Tuberculosis (White Plague): Symptoms, Causes, Diagnosis & Treatment

Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist latent TB infection (LTBI) and TB disease. If not treated properly, TB disease can be fatal.

The symptoms of TB disease include weakness, weight loss, fever, no appetite, chills, and sweating at night. Other symptoms of TB disease depend on where in the body the bacteria are growing. If TB disease is in the lungs (pulmonary TB), the symptoms may include a bad cough, pain in the chest, or coughing up blood. A person with TB disease may be infectious and spread TB bacteria to others.

Tuberculosis (TB) is a major public health concern worldwide: despite a regular, although slow, decline in incidence over the last decade, as many as 8.6 million new cases and 1.3 million deaths were estimated to have occurred in 2012.

TB occurs more commonly when people live in conditions which promotes its spread. People living in poverty (which is associated with overcrowding), substance abuse, stress unemployment and malnutrition are more likely to get TB. In an overcrowded, poorly ventilated home TB germs will spread more easily to other members of the household.

Self diagnisis – Most people infected with the bacteria that cause tuberculosis don’t have symptoms. When symptoms do occur, they usually include a cough (sometimes blood-tinged), weight loss, night sweats and fever.

How does Tuberculosis affect your body?

TB commonly presents as a disease of the lungs. However, the infection can spread via blood from the lungs to all organs in the body. This means that you can develop tuberculosis in the pleura (the covering of the lungs), in the bones, the urinary tract and sexual organs, the intestines and even in the skin. Lymph nodes in the lung root and on the throat can also get infected.

Tuberculous meningitis is sometimes seen in newly infected children. This form of the disease is a life-threatening condition.

Non-lung TB is an important cause of skin, bowel and gynaecological problems.

What are the Causes of Tuberculosis?

Tuberculosis (TB) is caused by a type of bacterium called Mycobacterium tuberculosis.

It’s spread when a person with active TB disease in their lungs coughs or sneezes and someone else inhales the expelled droplets, which contain TB bacteria.

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What are the Risk Factors of Tuberculosis?

Common risk factors include :

Living where TB is common – You are more likely to be exposed to TB bacteria if you live in an area where TB is common. TB tends to cluster in urban areas – London has over 40% of the UK’s TB cases. Worldwide, just 22 of countries have more than 80% of the world’s TB cases.

Homelessness, or living in poorly ventilated or overcrowded accommodation – TB bacteria can spread more easily and remain suspended in the air for longer in poor housing conditions or working environments.

Immune system pressures – Poor nutrition, poverty, poor housing and substance misuse can all weaken the immune system. Other illnesses can also make someone more vulnerable to TB. People living with HIV are at a particular risk from TB.

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What are the symptoms of Tuberculosis?

Common symptoms include :

  • A cough, for three weeks or longer
  • Extreme tiredness
  • Fever
  • Night sweats
  • Loss of appetite
  • Weight loss
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How is  Tuberculosis Diagnosed?

Culture test – A sample of bodily fluid or tissue is taken from someone with suspected TB. For suspected pulmonary TB, sputum (phlegm) may be collected in a jar. If TB is thought to be in another area of the body, a biopsy may be performed.Any bacteria present in the sample can be grown in a culture, under laboratory conditions. Culture tests are very reliable, and can also help determine the right medication for the type of TB found as they can differentiate between drug resistant or drug sensitive TB.

Chest X-ray – A chest X-ray can identify damage to the lungs, an indicator of pulmonary TB. If damage is spotted, further testing is necessary to prove TB is the cause.

Sputum smear microscopy – If a patient has a cough that produces sputum, a sample may be looked at under a microscope. Visible TB germs indicate an active TB infection in the lungs and throat – sputum smear positive TB. This form of TB is also known as pulmonary TB, which is the only infectious form of the illness. If TB bacteria are not visible, this does not mean that TB is not present. There may simply be too few bacteria to be visible. A culture test is needed to clarify this.

GeneXpert – The GeneXpert system can identify TB bacteria from sputum samples. It is also able to test whether any TB bacteria present is resistant to rifampicin (RIF) – a frontline TB drug. The system is cartridge-based, easy to use and provides results in 90 minutes. In 2010, WHO endorsed the product for use in TB endemic countries. The test is more sensitive than sputum smear microscopy, but less sensitive than a culture. It is of limited effectiveness in children, people with low CD4 counts (most often people living with HIV) and people with extra pulmonary disease — because they have fewer bacteria in their sputum.

