TUBERCULOSIS.

TUBERCULOSIS:-




What Is Tuberculosis?

Tuberculosis, commonly known as TB, is a bacterial infection that can spread through the lymph nodes and bloodstream to any organ in your body. It is most often found in the lungs. Most people who are exposed to TB never develop symptoms because the bacteria can live in an inactive form in the body. But if the immune system weakens, such as in people with HIV or elderly adults, TB bacteria can become active. In their active state, TB bacteria cause death of tissue in the organs they infect. Active TB disease can be fatal if left untreated.

Tuberculosis, commonly known as TB, is a bacterial infection that can spread through the lymph nodes and bloodstream to any organ in your body. It is most often found in the lungs. Most people who are exposed to TB never develop symptoms because the bacteria can live in an inactive form in the body. But if the immune system weakens, such as in people with HIV or elderly adults, TB bacteria can become active. In their active state, TB bacteria cause death of tissue in the organs they infect. Active TB disease can be fatal if left untreated.

Because the bacteria that cause tuberculosis are transmitted through the air, the disease can be contagious. Infection is most likely to occur if you are exposed to someone with TB on a day-to-day basis, such as by living or working in close quarters with someone who has the active disease. Even then, because the bacteria generally stay latent (inactive) after they invade the body, only a small number of people infected with TB will ever have the active disease. The remaining will have what's called latent TB infection -- they show no signs of infection and won't be able to spread the disease to others, unless their disease becomes active.

TB was once a widespread disease in pakistan mostly trible /rural areas papulation effected . It was virtually wiped out with the help of antibiotics developed in the 1950s, but the disease has resurfaced in potent new forms -- multidrug-resistant TB and extensively drug-resistant TB. Today, these new and dangerous forms of the disease -- resistant to some of the commonly used drug treatments -- have created a public health crisis in many large cities worldwide. If you have TB -- in its active or latent state -- you must seek medical treatment.

Symptoms and causes;

Although your body may harbor the bacteria that cause tuberculosis, your immune system usually can prevent you from becoming sick. For this reason, doctors make a distinction between:

Latent TB.
In this condition, you have a TB infection, but the bacteria remain in your body in an inactive state and cause no symptoms. Latent TB, also called inactive TB or TB infection, isn't contagious. It can turn into active TB, so treatment is important for the person with latent TB and to help control the spread of TB. An estimated 2 billion people have latent TB.

Active TB. 
This condition makes you sick and can spread to others. It can occur in the first few weeks after infection with the TB bacteria, or it might occur years later.
Signs and symptoms of active TB include:

Coughing that lasts three or more weeks
Coughing up blood
Chest pain, or pain with breathing or coughing
Unintentional weight loss
Fatigue
Fever
Night sweats
Chills

Loss of appetite;

Tuberculosis can also affect other parts of your body, including your kidneys, spine or brain. When TB occurs outside your lungs, signs and symptoms vary according to the organs involved. For example, tuberculosis of the spine may give you back pain, and tuberculosis in your kidneys might cause blood in your urine.

The Centers for Disease Control and Prevention recommends that people who have an increased risk of tuberculosis be screened for latent TB infection. This recommendation includes:

People with HIV/AIDS
IV drug users
Those in contact with infected individuals
Health care workers who treat people with a high risk of TB
Causes

Tuberculosis is caused by bacteria that spread from person to person through microscopic droplets released into the air. This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings.

Although tuberculosis is contagious, it's not easy to catch. You're much more likely to get tuberculosis from someone you live with or work with than from a stranger. Most people with active TB who've had appropriate drug treatment for at least two weeks are no longer contagious.

HIV and TB ;

Since the 1980s, the number of cases of tuberculosis has increased dramatically because of the spread of HIV, the virus that causes AIDS. Infection with HIV suppresses the immune system, making it difficult for the body to control TB bacteria. As a result, people with HIV are many times more likely to get TB and to progress from latent to active disease than are people who aren't HIV positive.

Drug-resistant TB ;

Another reason tuberculosis remains a major killer is the increase in drug-resistant strains of the bacterium. Since the first antibiotics were used to fight tuberculosis more than 60 years ago, some TB germs have developed the ability to survive, and that ability gets passed on to their descendants.

Drug-resistant strains of tuberculosis emerge when an antibiotic fails to kill all of the bacteria it targets. The surviving bacteria become resistant to that particular drug and frequently other antibiotics as well. Some TB bacteria have developed resistance to the most commonly used treatments, such as isoniazid and rifampin.

