do not abuse smoking or alcoholic beverages.

So, tuberculosis is a fairly serious disease that is easier to prevent than to cure.

According to statistics provided annually by the World Health Organization, the incidence of tuberculosis reaches 10.4 million people. About 500 thousand are caused by a strain of mycobacterium that is resistant to most drugs. This means that such patients simply have no hope of recovery. The spread of tuberculosis among people diagnosed with HIV and AIDS annually claims about 2 million lives, the global child mortality rate is 1.8 million. Whatever the cause of tuberculosis, this infectious disease can be cured, but only with timely diagnosis and intensive treatment.

The first mentions of the “contagious” disease appear in the literary sources of the state of ancient Persia and Rome. And already in the 18th century, tuberculosis infection spread throughout Italy, Portugal and Spain. But, not having sufficient ideas and the ability to carry out medical practice and scientific research, previously had tuberculosis Until the 20th century it was called dryness or consumption. For a long time was known as a disease of the poor, workers and artisans. Let's briefly consider the history of studying the disease tuberculosis, determine what kind of infection it is and why it is so dangerous.

Scientist ancient East Avicenna identified the reason for the infectiousness of the virus in sputum and cough. This theory was later supported by the Venetian Girolamo Fracastoro in 1540. The Dutch doctor Francis Sylvius first linked respiratory disease with the formation of affected areas, granulomas, in the 17th century. Benjamin Merten's belief that tuberculosis can be caused by microbes was also important. A great contribution to the diagnosis of the pulmonary form was made by the Frenchman Rene Laennec, who began to listen to the functioning of organs with a stethoscope.

And already in 1839, instead of the name “consumption”, medical term"tuberculosis". Evidence that tuberculosis is an infectious disease was provided by Jean-Antoine Villemain in 1865 and in 1879 by Julius Conheim. The presence of large cells in lesions was described in 1852 by the Russian surgeon Nikolai Pirogov and in 1868 by the German scientist Theodor Langhans.

And only in 1882 by microscopic examination The true causative agent of tuberculosis was discovered from the patient’s sputum, which was named bacillus or Koch’s bacillus. And in 1890, a new type of diagnosis of the disease was developed in the form of a tuberculin test. And, again, this was the merit of the German scientist Robert Koch, who had previously discovered the genus of pathogenic mycobacteria that causes tuberculosis.

It is from this moment that development begins new area clinical medicine- phthisiology, which knows everything about tuberculosis: what causes it, whether it is contagious or not, how the symptoms manifest. Great value Phthisiology has the diagnosis, treatment and prevention of disease, rehabilitation of patients after recovery.

The causative agent of tuberculosis

The fact that tuberculosis is a dangerous infectious disease is known all over the world. And only a few know how you can become infected with this disease. Unique Koch's bacilli or very viable. A person does not even suspect that he encounters them every day.

The Koch virus or tuberculosis virus can exist in liquid for more than 5 months, under the influence sun rays- about 1.5-2 hours. In a dark and dry room, Koch's wand lives up to a year, and at a temperature of 23°C it lasts up to 7 years. Tuberculosis infection spreads with street dust for 2 months, and lives on the pages of books for up to 120 days. Disinfectants, boiling and ultraviolet lamps kill the bacillus only after 5 minutes.

The tuberculosis bacillus has adapted to exist in the body. A protective cell infected with mycobacteria, a macrophage, helps the bacillus eliminate interaction with antibodies. A person with tuberculosis does not know about the infection for a long time until he weakens. immune system.

What is tuberculosis

Koch's bacillus is found in the body of 3 parts of the entire world population and is the reason why tuberculosis is observed in more than 11 million people, among them 1 million are children under 14 years of age and more than 5 million are HIV-positive people, the mortality rate of which occurs in 1.5%. This means that tuberculosis is not only a dangerous infectious disease, but also a global problem, as indicated by statistics, of course, World Organization healthcare.

Infection of the body with mycobacterium Mycobacterium tuberculosis or Koch's bacillus is what tuberculosis is. Clinical forms of tuberculosis depend on the location. In 95% of cases these are pulmonary forms, the remaining 5% are extrapulmonary manifestations. Tuberculosis occurs in the organs of vision, lymph nodes and mammary glands, digestive and excretory organs, and skin.

