Tuberculosis: symptoms and first signs in the initial stage (7 photos)

Author: Alorous

August 20, 2022 08:44

Community: Medicine on Chips

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Pulmonary tuberculosis is an infectious lung disease that is transmitted by airborne droplets and is characterized by an inflammatory process.

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The disease occurs due to the tuberculosis bacillus, it penetrates from the patient through coughing, sneezing, and dialogue. According to generally accepted data, there are about 2 billion infected people in the world. During the year, out of 100 thousand people who become ill with tuberculosis, approximately 18 people die. Symptoms of tuberculosis are the first manifestations of a dangerous disease that a person can detect at home. Once symptoms are identified, treatment should be started immediately so as not to aggravate the clinical picture. In general, they can be different and depend on the type of development of the disease.

What it is?

In simple words, tuberculosis is an infectious disease of bacterial etiology. The disease has not only a medical, but also a social aspect: the most sensitive to the causative agent of tuberculosis are people with a low level of immunity, an unbalanced diet, living in conditions of non-compliance with sanitary and hygienic standards, and poor social and living conditions. The development of the disease is influenced by the level of a person’s quality of life. However, the risk group for tuberculosis consists of all segments of the population, regardless of age and gender. The high frequency of deaths (up to 3 million people per year) and the prevalence of the disease are due not only to social reasons, but also to the long period of latent course of the disease, when symptoms of tuberculosis do not appear. This time is the most favorable for therapy, and to determine the likelihood of infection, an assessment of the body’s reaction to the Mantoux test is used.

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TUBERCULOSIS: HOW THE DISEASE STARTS IN CHILDREN

In children, the first symptom of incipient tuberculosis is general weakness. If we are talking about small children, then they stop gaining weight and become very irritable. As for children attending school, their academic performance is noticeably falling. The child becomes very tired from activities, becomes absent-minded and inattentive. As in adults, incipient tuberculosis in children is accompanied by an increase in temperature to 37-37.5 degrees.

With tuberculosis in children, enlarged lymph nodes are possible, and tuberculin tests are usually positive. Such changes in the onset of the disease are due to the fact that the causative agent of tuberculosis also enters the lymph nodes, where it releases toxic substances, which has a harmful effect on the body.

Most often, children suffer from a form of tuberculosis, which is chronic tuberculosis intoxication. If you notice the first symptoms in time and begin treatment, then, as a rule, the body copes well with this disease.

Pathogen

The causative agent of the pathology is the tuberculosis bacillus. A distinctive feature of the bacterium is its shell, which protects the microbe from changing environmental conditions and the effects of medications. The tuberculosis bacillus develops very slowly, so diagnosing the disease can be difficult. Microorganisms are usually transmitted through the air: when a patient coughs, sneezes or talks. When drops containing components of the tuberculosis bacillus dry, even smaller particles are formed that remain in the air for a long time and do not settle down under gravity. From the air, the pathogen penetrates the mucous membranes of the human nasopharynx and into the respiratory tract. The likelihood of infection depends on the duration of contact with the patient and the form of pathology from which he suffers. So, when communicating with a person suffering from pulmonary tuberculosis, the risk of contracting the disease increases many times over. When bacteria enter the lungs, they do not always cause tuberculosis. The risk of developing pathology depends on the state of a person’s immune system, as well as on his individual sensitivity to a particular type of microorganism. The likelihood of infection is also influenced by a person’s age: the largest number of cases of the disease occur in the age group of 25–35 years. Tuberculosis actively develops in persons suffering from infectious and chronic pathologies: HIV; renal failure; diabetes mellitus; oncological diseases. The risk category for tuberculosis infection includes children under 5 years of age, people living in poor living conditions, and the elderly.

Vulnerable but resilient

Tuberculosis is caused by mycobacteria. In Latin they are called Mycobacterium tuberculosis. At first glance, these microorganisms, which look like rods 1–10 microns long, are unremarkable. But in the world of bacteria they are unique, primarily due to their survivability and ability to adapt to unfavorable conditions. In this they can compete even with the “champions” of survival - bacteria that form spores.

There are many lipid molecules present in the cell wall of tuberculosis bacilli. This “smart armor” provides resistance to certain antibiotics and ensures the ability to survive in very acidic or alkaline environments. Mycobacteria survive well without oxygen and can even exist inside human cells. For example, after macrophages - “eater cells” - absorb mycobacterium tuberculosis, they, as if nothing had happened, remain viable in the “cellular stomach” that is trying to destroy them, and can be activated again and cause the disease years later, lived by an infected person without any symptoms.

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These bacteria are also quite stable in the external environment. Outside the human body they can persist for several days, in water - up to five months. They are resistant to acids, alcohols, and many disinfectants. You can destroy them in several ways: firstly, light. Although tuberculosis pathogens are resistant to diffuse sunlight, they die within 1.5 hours when exposed to direct rays. Ultraviolet radiation kills them even faster in 2–3 minutes. Secondly, boiling. In a hot liquid environment, mycobacteria will die in five minutes. And finally, chlorine - mycobacteria dissolve in its solution within five hours.

Tuberculosis is also a big problem because its pathogens are able to bypass the natural defense mechanisms in the human body. They skillfully “confuse” the immune system with the help of special effector proteins and can exist for a long time in a kind of equilibrium with the body in special structures - granulomas. While the immune system is holding its defense well, the bacteria “sleep” and do not cause trouble.

This is the so-called latent phase. But when the defense weakens, the disease flares up again in full force. Therefore, for example, HIV infection in combination with tuberculosis becomes a “deadly cocktail.” People with HIV are 18 times more likely to develop active TB than those whose immune systems are normal. About a seventh of people who die from tuberculosis are infected with HIV.

Risk factors

The people most often affected by tuberculosis are: those who have been in contact with an infected person for a long time; having chronic diseases of the respiratory system; those suffering from stomach or duodenal ulcers, diabetes mellitus; taking glucocorticoid medications for a long time (hormones strongly suppress the immune system); infected with the HIV virus; alcohol abusers, those in prison, those taking narcotic drugs; employees of medical institutions where patients with tuberculosis are treated; previously had non-pulmonary/pulmonary tuberculosis.

