What is a pulmonary tuberculosis: symptoms in adults
If there is pulmonary tuberculosis, symptoms in adults do not appear immediately. For a long time, the disease can occur unnoticed by the patient. Currently, tuberculosis is one of the most urgent problems in modern medicine. The disease is characterized by the spread of the pandemic. TB is diagnosed in all countries of the world. In our country the incidence is growing every year. TB infection in most cases affects persons of disability age, resulting in the state applied to large economic losses. In addition, tuberculosis is difficult to treat because of resistance of the pathogen to many anti-TB drugs. What is the etiology, clinic and treatment of pulmonary tuberculosis?
Features of pulmonary tuberculosis
Tuberculosis is the name for chronic disease caused by Mycobacterium tuberculosis, which can affect various organs (lungs, skin, bones). Most often there is damage to the lung tissue. An infectious agent is transmitted from an infected person with an aerosol mechanism. Today millions of people are infected with Mycobacterium tuberculosis, but not all of them occurring disease. In a healthy person the immune system to cope with bacteria and not allow them to reproduce. The most dangerous is the active form of tuberculosis, when a person is constantly identifies the pathogen in the environment during talking, coughing, sneezing.
In children the pulmonary form of tuberculosis occurs much less frequently. Mycobacteria are very resistant to adverse environmental factors. They are capable of long time to persist in the environment. Symptoms in infected individuals is often manifested in adolescence and young age. In women the peak incidence occurs between the ages of 25 to 35 years. There are the following types of pulmonary tuberculosis:
- primary tuberculosis complex;
- focal tuberculosis;
- cavernous form;
Sometimes there is a mixed form in which tuberculosis combined with pneumoconiosis. There are also primary and secondary form of the disease.
Pulmonary tuberculosis develops by direct contact with sick or infected persons by reducing the immunity. Predisposing factors of the disease are:
- crowding groups;
- reduced resistance of the organism on the background of severe somatic disease orHIV infection;
- mental and physical stress;
- the use of drugs;
- the abuse of alcohol;
- the presence of diabetes;
- frequent overcooling;
- residence in damp, cold rooms.
Signs of tuberculosis infection are different. Early manifestations of the disease include:
- a slight rise in temperature;
- sweating at night;
- loss of appetite;
- pallor of the skin;
- the decrease in body mass.
Often there is swollen lymph nodes. With the progression of the disease there are a more specific manifestation. They include:
- chest pain;
- shortness of breath;
Features of the cough
From all pulmonary symptoms, the most specific is the cough. It has the following features:
- initially dry and then becomes productive;
- sputum is often determined by the admixture of blood or pus;
- often combined with hemoptysis;
- long lasting;
- occurs most often in the morning and increases by evening.
Cough every form of the disease your. In focal form, when there are several foci of inflammation in the pulmonary tissue, the cough is weak or absent. In the case of the miliary form of the infection he is intense with thick sputum. Cough in this situation may occur causeless. Loud, hysterical cough combined with a sore throat may indicate a destructive process in the lung tissue. It is often observed in cirrhotic tuberculosis.
The occurrence of morning cough are caused by change of body position. When you sleep, mucus accumulates in the bronchi and can't get out. In the morning, when the man begins to walk and run, the phlegm starts to come out. All this is accompanied by a cough. Coughing is a protective mechanism, aimed at cleansing the lower and upper respiratory tract. Active tuberculosis is often accompanied by hemoptysis. It occurs in parallel with the cough. In the sputum reveals fresh scarlet blood. Coughing up blood if untreated can cause pulmonary hemorrhage.
Cough in tuberculosis infection can be mistaken for symptoms of other diseases (bronchitis, influenza, SARS, pneumonia). When tuberculous lung disease coughis a chronic. He persists simple mucolytics and antitussive agents. Bronchitis, laryngitis most often, the cough gradually regresses and disappears within 1-2 weeks. If cough persists for Crescent and more, you should consult a doctor.
Often there are wheezing, runny nose. Temperature in tuberculosis in most cases does not exceed 38 degrees. High temperature indicates severe disease. In our country, to identify changes in the pulmonary tissue, and of mass screening is organized annually by fluorography.
An increased risk are individuals with diseases of the kidneys, heart, malignant tumors. Another important factor is poor nutrition (lack of vitamins and animal protein in the diet). The group risk include children, people living with HIV, persons serving sentences in places of deprivation of liberty. Signs of pulmonary tuberculosis in adults can occur when living together with the sick person. Use some Cutlery, crockery, linen - all this is a risk factor for infection.
Signs of various forms of tuberculosis
Must be able to distinguish different forms of pulmonary tuberculosis. Often diagnosed with infiltrative form of the disease. It is characterized by inflammatory changes in the lung tissue, and caseous necrosis in the Central part. This form occurs most often (more than half of all patients). The magnitude of the infiltration of different.
It varies from 1-2 cm up to the size of the size of the whole lobe of the lung. In some cases, in the absence of treatment the site of inflammation can turn into tuberculoma. In this form of the disease, patients may present complaints:
- weak cough;
Less common miliary tuberculosis. When in the lung tissue formed small lumps (about the size of a millet seed). Often affects other organs. The disease can occur in acute and chronic form. It is not always the entire affected lung tissue. With limited inflammation most often affected lung apex and subclavian areas. In the case of extensive miliary tuberculosis of the lungs patients have observed malaise, hacking cough, fever, shortness of breath, headache, dyspepsia.
Immediately prior to medication the patient should be evaluated. Diagnosis includes:
- collection of anamnesis of disease and life;
- General medical examination;
- blood test;
- the examination of the sputum for the presence ofof mycobacteria;
- x-ray examination of the lungs;
- the conduct of a Mantoux test and Diaskintest.
Primary screening is performed by a therapist. If necessary, you may need to consult a tuberculosis specialist. In the process of survey of the patient clarifies the presence of the patient's contact with tuberculosis patients, the presence of harmful habits (Smoking), duration of Smoking and number of cigarettes smoked. Final diagnosis is made after the detection in the sputum of mycobacteria and identify characteristic changes in lung tissue. X-ray may include the following characteristics: the presence of infiltrates of different size, defined by the areas of the blackout, which localized mainly in the upper segments of the body, the presence of paths to the roots of the lungs. In the case of miliary tuberculosis are determined by the multiple shadows the size of a few millimeters.
For the treatment of pulmonary tuberculosis most commonly applied combination of the following drugs: Streptomycin", "Isoniazid", "Ethambutol", "Rifampicin", "Pyrazinamide".
Treatment of active forms of the disease is available in the TB dispensary. The course of treatment is several months. In the course of treatment each month a study on mycobacteria. This allows you to evaluate the effectiveness of therapy.
In severe cases, treatment may be delayed up to a year and a half years. In addition to medication, treatment involves cessation of Smoking and alcohol, normalization of nutrition, vitamins and immunomodulators. Treatment must be carried out in the early stages of the disease, otherwise there is a risk of complications (bleeding, development of respiratory failure, pneumothorax). Specific prevention of tuberculosis is BCG and BCG-m. Thus, tuberculosis is a very common and dangerous disease.