There are also primary and secondary forms, which correspond to the first and re-infection. Secondary infection can also appear as a result of the development of existing primary foci. has an open and closed form pulmonary damage.

But even a conditionally isolated complex of various types mycobacteria, which cause tuberculosis, does not guarantee timely diagnosis. Pathogenic mycobacteria have a high degree of virulence and attach to antibodies, making the immune system unable to detect them. Over time, a serious inflammatory disease develops, which is granulomatous in nature, and is called tuberculosis. Depends on the strain of the pathogen and its bacterial aggressiveness.

How is tuberculosis transmitted?

Contact with the source plays a major role in the infection process. Out of 10 people, 1 gets sick, and every third person becomes a potential carrier of an asymptomatic form, known as latent tuberculosis. There are other ways of transmission:

• domestic. The tuberculosis bacillus can remain on furniture, paper and untreated dishes for more than 2 hours;
• airborne. Mycobacteria enter the lungs from environment and dust;
• contact. Contact with mucous membranes of eyes, skin;
• nutritional. Meat from infected animals. Tuberculosis occurs in dairy products and cheese;
• intrauterine method. It is observed when the placenta is damaged during labor.

There are also so-called risk groups where tuberculosis is caused by a lack of the immune system and an unhealthy lifestyle. These are people with HIV and AIDS, diabetes, children under 14 years old and adolescents from 18 to 26 years old, pensioners.

The first signs of tuberculosis

The lack of response to tests and the Mantoux test already means possible infection and the presence of Koch's bacillus in the body. The disease can be determined by blood tests and low rates erythrocytes, leukocytes and hemoglobin. Patients experience anemia and other characteristic symptoms:

1. prolonged temperature 37-38°C;
2. weight loss;
3. sweating;
4. swollen lymph nodes;
5. sputum, cough and wheezing;
6. defecation with blood.

At an early stage, tuberculosis may not manifest itself. The latent, asymptomatic form is almost impossible to define. But this does not mean that the disease does not exist.

Forms and symptoms of pulmonary tuberculosis

Latent flow. Doesn't show itself. Each person with a latent form can cause the spread and result in infection of 10-15 people around him.

The disseminated process in the lungs occurs against the background of primary damage and dissemination of mycobacteria throughout the body through the bloodstream. Often, pulmonary tuberculosis in acute disseminated form resembles viral infections, which does not allow diagnosing this disease and starting the necessary treatment. A patient with tuberculosis has shortness of breath, a dry cough and a temperature of up to 38°C, purulent discharge in the sputum and blood cells. The typhoid stage involves toxic poisoning body. The chronic process is similar to the latent type.

Miliary form. Tuberculosis infection causes severe poisoning of the body with foci in the subclavian zones of the lungs, expressed in blueness of the skin, weak breathing, and tachycardia. Temperatures can reach 39-40°C. Drug treatment is combined with chemotherapy and surgery.

Focal. Accompanied by mild symptoms, such as pain in the side and cough, and in neglected form provokes an enlargement of the thyroid gland, pain in the muscles and between the shoulder blades. Dimensions lung lesions usually do not exceed 10 mm.

It is characterized by the formation of pneumatic type foci with a characteristic sign of necrotic casative decay in the center, characteristic of the disease. Body temperature reaches 38-38.5°C, sweat and phlegm production becomes profuse, and heart rate increases. Occurs in people suffering from alcoholism, nicotine and drug addiction, chronic diseases.

Tuberculoma. It is a capsule or granuloma filled with cheesy contents from necrotic tissue. The value ranges from less than 2 cm to more than 6 cm. Accompanied by a slight cough and sputum, wheezing. In 95% of cases, complete recovery occurs.

Progressive stage or cavernous and fibrous-cavernous forms. New formations appear, called cavities, with a liquid content of necrotic tissue. May cause pulmonary hemorrhage. Treatment of the cavernous and fibrous-cavernous forms is carried out, in most cases, surgically.