Tuberculosis

Tuberculosis is one of the oldest infectious diseases. As the results of excavations of ancient civilizations show, tuberculosis is as old as humanity. “Consumption”, “white death” - this is how tuberculosis was figuratively called at different times. There is reason to believe that it existed before the advent of man. The disease, caused by a human pathogen (Mycobacterium tuberculosis), also affects some warm-blooded animals. Bovine tuberculosis is of greatest importance. There are other causative agents of tuberculosis: bovine (Mycobacterium bovinus), avian (Mycobacterium avium), which can also cause disease in humans. It is important to note that tuberculosis as an infectious disease develops in a socially organized human society and the spread of tuberculosis largely depends on the organization and well-being of this society. Unlike many other infections, it has a chronic and often hidden course, which increases the likelihood that a sick person will spread tuberculosis many times over. It is believed that in a year a patient with an “open” form of tuberculosis infects an average of 10-15 people. Once infected, approximately 8-10% of those infected will develop some form of tuberculosis during their lifetime. The disease, as a rule, does not occur immediately: from infection to the manifestation of the disease it can take from several months to several years. An important role is played by the state of the defenses of the infected body and, first of all, the immune system. Therefore, people who have certain risk factors—factors that reduce anti-tuberculosis protection—get sick more often. A LITTLE HISTORY

Tuberculosis, having appeared at the dawn of mankind, became increasingly widespread; in Europe and North America its scale reached its peak at the end of the 19th and beginning of the 20th centuries, when it became the “white plague.” It is no coincidence that “consumption” was reflected in the works of F.M. Dostoevsky and A.P. Chekhov, C. Dickens and A. Dumas, in the paintings of artists N.P. Klodt, V.M. Maksimova, V.D. Polenov, in the operas of D. Verdi, D. Puccini. V.G. suffered from tuberculosis and died from it. Belinsky, N.A. Dobrolyubov, A.P. Chekhov, F. Chopin and many other famous people on whose lives and works tuberculosis left its mark. In the century before last, tuberculosis was a terrible scourge in the most advanced countries of that time, including Russia. The diagnosis of tuberculosis was considered almost a death sentence; the average life expectancy of patients did not exceed 3-5 years. There was much debate about the nature of this disease until March 24, 1882 . This day is considered the birthday of phthisiology - the science of tuberculosis (from the Greek phthisis - consumption). On this day, the German scientist Robert Koch informed the world about his discovery of the causative agent of tuberculosis. Considering the significance of the problem, many outstanding scientists and doctors studied tuberculosis; after the discovery of Robert Koch, methods for the prevention and control of this disease were developed, and this bore fruit. By the middle of the 20th century, thanks to sanitary and anti-epidemic measures and preventive measures, epidemiological indicators for tuberculosis were significantly improved throughout the world. And after the first anti-tuberculosis drug streptomycin was obtained in 1942, and then a number of other effective drugs that could cure the majority of patients, tuberculosis came under control in developed countries, and even an opinion arose that tuberculosis could be defeated in the same way as natural smallpox In our country, by the end of the 80s, the situation was assessed as favorable - the incidence rate was already quite low. However, since the beginning of the 90s, an increase in incidence has been noted throughout the world, and in Russia, against the backdrop of a decline in the living standards of the population, by the end of the 20th century, the incidence more than doubled. This convincingly indicates that tuberculosis is a medical and social problem. We have entered the new millennium with a very difficult situation regarding tuberculosis. Today in Russia more people die from it than from all infectious diseases combined. In the world, mortality from tuberculosis among infectious diseases ranks second after malaria. Every year, according to WHO, about 9 million people fall ill with tuberculosis, of which about 3 million die from this disease. Of particular concern is the significant increase in the incidence of children, which indicates the high prevalence and risk of contracting tuberculosis. In other words, among the population there are more patients who are bacteria-transmitters, sources of infection who are the most dangerous for others, especially children, whose bodies are more susceptible to infection and disease. IN MODERN SOCIO-ECONOMIC CONDITIONS, when in a significant part of the population the DEFENSE FORCES OF THE ORGANISM are seriously weakened, and the pathogen has acquired HIGH RESISTANCE TO MANY ANTI-TUBERCULOSIS DRUGS, IN CONDITIONS OF NEGLECT TO PREVENTIVE MEASURES, tuberculosis is capable of AFFECTING ALL LAYERS POPULATION! CAUSE OF THE DISEASE The causative agent of the disease - Mycobacterium tuberculosis - was discovered by Robert Koch in 1882, it was called "Koch's bacillus", now you can find the abbreviated name: MBT - Mycobacterium tuberculosis or BC "Koch's bacillus". A distinctive property of MBT (TB) is its stability in the external environment, although tuberculosis bacilli are able to reproduce only in the host’s body. They can remain viable when exposed to various physical and chemical agents; they are resistant to acids, alkalis, alcohols, and resistant to drying and heating. In the external environment, MBT can remain viable for up to six months, and in the composition of tiny dust particles on various objects (furniture, books, dishes, bed linen, towels, floors, walls, etc.) they can retain their properties for several weeks and even months , are stored for up to several months in dairy products obtained from cows with tuberculosis and not undergone treatment. The most destructive effect for mycobacteria is sunlight and especially ultraviolet rays. “We will not defeat tuberculosis as long as there are human habitations on earth into which a ray of sun does not penetrate,” Robert Koch wrote more than 100 years ago, and today one cannot but agree with him. AN IMPORTANT FEATURE OF MYCOBACTERIA TUBERCULOSIS After the initial infection, no noticeable manifestations of the disease may occur and in most cases the disease will not develop, however, mycobacterium tuberculosis can survive in the body for a long time (years, decades) without causing harm to it, retaining its properties as the causative agent of tuberculosis. This state of relative balance can be disrupted in favor of the pathogen when the body’s defenses decrease (deterioration of social living conditions, malnutrition, stressful situations, aging, concomitant diseases). That is why, having become infected in childhood (adolescence), an adult and even an elderly person (over 60 years old) can become ill with tuberculosis, although the infection occurred half a century ago or more. Therefore, in children and young people, the disease, as a rule, occurs as a result of an external infection, and in most adults and the elderly, it is more often as a result of reactivation of an infection that has been dormant in the body for a long time. If children, first of all, should be protected from fresh infection, then older people should mainly prevent the possibility of a decrease in immunity and try to identify the disease at the earliest possible stage. However, the role of external infection remains relevant for people of any age. The SOURCE of tuberculosis is most often a sick person, who sometimes does not even know about the disease, because tuberculosis can occur under the guise of a common cold, pneumonia that cannot be cured for a long time, and sometimes without any manifestations, therefore, in case of tuberculosis, carrying out preventive examinations AND EARLY DETECTION OF tuberculosis IS OF PARTICULAR IMPORTANCE . HOW DOES INFECTION OCCUR?