Some strains of TB have also developed resistance to drugs less commonly used in TB treatment, such as the antibiotics known as fluoroquinolones, and injectable medications including amikacin, kanamycin and capreomycin. These medications are often used to treat infections that are resistant to the more commonly used drugs.

Risk factors ;-

Anyone can get tuberculosis, but certain factors can increase your risk of the disease. These factors include:

Weakened immune system

A healthy immune system often successfully fights TB bacteria, but your body can't mount an effective defense if your resistance is low. A number of diseases and medications can weaken your immune system, including:

HIV/AIDS
Diabetes
Severe kidney disease
Certain cancers
Cancer treatment, such as chemotherapy
Drugs to prevent rejection of transplanted organs
Some drugs used to treat rheumatoid arthritis, Crohn's disease and psoriasis
Malnutrition
Very young or advanced age
Traveling or living in certain areas

The risk of contracting tuberculosis is higher for people who live in or travel to countries that have high rates of tuberculosis and drug-resistant tuberculosis, including:

Africa
Eastern Europe
Asia
Russia
Latin America
Caribbean Islands
Poverty and substance abuse

Lack of medical care.

 If you receive a low or fixed income, live in a remote area, have recently immigrated to the United States, or are homeless, you may lack access to the medical care needed to diagnose and treat TB.

Substance abuse.

 IV drug use or alcohol abuse weakens your immune system and makes you more vulnerable to tuberculosis.

Tobacco use.

 Using tobacco greatly increases the risk of getting TB and dying of it.
Where you work or live

Health care work.

 Regular contact with people who are ill increases your chances of exposure to TB bacteria. Wearing a mask and frequent hand-washing greatly reduce your risk.

Living or working in a residential care facility. 

People who live or work in prisons, immigration centers or nursing homes are all at a higher risk of tuberculosis. That's because the risk of the disease is higher anywhere there is overcrowding and poor ventilation.

Living in a refugee camp or shelter. 

Weakened by poor nutrition and ill health and living in crowded, unsanitary conditions, refugees are at especially high risk of tuberculosis infection.
Complications

Without treatment, tuberculosis can be fatal. Untreated active disease typically affects your lungs, but it can spread to other parts of your body through your bloodstream. Examples of tuberculosis complications include:

Spinal pain.

 Back pain and stiffness are common complications of tuberculosis.
Joint damage. Tuberculous arthritis usually affects the hips and knees.
Swelling of the membranes that cover your brain (meningitis). This can cause a lasting or intermittent headache that occurs for weeks. Mental changes also are possible.

Liver or kidney problems.

Your liver and kidneys help filter waste and impurities from your bloodstream. These functions become impaired if the liver or kidneys are affected by tuberculosis.

Heart disorders.

 Rarely, tuberculosis can infect the tissues that surround your heart, causing inflammation and fluid collections that may interfere with your heart's ability to pump effectively. This condition, called cardiac tamponade, can be fatal.

Treatment;

Medications are the cornerstone of tuberculosis treatment. But treating TB takes much longer than treating other types of bacterial infections.

With tuberculosis, you must take antibiotics for at least six to nine months. The exact drugs and length of treatment depend on your age, overall health, possible drug resistance, the form of TB (latent or active) and the infection's location in the body.

Recent research suggests that a shorter term of treatment — four months instead of nine — with combined medication may be effective in keeping latent TB from becoming active TB. With the shorter course of treatment, people are more likely to take all their medication, and the risk of side effects is lessened. Studies are ongoing.

Most common TB drugs

If you have latent tuberculosis, you may need to take just one type of TB drug. Active tuberculosis, particularly if it's a drug-resistant strain, will require several drugs at once The most common medications used to treat tuberculosis include:

Isoniazid
Rifampin (Rifadin, Rimactane)
Ethambutol (Myambutol)
Pyrazinamide
If you have drug-resistant TB, a combination of antibiotics called fluoroquinolones and injectable medications, such as amikacin, kanamycin or capreomycin, are generally used for 20 to 30 months. Some types of TB are developing resistance to these medications as well.

A number of new drugs are being looked at as add-on therapy to the current drug-resistant combination treatment, including:

Bedaquiline
Linezolid

Medication side effects.

Serious side effects of TB drugs aren't common but can be dangerous when they do occur. All tuberculosis medications can be highly toxic to your liver. When taking these medications, call your doctor immediately if you experience any of the following:

Nausea or vomiting
Loss of appetite
A yellow color to your skin (jaundice)
Dark urine
A fever that lasts three or more days and has no obvious cause
Completing treatment is essential.

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