Cirrhotic pulmonary tuberculosis develops against the background of earlier, difficult to treat forms. It represents the last stage of the development of the disease and is accompanied by a cough with residual blood, respiratory and heart failure, and intoxication of the body. The incurable form often ends in death.

Lupus

The pathology that causes cutaneous tuberculosis is typical for all diseases of this group. Mycobacterium tuberculosis or Koch's bacillus penetrates the subcutaneous tissue through damaged areas of the skin or a source of infection already present in the body. The forms of skin tuberculosis and their symptoms are varied.

Primary infection or tuberculous chancre. Painless formation of a red or brown papule, which forms a focal ulcer after 3-5 weeks. After a month, the wound heals.

Acute miliary stage- severe form of the disease. The torso and limbs are covered with symmetrical rashes like vesicles or papules.

Tuberculous lupus. They are tubercles up to 3 mm in diameter on the face, ears, neck. After recovery, it leaves scars on the skin.

Scrofuloderma or . Affects children with infected lymph nodes. Armpits, lower jaw and neck acquire blue tint, ulcerative lesions form.

Warty form. Tuberculosis infection affects people who are involved in the production and processing of meat products. Extensive lesion arms and hands lasts several months until healing occurs;

Papulonecrotic degree. Accompanied allergic reactions, vasculitis. Formed ulcers occur on the flexure line of the limbs and buttocks.

Is a flaw sunlight And low immunity. For treatment, physiotherapeutic procedures, ultraviolet lamps and drugs that increase protective functions body.

Kidney tuberculosis

Extrapulmonary nephrotuberculosis is characterized by pain in lumbar region, renal colic, cystitis and false urges to urination. Genital tuberculosis in men often leads to damage to the prostate and testicles; in women, the structure of the endometrium and ovaries is disrupted.

Cause of organ infection genitourinary system tubercle bacilli are advanced pulmonary or bone form diseases, urolithiasis disease or kidney failure. Bleeding during urination, pyelonephritis and slight fever, formation of foci with purulent contents in the cortical and medullary layer of the kidney are possible.

To treat kidney tuberculosis, combined methods are often used, which include surgery with installation drainage system for removing urine from the pelvis, and medications. It is possible to remove the affected areas of the kidney and perform open surgery.

Tuberculosis of bones, joints and spine

The second place among diseases caused by Koch's bacillus is bone tuberculosis, because it simultaneously causes damage to the spine, knee, hip, elbow, ankle, wrist, shoulder joints and tubular bone. The causes of occurrence are associated with hypothermia, difficult working conditions, low level life.

Characteristic signs of bone tuberculosis are deformation and shortening of the limbs, the formation of fistulas and abscesses, pronounced curvature of the spine and paralysis. IN childhood- stoop, clubfoot, lameness. Patients' temperature rises to 39-40°C and pain occurs.

Drug treatment is carried out in an inpatient setting at an anti-tuberculosis dispensary with the appointment physical therapy and massage. In case of extensive bone destruction, the affected segment is removed, followed by rehabilitation.

Brain tuberculosis

Phthisiatricians and neurologists, to whom people with severe disorders of the central nervous system are usually referred, first of all, pay attention to temperature indicators above 37°C, frequency of headaches, fatigue and impaired consciousness. In advanced cases, inflammation occurs meninges, tuberculous meningitis, and the appearance of neoplasms, epilepsy, paralysis and seizures. The temperature reaches 40-41°C and death occurs.

Treatment is carried out strictly in a hospital setting with medications prescribed mandatory chemotherapy, therapeutic massage and bed rest. Surgical intervention is used when it is impossible to influence the source of infection.

Abdominal tuberculosis

Defeat digestive tract and intestines is a separate extrapulmonary form of tuberculosis. The cause of primary infection can be low-quality dairy products, and the secondary form is self-infection through ingestion of sputum. The main symptoms manifest themselves in the form of dyspeptic disorders, such as vomiting, causeless nausea, diarrhea or constipation, the presence of blood in bowel movements, and cramping pain.

Complications of tuberculosis abdominal cavity provoke intestinal obstruction, fistula formation, attack acute appendicitis. Used for treatment drug therapy, and in severe cases of damage to the abdominal cavity - surgical intervention and laparotomy.