ENTRANCE GATE: the most common route of entry for infection is the respiratory tract. Bacilli, which are expelled in large quantities by patients with tiny droplets of mucus, forming peculiar aerosols when coughing, sneezing, and even talking loudly . When droplets of mucus evaporate, Mycobacterium tuberculosis remains in the air for up to several hours, settling on the smallest particles of dust . Inhalation of such “aerosols” causes Mycobacterium tuberculosis to enter the respiratory tract of healthy people, after which the fight between the microbe and the body begins. Less commonly, infection occurs when eating dairy products from animals with tuberculosis. There may be other extremely rare routes of infection (through the skin, tonsils); in exceptional cases, intrauterine infection of the fetus in pregnant women with tuberculosis is possible. Airborne infection is the most dangerous, in which Mycobacterium tuberculosis enters the respiratory tract of healthy people from coughing patients. Mycobacterium tuberculosis has a high infectious ability and for infection it is enough to penetrate the body with only 1 to 5 mycobacteria. In this regard, a patient with tuberculosis who excretes bacteria must be aware that he poses a danger to others (especially to those from the immediate family environment - in the focus of tuberculosis infection ) . He is obliged to follow the recommendations given by the doctor, prescribed by the provisions of sanitary prevention of tuberculosis. MYCOBACTERIA TUBERCULOSIS AND THE HUMAN BODY The development and outcome of such a confrontation depend on many reasons:

· massiveness of infection (the number of mycobacterium tuberculosis entering the body);

· characteristics of the pathogen - high or low viability and aggressiveness;

· the degree of susceptibility of the body to the pathogenic effects of the microbe.

It should be taken into account that the basis of this interaction is the human body and the state of its protective systems, and primarily the immune system. Factors that contribute to a decrease in immunity also contribute to the disease of tuberculosis. Factors contributing to the disease of tuberculosis Factors contributing to the disease of tuberculosis should, first of all, include:

· having contact with people or animals sick with tuberculosis; · presence of social maladjustment; · unsatisfactory working and living conditions; · malnutrition; · alcoholism; · smoking; · drug addiction; · HIV infection; · presence of concomitant diseases (diabetes mellitus, peptic ulcer of the stomach and duodenum, chronic nonspecific lung diseases, immunodeficiency states and diseases).

At present, when modern reality is replete with stress, it should be remembered that chronic stress can significantly suppress the immune system. There are many options for the interaction between mycobacteria that have entered the body and the body itself. The development of one or another form of tuberculosis largely depends on the dose of the infectious agent and the state of the body’s defenses. Tuberculosis is one of the most diverse diseases in terms of the manifestations of the disease and its localization. Tuberculosis can affect any organ, any system of the human body. The respiratory organs are the favorite localization of the tuberculosis process, however, the frequency of extrapulmonary localizations of specific lesions (bones, joints, genitourinary organs, eyes, meninges, lymph nodes, etc.) has increased in recent years and continues to increase. In developed countries, the incidence of extrapulmonary localizations accounts for more than a third of all cases of tuberculosis. PREVENTION OF TUBERCULOSIS In preventing tuberculosis, it is essential, on the one hand, to reduce the risk of transmission of infection from a sick person to a healthy person (sanitary prevention) - for this purpose, work is carried out in foci of infection, early detection of tuberculosis among the population and especially in high-risk groups; on the other hand, eliminating and reducing the influence of factors that cause a decrease in human immune defenses (social prevention), reducing the number of people at risk. An integral element of tuberculosis prevention is health education. Patients must be prepared for difficult daily work on themselves in following the doctor’s instructions and certain hygiene rules. This is the main guarantee of successful treatment. Preventive examinations of the population for tuberculosis Preventive examinations are carried out with the aim of early detection of patients with tuberculosis at that stage of the development of the disease when the patient can be relatively quickly and effectively cured of tuberculosis, and on the other hand, thanks to the early detection of low-symptomatic forms, the spread of the disease among the people around the patient is prevented. There are two main methods for the early detection of tuberculosis: in children and adolescents this is an annual mass tuberculin diagnosis, and in adolescents and adults this is screening fluorography. Tuberculin diagnostics is carried out annually for children and adolescents, in organized groups at the place of study or in kindergartens, and for the unorganized children's population in a children's clinic at their place of residence. This method allows you to identify the fact that a child is infected with tuberculosis and take the necessary actions. These actions include in-depth examination to identify minimal manifestations of tuberculosis at the initial stage of its development and prophylactic or preventive treatment to prevent the infection from becoming a disease. Fluorography should be performed on all persons over 15 years of age at least once every two years, however, there are so-called decreed population groups in which fluorography should be performed more often - once a year or even once every six months. Determining the timing depends on the danger that tuberculosis poses to certain categories of people. Once a year, fluorography is performed for employees of children's and adolescent institutions, people working in the food industry, as well as patients with diseases that reduce anti-tuberculosis protection. Twice a year, fluorography is performed on conscripts, employees of maternity hospitals, persons in prison, infected with the immunodeficiency virus, as well as those in contact with tuberculosis patients. In addition to these detection methods, tuberculosis is detected when seeking medical help regarding complaints of suspected tuberculosis, so everyone needs to know the first manifestations of tuberculosis in order to find them in themselves or loved ones in time to undergo further examination and begin treatment in a timely manner. SIGNS of tuberculosis Tuberculosis can begin quite quickly, or it can proceed without affecting the patient’s well-being at all, but in most cases it develops gradually and is characterized by the following manifestations:

· FATIGUE AND APPEARANCE OF GENERAL WEAKNESS especially in the evening;

· REDUCED OR LACK OF APPETITE;

· INCREASED SWEATING, ESPECIALLY at night;

· WEIGHT LOSS;

· SIGNIFICANT INCREASE IN BODY TEMPERATURE;

· APPEARANCE OF DYSPNEA WHEN SMALL PHYSICAL ACTIVITY;

· COUGH OR COUGHING WITH SMUT, mucous or mucopurulent, usually in small quantities, POSSIBLY WITH BLOOD