A tuberculin skin test (TST) – or Mantoux test – checks the immune system’s response to TB bacteria. A tiny amount of tuberculin extract is injected under the skin. If the immune system has come into contact with TB the skin becomes raised and red. However, a positive result does not confirm an active infection. Further testing is required. Latent TB and a history of BCG vaccination will also cause a reaction.

Blood test – A TB blood test is a reliable indicator of a TB infection. Results can be provided in just one visit to a clinic. However, a positive result does not indicate whether an infection is latent or active. Further tests are necessary to clarify this. There are currently two types of blood test technology, QuantiFERON and T-SPOT.TB.

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How to prevent & control Tuberculosis?

The BCG vaccination – The BCG (Bacille Calmette-Guérin) is a live vaccine against tuberculosis. The vaccine is prepared from a strain of the weakened bovine tuberculosis bacillus, Mycobacterium bovis. The BCG is currently the only licensed vaccine against TB.

As TB is an airborne infection, TB bacteria are released into the air when someone with infectious TB coughs or sneezes. The risk of infection can be reduced by using a few simple precautions:

  • Good ventilation – As TB can remain suspended in the air for several hours with no ventilation
  • Natural light – UV light kills off TB bacteria
  • Good hygiene – Covering the mouth and nose when coughing or sneezing reduces the spread of TB bacteria.

Treatment of Tuberculosis Allopathic Treatment

Standard treatment – TB treatment lasts at least six months. Treatment for TB is usually a mixture of four antibiotics:

Treating drug-resistant TB – Drug-resistant TB requires a longer course of treatment, with different combinations of drugs that can have more side effects. A patient will be tested to find out the exact course of treatment that should work for them.

Treating latent TBb- Most cases of latent TB are not considered for treatment, as 90% of people with latent TB do not go on to become ill with active TB. Treatment is recommended for people whose immune systems are weaker as they are more likely to go on to develop an active infection. This includes children and people living with HIV. The dormant bacteria present in cases of latent TB can be cleared completely using some of the same drugs used to treat active TB.

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Tuberculosis – Lifestyle Tips

  • Take your medicine exactly as the healthcare provider directed.
  • When you cough, sneeze or laugh, cover your mouth with a tissue. Put the tissue in a closed bag and throw it away.
  • Do not go to work or school until your healthcare provider says it’s OK to go back. Avoid close contact with anyone. Sleep in a bedroom alone.
  • Air out your room often so the TB germs don’t stay in the room and infect someone who breathes the air.

What are Recommended Exercises for Person with Tuberculosis?

For those patients that are fighting their symptoms of TB, the idea behind exercise is that you perform simple activities such as taking a brisk walk outdoors. Not only is walking a fantastic form of exercise, it also allows you to get outside and take in some fresh air.

It is recommended that you aim for 30 minutes every day for five days of the week, however, you should only ever exercise as much as you feel that you are physically able to, especially during your recovery time.

When you start to feel that your symptoms are improving, you may feel comfortable to increase the intensity levels of the exercise that you are undertaking.

Stationary cycling, resistance training and light jogging are great ways to make sure that the TB infection that was once in your system has been completely eradicated. Once recovered, it is a good idea to keep up the exercise, as this is a factor in stopping the TB from returning at a later date.

Tuberculosis & Pregnancy – Things to know

While TB treatment is safe during pregnancy, maternal TB infection has been linked to complications such as premature birth, low birth weight and increased side-effects from TB treatment. TB is a leading infectious cause of death during pregnancy and delivery, especially among women living with HIV.

Common Complications Related to Tuberculosis

Common 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.

Other FAQs about Tuberculosis

What Should I Do If I Have Spent Time with Someone with Latent TB Infection?

A person with latent TB infection cannot spread germs to other people. You do not need to be tested if you have spent time with someone with latent TB infection. However, if you have spent time with someone with TB disease or someone with symptoms of TB, you should be tested.

What is Bacille Calmette–Guèrin (BCG)?

BCG is a vaccine for TB disease. BCG is used in many countries, but it is not generally recommended in the United States. BCG vaccination does not completely prevent people from getting TB. It may also cause a false positive tuberculin skin test. However, persons who have been vaccinated with BCG can be given a tuberculin skin test or TB blood test.

What Does a Positive Test for TB Infection Mean?

A positive test for TB infection only tells that a person has been infected with TB germs. It does not tell whether or not the person has progressed to TB disease. Other tests, such as a chest x-ray and a sample of sputum, are needed to see whether the person has TB disease.

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