Learn: disseminated tuberculosis of the lungs
Disseminated pulmonary tuberculosis is a very dangerous disease for humans, because it occurs as a result of severe and numerous lesions of all the organs of breathing. This is its distinguishing feature from the usual form of tuberculosis that affects only some parts of the respiratory system. Typically, such a serious disease occurs in adults. In children and adolescents pulmonary tuberculosis this form occurs very rarely. Approximately 25% of all cases of the disease referred to disseminirovannom tuberculosis.
Today, specialists distinguish several forms of disseminated tuberculosis:
- generalized hematogenic-disseminated tuberculosis.
The causes of this type of tuberculosis
During the treatment of common forms of the disease may experience different kinds of complications due to the fact that every body is different and struggling to cope with the infection that got him. Obligate bacteremia often can spread to all the organs of breathing. A manifestation of primary tuberculosis is the formation of caseous altered intrathoracic lymph nodes, which are closely related to cardiovascular system. In this case, the pathogenic microorganisms without problems get into the bloodstream, and then on the walls of the pulmonary vessels. After that, the infection through the main lymphatic duct to the subclavian vein, enters. It ends the journey in the lungs of people once the right heart and pulmonary division, Vienna.
If the dissemination is hematogenous in nature, foci of infection are observed in both lungs. The disease spreads through the vessels. In this case, the sick person is a unilateral lymphogenic disseminated tuberculosis.
In some cases, there may be enough late generalization. A few years after it was cured primary tuberculosis might again be infected lymph nodes of the so-called foci of the Rut. This happens due to the fact that the immune system has become weaker and cannot fight infection. In addition, the reactivity of the lung tissue can be increased several times, and vessels can't cope with the tubercle Bacillus.
Doctors distinguish risk groups of people who can primarily to chronic disseminated pulmonary tuberculosis. They caninclude:
- children who have not been made by the BCG vaccine;
- people who have congenital or acquired immunodeficiency;
- sick people who for a long time took a different kind of immunosuppressants;
- people whose body is weakened during major hormonal changes and adjustment;
- during the fasting;
- if a person gets sick very often all sorts of infectious diseases.
It should be noted that caseous lymph nodes can be damaged, and during a break occurs contact a large number of MBT in the blood that can trigger the development of disseminated tuberculosis.
A disease occurs and if the person there's a tuberculoma. This education is an abscess, around which is quite a large amount of connective tissue. In this case, we can say that a person is present disseminated pulmonary tuberculosis in the phase of infiltration. Periods of remission and exacerbation alternate with each other; at this time the abscess continues to spread, then starts forming the cavity, which soon becomes large enough. This indicates that the disseminated type of tuberculosis will be accompanied by frequent bleeding and even pneumothorax.
The symptoms of this disease can be very different, depending on the form in which the person is observed tuberculosis. The manifestation of the lesions of tuberculosis may occur suddenly - acute form of the disease, or develops gradually and imperceptibly for the patient with chronic form of the problem.
Extensive lesions of tuberculosis occur in connection with the patient has a chronic disease, if not enough vitamins or a very weak immune system. Disseminated tuberculosis can damage not only the respiratory system but also kidney, bones, joints, spleen, liver or even the heart and brain. As a result, the symptoms of the disease is difficult to name specific. As practice shows many signs of tuberculosis can remind the person the symptoms that occur during a colds, bronchitis, acute respiratory infections, pneumonia.
At the same time disseminated tuberculosis has a special feature: the symptoms do not disappear very long. Over time, the cough doesn't go away, shortness of breath, severe wheezing, vomiting and constant nausea. In some cases it is prolonged muscle tension in the back of the head, a person of impaired consciousness and is constantly kept a very high temperature. Patients usually complain of the presence of sweating that occursmainly at night, severe fatigue, weight loss, lack of appetite. In most cases, people do not pay attention to such things and consider it a trivial vitamin deficiency, or fatigue, malaise.
When the disease is in the phase of infiltration, then there is another unpleasant symptom is hemoptysis.
Differential diagnosis of the disease
In order to determine in humans the prevalence of tuberculosis and to make an accurate diagnosis, you need a differential diagnosis.
So we need to examine historical data, conduct three tests of blood and sputum to human and instrumental diagnostics. Important role to play in hemogram. It is possible to determine the presence of leukopenia and relative lymphocytosis.
In the presence of disseminated pulmonary tuberculosis in humans will be present moderate leukocytosis, but the neutrophils will move slightly to the left.
During differential diagnosis, you may notice that gradually starts to increase the number of band neutrophils (about 25%), and the ESR is increased to 40 mm/h. furthermore, it is possible to conduct etiological diagnosis, which includes fluorescent microscopy of capillary blood, she painted auramine and rhodamine method of Combat.
Advanced radiology, computer tomography, radiography of the chest, bronchoscopy with different types of biopsies enables an accurate and detailed study of material from the lungs of the sick person, cytological and histological means.
Thus it is possible to make the most accurate diagnosis. It should also pay attention to the test therapy. It is carried out using special drugs against tuberculosis. Their appointment lasts for two months. If the result is positive, then the supplementation should continue for some time.
Using the same research can not only be diagnosed at different stages of the disease, but also to determine the presence of residual polyubiquitin changes of human lung fibrotic foci, calcification, adhesions that can form on the pleura. The accuracy of surveys is quite high.
Treatment of disseminated pulmonary tuberculosis
The most important condition that you need to perform first is to put the sick person in a hospital of special type. Then the doctor TB doctor needsto assign specific chemotherapy, during which a mandatory use of the following medications:
The next phase of treatment involves the use of only two drugs. Such drugs are medicinal in nature are referred to the standard regimen of the first phase. If the disease becomes chronic form, doctors prescribe a fourth mode during which the used anti-tuberculosis drugs reserve type.
During the acute period, the treatment of disseminated tuberculosis needs special attention and surveillance. In order to overcome the disease, you need to use corticosteroid and immunomodulators. Among them include Prednisone (15-20 mg per day) and T-activin or Leikinferon. The course of treatment, if pulmonary tuberculosis becomes acute form can take a very long time, averaging 6-12 months.
If you have a chronic form of the disease, which is in the phase of infiltration, the treatment is strong enough medicine to Pneumoperitoneum.
If not is lesions of the disease, it can lead to the development of cavities and pulmonary hemorrhage. Accordingly, it is necessary to immediately carry out surgery, because it can lead to death.
An important role plays the correct food and following a special diet. In the human diet should be the foods that contain a lot of vegetable fats, proteins and vitamins. You can also treat the disease folk remedies that will strengthen immunity and to make the effect of the chemical therapy is not as harmful and dangerous for human health.