If these signs appear in you or someone you know, you should immediately consult a doctor! It should be remembered that avoiding examination leads to infection of others, identification of already severe forms of the disease, which take years to treat and can result in disability and even death, while timely detected tuberculosis can be successfully cured. FOCUS OF INFECTION The focus of tuberculosis infection is the place of residence of a patient with tuberculosis and those people who are there and are at risk of contracting tuberculosis. The epidemic danger of foci of tuberculosis infection may be different. There are three groups of foci depending on the degree of danger of the spread of tuberculosis. This danger is assessed according to the following criteria: the massive release of bacteria from the patient, the presence of children and adolescents in the family, living conditions and compliance by the patient and his family with sanitary and hygienic standards. People living in outbreaks of the first group are most at risk; these are outbreaks where patients with abundant (moderate or massive) bacterial excretion live. This group also includes foci in which, even with scant isolation of Mycobacterium tuberculosis, children or adolescents live with the patient, as well as in poor living conditions and in cases of alcohol abuse in the family. The second, less dangerous group includes outbreaks where patients with poor bacterial excretion and no children live. In the least dangerous foci of the third group, patients with possible but undetected bacterial excretion live (after its cessation as a result of successful therapy), and are considered epidemically potentially dangerous. It must be borne in mind that a patient with an active form of tuberculosis is always potentially dangerous in terms of possible infection, even if mycobacteria are not detected in his sputum by modern methods. Only with stable healing of tuberculosis does the danger of infection disappear. MEASURES AT THE AREAS In outbreaks of tuberculosis, ongoing and final (after removal of the patient from the outbreak) disinfection, as well as other measures through the medical service, are envisaged. People around you should remember: It is very important to hospitalize a bacterial excretor for a full course of anti-tuberculosis therapy until they stop releasing mycobacterium tuberculosis! Every patient should be aware of the importance of this event, which allows you to protect your loved ones from a possible disease! Being in a tuberculosis outbreak, the patient must remember and follow some sanitary rules. First of all, we should remind you of “cough discipline”. The patient should, if possible, refrain from coughing in the presence of other people, when coughing, turn away from people nearby, cover his mouth with a handkerchief, and spit sputum into an individual pocket spittoon (glass with a tight-fitting lid or disposable plastic). It is necessary to have at least two spittoons (one is used, the other with sputum is disinfected). The patient must have a separate room, a separate bed, dishes, linen, toiletries, care items, etc. The apartment must be routinely disinfected:

· disinfection of sputum and spittoons, dishes, food debris;

· collection, putting in bags, storing until disinfection of linen;

· daily wet cleaning of the room where the patient is, as well as furniture and household items with which he comes into contact.

Disinfection is carried out by physical and chemical methods and their combinations. The spittoon with sputum should be boiled in a 2% soda solution for at least 15 minutes or kept in a 5% chloramine solution for 6 hours. It is possible to use other new disinfectants on the recommendation of the anti-tuberculosis dispensary in accordance with the instructions for use. Disinfection is carried out in approximately the same way as dishes, care items, linen, and leftover food (boiling or soaking in the same solutions). Wet cleaning of the premises must be carried out daily. In case of massive bacterial excretion, it is advisable to add a disinfectant (chlorine-containing preparations) and a little ammonia or washing powder to warm (hot) water. Books are vacuumed and wiped with a damp cloth. More detailed (private) recommendations can be obtained from employees of anti-tuberculosis institutions - dispensaries, who should be the organizers of this work. An important preventive measure in the outbreak is periodic:

· examination of people who were in contact;

· carrying out preventive (preventing infection and disease) treatment;

· resolving questions about indications for BCG vaccination (re-vaccination).

These issues are resolved by specialists from the TB dispensary. A patient with tuberculosis and his relatives should be aware of the possibilities for curing tuberculosis that are available today and the dangers that may affect the results of treatment. ABOUT TREATMENT OF TUBERCULOSIS Urgent treatment of a patient, achieving cessation of bacterial excretion in him is one of the most important epidemiological links in reducing the incidence of tuberculosis among the population. The basis of complex treatment of patients with tuberculosis is currently treatment with anti-tuberculosis drugs - drugs that have a detrimental effect on the mycobacteria present in the patient’s body. Today this is the only opportunity to cope with tuberculosis. WHAT ARE THE BASIC CONDITIONS FOR SUCCESSFUL THERAPY? An indispensable condition for successful chemotherapy is the simultaneous administration of several drugs (combination therapy). Treatment with one drug (monotherapy) is ineffective; moreover, it leads to the development of Mycobacterium tuberculosis resistance to the drug used. Thus, with monotherapy with streptomycin or rifampicin, resistance to them develops within 1-2 months, and after 2-6 months. is registered in 90% of patients or more. The second indispensable condition for successful treatment is continuous long-term use of drugs. These treatment conditions are determined by the doctor individually depending on the characteristics of the patient and his illness. HOW IS THE TREATMENT GOING? Treatment of tuberculosis, depending on the characteristics of the case, is carried out in a hospital, sanatorium, day hospital or outpatient setting and its duration should not be less than six months. Some patients need to use additional therapeutic interventions - collapse therapy and surgical interventions. As a rule, this occurs when conservative treatment is insufficiently effective in identifying advanced cases. WHAT IS DRUG RESISTANCE? A significant proportion of chronically ill patients develop drug resistance to Mycobacterium tuberculosis. Drug resistance is a situation where anti-tuberculosis drugs do not act on Mycobacterium tuberculosis. Treatment of such a contingent largely requires the use of reserve drugs and the cost of treatment increases significantly. Curing this category of patients already presents significant difficulties. THE MAIN TASK OF RELATIVES The main thing is to convince patients to strictly follow the prescribed treatment regimen - take anti-tuberculosis drugs regularly, continuously, for the recommended period. If symptoms of drug intolerance or symptoms of side effects occur, together with the attending physician, one should strive to overcome them, trying, as far as possible, not to stop the course of treatment. The speedy recovery of the patient and the exclusion of infection of his family and friends will largely depend on this. In addition, by taking drugs in the proper amount for the proper period of time, the patient helps to ensure that he does not develop drug-resistant strains of the pathogen, which can be transmitted to healthy individuals and cause a new disease with drug resistance. This will help improve the epidemiological situation of tuberculosis in the district, city, region, region, and in general will be a significant contribution to reducing the burden of tuberculosis in Russia. Success or failure in the battle against tuberculosis depends more than half on the patient himself. His will, the desire to get well no matter what, can work miracles. For any questions - from nutrition to ways to reduce the toxic effects of anti-tuberculosis drugs, you can consult your doctor or the nearest TB dispensary.

Forms and stages of the disease

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Scientists have now identified many different forms of tuberculosis. This infection is primarily classified by the manifestation of its symptoms. In this regard, there are two types of illness: Open form. In this case, a sick person releases a pathogenic bacterium into the environment, which can infect others. Most often this occurs when coughing or expectoration. This form is designated as BC+ or TB+. This mark indicates that infectious agents were detected in the sputum smear. Closed form. With this disease, pathogenic microbes can exist in the human body, but they do not enter the environment. This means that the patient is not contagious. In this case, the marking is BK- or TB-. There are also such forms of the disease as primary and secondary. They are set depending on whether the person is experiencing the disease for the first time or has had a relapse. In addition, it is worth noting that there are dozens of types of tuberculosis diseases that can be caused by the bacterium Mycobacterium tuberculosis complex. Among them, it is necessary to highlight disseminated pulmonary tuberculosis, miliary pulmonary tuberculosis, focal pulmonary tuberculosis, infiltrative pulmonary tuberculosis, caseous pneumonia, pulmonary tuberculoma, cavernous pulmonary tuberculosis, fibrous-cavernous pulmonary tuberculosis, cirrhotic pulmonary tuberculosis and tuberculous pleurisy. All these diseases have certain characteristics, diagnostic methods, and treatment methods.

Statistics and Geography

The geography of the spread of tuberculosis is more than extensive. There are countries with a more or less favorable situation, but cases of the disease are recorded almost everywhere. 90 percent of the total volume comes from 30 countries - India leads the ranking, followed by China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh and South Africa.

In the relatively recent past, our country was also included in the global list of countries with the highest rates of tuberculosis infections. In pre-revolutionary Russia, the disease decimated the population with depressing scope and regularity. The Soviet government devoted considerable effort to the fight against tuberculosis, and the result was not long in coming - in the 1920-1930s, the incidence of “consumption” decreased significantly. A sharp deterioration in indicators occurred at the end of the Great Patriotic War; gradually and only with the passage of time, preventive measures and an early diagnosis program helped bring the situation under control again.

A new surge in the incidence of tuberculosis, caused by a decline in living standards and an increase in the incidence of HIV infection, occurred in the 1990s. Since then, this infection has remained a real threat and only in 2022 a historical minimum was recorded in Russia. The incidence of tuberculosis has fallen threefold over 20 years, and mortality rates have decreased fivefold. WHO experts excluded Russia from the “black list” of countries for tuberculosis. In 2010, the number of cases of diagnosed active tuberculosis in our country was 77.2 per 100 thousand population, and in 2022 - 32.3 cases.

Patients with consumption in the 19th century / ©Getty images

But it’s too early to relax. The situation is worsening again amid the coronavirus pandemic, not only in Russia, but throughout the world. Due to fear of the new coronavirus and restrictive measures, the population's access to medical care has worsened. WHO experts reported that in 2022, approximately 4.1 million patients did not know that they had tuberculosis and were not included in official statistics. This is despite the fact that in 2022 there were approximately 2.9 million such people. The number of new diagnoses may increase in the coming years, and after this the mortality rate will inevitably increase.

The first symptoms of tuberculosis

Pulmonary tuberculosis can occur for a long time without visible symptoms and be discovered accidentally during fluorography or on a chest x-ray. The fact of contamination of the body with tuberculous mycobacteria and the formation of specific immunological hyperreactivity can also be detected by performing tuberculin tests. In the initial stage of tuberculosis development, the symptoms are quite difficult to differentiate from ordinary acute respiratory infections or chronic fatigue syndrome. But if we consider the first signs of tuberculosis in adults in more detail, it will be possible to identify them in advance. In cases where tuberculosis manifests itself clinically, usually the very first symptoms are nonspecific manifestations of intoxication: weakness, pallor, increased fatigue, lethargy, apathy, low-grade fever (about 37 ° C, rarely above 38 °), sweating, especially disturbing the patient at night, weight loss Often generalized or limited to any group of lymph nodes, lymphadenopathy is detected - an increase in the size of the lymph nodes. Sometimes it is possible to identify a specific lesion of the lymph nodes - “cold” inflammation. 1) Elevated body temperature The most important first sign of tuberculosis is considered to be elevated body temperature, which does not normalize within a month. Moreover, its appearance cannot be explained by any objective reasons - there are no inflammatory processes occurring in the body, there are no signs of a cold or flu. In the morning, the body temperature of a patient with tuberculosis is within the normal range, but in the evening it invariably rises to 38.5 degrees and is always accompanied by chills. Please note: in the initial stages of tuberculosis development, body temperature never reaches febrile levels (39 degrees and above), but this is typical for the later stages of the disease. 2) Cough A patient with tuberculosis coughs constantly, but at the very beginning of the disease the cough will be dry and paroxysmal, from the outside it looks like a nervous reaction. As the pathology progresses, the cough becomes wet; after coughing up sputum, the patient experiences relief for a short time. Please note: if a person has had a dry cough for 20 days or more, and there are no other symptoms of cold/bronchitis, then this is a reason to immediately contact a phthisiatrician to clarify the diagnosis. 3) Shortness of breath and wheezing Shortness of breath appears at the slightest physical exertion, a person behaves like a fish out of water - he is catastrophically short of air. Wheezing of various types occurs. They can be dry or wet, it all depends on the damage to the lung tissue and the individual characteristics of the patient. Only a doctor can determine this diagnosis based on listening and additional symptoms. 4) Change in the patient’s appearance The disease in question makes the patient’s face haggard, his skin acquires a pale tint, but on the contrary, an unnatural blush “burns” on his cheeks. A patient with tuberculosis is rapidly losing weight, despite the fact that his appetite remains normal and his diet has not undergone any adjustments. At the very beginning of the development of tuberculosis, changes in appearance are not very noticeable, and as the pathology progresses, a diagnosis can presumably be made based on the patient’s appearance. 5) Chest pain This symptom is more typical for the later stages of tuberculosis, when it has already become chronic. But at the beginning of the development of the disease, mild pain may be present only during moments of deep inspiration, and the pain will be localized under the ribs.

Pulmonary tuberculosis on x-ray

The description of x-rays for tuberculosis can be very varied, since this disease has many forms. However, the main sign of tuberculosis of the lung on an x-ray is a violation of the structure of the organ, depending on the duration of the disease. To exclude other diseases affecting the lungs, it is necessary to supplement x-rays with tests and other diagnostic methods. In some cases, MRI and CT are prescribed to diagnose tuberculosis, but x-ray remains the most accessible.

Symptoms of extrapulmonary forms of tuberculosis

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Koch's bacillus can affect not only lung tissue, but also multiply and cause inflammatory processes in other organs. With such localization they speak of an extrapulmonary type of disease. A nonspecific type of tuberculosis damage to internal organs and systems is diagnosed, as a rule, by excluding other diseases and pathologies. The clinical picture depends on the severity of the process and the location of the organ or tissue affected by the bacterium. Tuberculous damage to the organs of the digestive system is expressed in periodic defecation disorders, a feeling of bloating, pain in the intestinal area, signs of hemorrhagic bleeding (blood in the stool), and an increase in body temperature up to 40°C. When the inflammatory process is localized in the brain, the disease manifests itself in an increase in body temperature, disturbances in the functioning of the nervous system, sleep patterns, increased irritability, neurotic reactions, and enlargement of the neck and neck muscles. Characterized by pain in the back when straightening the legs, tilting the head towards the chest. The disease progresses slowly, and those at risk include preschool children, patients with diabetes, and HIV-infected people. Damage to the genitourinary system by tuberculosis bacteria is usually detected in the kidneys and/or pelvic organs. The clinical picture consists of painful attacks in the lower back, body hyperthermia, frequent, painful, unproductive urge to urinate, and the inclusion of blood in the urine. Tuberculosis damage to bone and joint tissue is manifested by pain in the affected areas and limited joint mobility. Due to the similarity of symptoms with other diseases of the musculoskeletal system, it is difficult to diagnose. Tuberculous lesions of the skin are expressed in the form of rashes widespread throughout the skin, merging and forming nodular formations that are dense to the touch. Other symptoms are possible when various organs are affected. A pathogenic organism, penetrating the bloodstream, can spread throughout the body and target almost any organ, tissue or system. In this case, clinical signs of the disease are difficult to differentiate from similar inflammatory processes of a different etiology. The prognosis for treatment of extrapulmonary forms depends on the time of diagnosis, the localization of the pathological process, its stage, the degree of organ damage, and the general health of the patient.

Reasons for a questionable and hyperergic reaction to the test

The response to the test can be positive, hyperergic and doubtful. Such processes indicate the absence of the disease and its pathogens in the body. The explanation for this is as follows:

1. The reaction to Diaskintest occurred due to an infection in the body that did not cause corresponding symptoms. Other pathologies that contribute to the body’s reaction. Sometimes symptoms occur due to recent infection;
2. Infection of the venue. This is especially true for children;
3. Having an allergy with an inadequate reaction to an allergen;
4. Somatic and autoimmune diseases.

There may be other reasons for such a reaction to the test. People predisposed to allergies are often given antihistamines before the test.

To avoid a false positive reaction, it is necessary to strictly adhere to contraindications. Adults are prohibited from drinking alcohol before and after the administration of Diaskintest. The breakdown products of ethyl alcohol with the reaction of the drug can cause redness of the injection site, which will be perceived as a positive Diaskintest reaction.

It is not recommended to wet the sample site, public baths, saunas, beaches or swimming pools. Such measures may cause a backlash.

Diagnostics

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Diagnosis of tuberculosis is based on fluorography, radiography and computed tomography of affected organs and systems, microbiological examination of various biological materials, tuberculin skin test (Mantoux reaction), as well as the method of molecular genetic analysis (polymerase chain reaction), etc. Also, the diagnosis of active tuberculosis is carried out by microscopic examination of sputum obtained by smear. Such diagnostics is one of the most popular methods, but it is far from the most unambiguous, since in the early stages of tuberculosis, as well as in its manifestations in children, such a study will give a negative result. It is more effective to use fluoroscopy or fluorography, which will give higher accuracy in the results, especially in the later stages. Polymerase chain reaction is also used to identify the pathogen.

Photos of results

You can independently determine the test result without waiting for an examination by a nurse using a photo with the results of the test.

Diaskintest photo performed on a child has a positive result. The size of the infiltrate is more than 5 mm.

With a comparative result, the infiltrate size is 2-4 mm.

The photo provided indicates a negative result. With it, there may be a trace of the injection, the infiltrate is completely absent.

Complications

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The worst complication may be death from tuberculosis. This is the case if it is not treated. And there are also other consequences of the disease: destruction of other organs occurs, for example, liver, heart, kidneys, etc.; the disease can destroy joints, leading to bone tuberculosis; pulmonary hemorrhage may occur - one of the most dangerous complications of tuberculosis. In this case, urgent medical attention is needed. If a person has once suffered from tuberculosis, then he is not immune from inflammation of the disease in the future. There is also no certainty that the child will not become infected from the mother and will be born completely healthy and without abnormalities. Often there is a frozen pregnancy or death of the baby during childbirth. After recovery, a person may still experience headaches, discomfort in bones and joints, and weakness for some time. Most often this happens due to strong medications. There may also be a disturbance in the functioning of the stomach and upset stool.

How the analysis works

Diaskintest is used to perform an intradermal test in all age groups for the purpose of:

1. Determination of the phase of development of tuberculosis;
2. Identification of individuals at high risk of developing the open form;
3. Diagnosing the form of the disease;
4. Treatment activity assessments, etc.

A test through the Diaskintest test is carried out in the following cases:

1. Persons who have received a referral to an anti-tuberculosis institution for examination for the development of the tuberculosis process;
2. Persons at high risk, taking into account epidemiological, medical and social factors.

One dose of the drug contains recombinant protein CFP10-ESAT6 - 0.2 μg, sodium phosphate. Existing synthetic antigens, after being introduced under the skin, cause an allergic reaction. This form of manifestation indicates the presence of an active phase in which tuberculosis develops or infection occurs without the formation of pathology. Additional components: sodium chloride, potassium phosphate, polysorbate 80, phenol.

What to do if you have tuberculosis at home

All members of the family in which there is a patient with tuberculosis must take precautions. The infected person should be isolated in a separate room or behind a screen. The number of things he will come into contact with should be limited as much as possible. All items in the house should be disinfected and cleaned daily. Soft toys, carpeting, curtains, and extra pillows must be removed from the room in which the patient lives. It is recommended to cover upholstered furniture with special covers, which need to be boiled from time to time. When moving around the house, the infected person must wear a mask (disposable or four-layer gauze).

Traditional methods of treatment

Before using traditional methods of treatment, you need to consult with your doctor, because the etiology of skin tuberculosis is complex and simple lotions may not help. Only a doctor can advise which recipes will be most effective.

Traditional medicine helps strengthen the immune system, saturate the body with protein, vitamins and minerals. Home remedies can reduce the unwanted effects of specific medications. Among the proven and effective remedies are the following recipes:

• You can use herbs such as knotweed, lilac, plantain, coltsfoot, and licorice root internally in the form of infusions;
• decoctions with dry and fresh berries, for example, lingonberries, quinces, strawberries, help strengthen the immune system;
• Infusions with spruce and pine needles will help relieve the inflammatory effect;

• Do not forget about taking aloe juice with the addition of honey, mixed in equal quantities;
• in order to saturate the body with protein, it is better to drink kumiss, if possible;
• To reduce the phenomenon of exudation, you can use ointments for skin tuberculosis with calendula, arnica, wild rosemary, using them twice a day.

In combination with other drugs, you should consume vitamin-containing fruits: apples, red and black currants, rowan, rose hips, viburnum, sea buckthorn, blueberries, etc.

Ancient Eastern medicine recommends the use of many herbal medicines to treat this serious illness.

Hospitalization for tuberculosis

It is not always necessary to go to the hospital to treat tuberculosis. There are indications for hospitalization: Suspicion of pulmonary tuberculosis. Carrying out differential diagnosis of tuberculosis with other diseases that have similar symptoms. Treatment of newly diagnosed extrapulmonary tuberculosis (course of chemotherapy). Treatment of tuberculosis resistant to anti-tuberculosis drugs. Treatment of active forms of the disease. Treatment of common forms of tuberculosis. The need for surgical treatment of tuberculosis. The duration of hospitalization for tuberculosis depends on the form of the disease: If the diagnosis confirms that the patient does not have tuberculosis, he is discharged immediately. If the preliminary diagnosis is confirmed, treatment takes about 3-4 months. Only after three sputum tests confirming that the patient does not secrete mycobacteria can he undergo further treatment on an outpatient or sanatorium basis. With multidrug-resistant tuberculosis, when the bacillus is resistant to all anti-tuberculosis drugs, the patient can spend up to one and a half years in the hospital.

Contraindications to X-rays

Before talking about contraindications, it is worth noting the development of modern fluorography

, which allows patients to receive a minimal dose of radiation. Therefore, during the treatment of tuberculosis, especially miliary tuberculosis, an x-ray of the lungs is a mandatory and safe procedure: inaction is much more dangerous to life. X-rays of the lungs are absolutely contraindicated for children under 15 years of age and pregnant women. An obstacle to the study is the patient’s serious condition, in which he cannot stand for a long time or hold his breath.

Chemotherapy

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In modern phthisiatric practice, anti-tuberculosis therapy is used with the participation of several types of antibiotics. At the moment, three treatment regimens are relevant: Three-component; Quadruple; Five-component. Treatment of tuberculosis consists of two main phases: Intensive; Prolonged. The goal of the first, intensive phase is to stop the inflammatory process, prevent further tissue destruction, resorption of infiltrate and exudate, and stop the removal of tuberculous mycobacteria from the body into the environment. That is, doctors are trying to make a person stop being contagious. This takes, on average, two to six months. Prolonged treatment of tuberculosis is aimed at complete healing of foci of inflammation, scarring of damaged tissue and restoration of strong immunity in the patient. Depending on the nature and severity of the disease, therapy can last up to two years, and in the case of multidrug-resistant tuberculosis - up to three to four years, until X-ray examination proves complete attenuation of the disease.

How does tuberculous inflammation occur?

When mycobacteria multiply, a moment comes when macrophages cease to control this process and die en masse. Inflammatory mediators and proteolytic enzymes that damage tissue enter the intercellular space. Damaged tissues are destroyed and become a good breeding ground for bacterial growth. Through dilated capillaries, cells rush to the site of damage, taking part in the formation of tuberculous granulomas, which gradually merge, increasing the volume of the lesion.

Additional drugs for treatment

Additional therapy for tuberculosis includes: Immunostimulants (galavit, xymedon, glutoxim) help the body fight mycobacterium tuberculosis; Hepatoprotectors are necessary to protect the liver from the destructive effects of antibiotics; they are prescribed with constant monitoring of the level of bilirubin in the blood; Sorbents (acetylcysteine ​​and rheosorbilact) are prescribed during chemotherapy withdrawal in case of extremely severe side effects. After a short period of rest, treatment still has to be resumed; B vitamins, glutamic acid and ATP are needed to prevent peripheral neuropathy and other undesirable effects from the central nervous system; Methyluracil, aloe vera, glunate, FiBS are prescribed during the treatment of tuberculosis to accelerate the processes of cellular regeneration; Glucocorticoids are a last resort because they have a strong immunosuppressive effect. But sometimes they are still prescribed for a short period of time in order to suppress the too violent manifestations of the inflammatory process in extensive and severe tuberculosis.

Diagnostic methods

Using the Mantoux test, you can assess how sensitive the patient’s body is to tuberculin. To confirm the diagnosis, the doctor may recommend laboratory and instrumental research methods:

• bacteriological analysis of discharge taken from lesions that affected the skin;
• tissue biopsy with further histology;
• Mantoux test;
• studies to determine how much tuberculosis has affected internal organs: bacteriological examination of urine, feces, sputum, X-ray of the lungs, ultrasound of the bladder, kidneys and other organs;
• trial therapy.

Diagnosis of skin tuberculosis will allow not only to make an accurate diagnosis, but also to determine how much the disease has affected the body. The earlier the pathology is detected, the more effective the therapy.

Diet

Nutrition for tuberculosis should be aimed at strengthening the immune system. The patient should consume from 120 to 150 g of pure protein per day. It is needed for the production of antibodies. Sources of protein: fish, seafood, dairy products, lean poultry and fish, liver of cattle and fish. The amount of fat the patient needs is from 50 to 80 g per day. They are necessary to restore cell membranes that have been damaged by mycobacteria. To avoid a shortage of fats, you need to eat butter and vegetable oils, fish oil, lard, and animal fats in small quantities. Carbohydrates for tuberculosis should correspond to the age norm - about 400 g per day. They can be obtained from cereals and vegetables. Eating more than 80 g of confectionery products per day is not recommended. Mineral salts normalize metabolism and improve the functioning of the endocrine system, thereby increasing the body's defenses. Their sources can be: tomatoes, figs, cauliflower, herbs, cheeses, cottage cheese.

How to treat consumption

Tuberculosis can be successfully combated, and there are effective drugs for this. According to WHO, early diagnosis and treatment of this infection have saved 66 million lives since 2000. The task with the latent form is to prevent the transition to the active one. For this purpose, 1–2 drugs are usually used. In the active form, combinations of several drugs are prescribed. The course of treatment lasts from 6 to 12 months, and during this time the patient must follow preventive measures so as not to infect other people.

Therapy is not always effective: there are strains of tuberculosis bacilli with multidrug resistance. They were found in all countries where research was conducted. Such “superbugs” arise primarily due to the poor quality of antibiotics and the fact that they are used incorrectly. This is part of the global problem of antibiotic resistance.

Production of the BCG vaccine at the enterprise of the Nacimbio holding company of Rostec / ©Press service of Rostec

Multidrug-resistant strains are bacteria that do not respond to the two most effective first-line drugs, isoniazid and rifampicin. For such cases, there are second-line drugs. They help many patients, although they are often more toxic and require a longer course of treatment. But some microorganisms are already resistant to these drugs. For some patients, there are no effective treatment options at all. This is a problem that modern scientists continue to seek solutions to at the moment.

Prevention

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Due to the fact that infection occurs quite easily, doctors have drawn up certain rules to prevent the pathogen from entering the human body. They are as follows: You cannot stay in the same room with a patient with tuberculosis for a long time. It is worth getting vaccinated periodically at the prescribed time in the form of BCG. First of all, this concerns children. The vaccine is also given to adults under 30 years of age if their Mantoux test gives a positive result. It is necessary to do fluorography once a year. This applies to both children and adults. In order to detect tuberculosis in the early stages, all adults must undergo a fluorographic examination in a clinic at least once a year (depending on profession, health status and membership in various “risk groups”). Also, if there is a sharp change in the Mantoux reaction compared to the previous one (the so-called “turn”), the phthisiatrician may suggest preventive chemotherapy with several drugs, usually in combination with hepatoprotectors and B vitamins. In some adults and in about 10% children who have not completed a course of preventive treatment during the period of change develop a condition called tuberculosis intoxication.

Why do you need to get the DST vaccine?

The causative agent of the disease is Mycobacterium tuberculosis. Develops against a background of decreased immunity, malnutrition, frequent hypothermia, malnutrition, HIV infection, drug addiction, and nervous hypothermia. Transmitted in several ways:

• Airborne: through communication, sneezing, contact with a patient;
• Household: when using dishes, things, kissing, etc.;
• Through contact with the carrier;
• Food: eating affected food;
• Intrauterine: from mother to child.

In the acute form of tuberculosis, a prolonged and wet cough with sputum production is observed; hyperthermia. The patient sharply loses weight, complains of fatigue, and a general deterioration in health. Performance is lost.

The cough is wet and pronounced. Occurs in the form of frequent attacks, especially in the morning. Often the disease at the initial stage is mistakenly confused with “smoker’s cough”, symptoms of chronic bronchitis.

According to statistics in the CIS countries, approximately 90% of people are carriers of Koch's bacillus. In this case, 5% get sick. The development of tuberculosis depends on the level of immunity. Therefore, the main method of preventing the disease is maintaining a healthy lifestyle. Children are required to be vaccinated; regular samples and tests are carried out, with the help of which it is possible to establish in the early stages. Diaskintest is a solution that helps identify the disease in the early stages.

Expert opinion

Author:

Alexander Vyacheslavovich Averyanov

Pulmonologist, Doctor of Medical Sciences, Professor, doctor of the highest qualification category

According to statistics, 90% of the population are carriers of the Koch bacillus, the causative agent of tuberculosis. However, the incidence is recorded in only 5%. The disease develops against the background of immunodeficiency, so it is important to lead a healthy lifestyle and engage in prevention.

Diaskintest allows you to diagnose tuberculosis. The method differs from the classical Mantoux in its accuracy. The effectiveness of Diaskintest is 90%. For comparison, Mantoux's accuracy ranges from 50 to 70%. The Yusupov Hospital uses Diaskintest to diagnose tuberculosis. The method is also effective for preventive purposes. Results are assessed after 72 hours. Diaskintest is well tolerated and rarely causes allergic reactions. Even if individual intolerance to a component of the test occurs, undesirable reactions disappear after 2–3 days.

Diaskintest has proven itself on the positive side with most domestic doctors. Diagnostics is being actively introduced into medical institutions. High efficiency allows you to prescribe correct treatment. This is important, since tuberculosis is characterized by a progressive course and high mortality without adequate therapy.

Fluorography

Fluorography is a method of x-ray examination that involves photographing an image from a fluorescent screen that appears on it after X-rays pass through the human body. There are several types of techniques:

• small frame;
• large-frame;
• electronic.

Small- and large-frame fluorography may not show tuberculosis if changes in the lungs are small in size or not clear enough. This is its main drawback, due to which it is impossible to make a diagnosis based on this study. Currently, only electron fluorography is relevant, in which the above disadvantages are eliminated.

It is used to detect tuberculosis during mass preventive studies. Modern fluorography reveals pulmonary tuberculosis thanks to the high quality of the resulting image, the ability to dynamically change the contrast and computer image editing. These features allow you to find the smallest changes.

Here are some examples of what tuberculosis looks like in a fluorography image:

Small-frame fluorogram.

Electronic fluorography. A large focal shadow in the region of the root of the left lung, heterogeneous in structure, has a clear contour.

Preventive measures

Full compliance with clinical recommendations for skin tuberculosis allows the patient to get rid of this serious illness and continue to live a full life. Especially if the patient follows advice on preventive measures that will protect against re-infection:

• Children must be vaccinated with BCG;
• try to avoid contact with antisocial individuals who can infect a person;
• strengthen the immune system, especially after colds;
• wash your hands well, especially between your fingers;
• less nervous shock;
• Healthy food;
• take vitamins in autumn and spring;
• do not constantly overload the body mentally and physically;
• Avoid contact with an infected person, especially during the period when pathogenic microorganisms are actively being released.

You should not give up when such a serious diagnosis is made. The disease can be cured, but you need to make an effort and follow all the doctor’s recommendations. Skin tuberculosis is a contagious disease, so all family members in contact with the patient must be regularly examined by a doctor, maintain hygiene and not have close contact with the infected person, especially if there are cuts, scratches and other skin damage on the body.

Skin tuberculosis is a complex and serious disease, but with timely treatment there is a chance for a complete recovery.

The causative agent of tuberculosis and its characteristics

The microbe mycobacteria tuberculosis has a characteristic flagellum shape and an extremely small size. It is only a few microns longer and thicker than most viruses, falling short of the scale of a typical bacterium. Some abilities, including maintaining pathogenicity for a long time in soil, street dust and forming colonies, are similar to mycobacteria and fungi. Another unique property of the pathogen is that it is able to remain in tissues, breaking up into tiny particles.

Mycobacteria tuberculosis is resistant to almost all disinfectants and can survive in secluded corners for years. Kills within a few minutes when boiled. The causative agent of the disease mutates even while in the body of its carrier. Over time, it forms new forms that are resistant to most antibiotics. This creates big problems in treatment.

Mycoplasma has no organs of movement, but it easily clings to any surface. It can persist for months on surrounding objects, furniture, floors, and sidewalks.