Tuberculosis

Tuberculosis (TB) is a potentially serious infectious disease that mainly affects the lungs and other parts
of the body. The bacteria that cause tuberculosis are spread from one person to another through tiny
droplets released into the air via coughs and sneezes.

Causes

Tuberculosis is caused by bacteria called mycobacterium tuberculosis 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.

Risk factors

Weakened immune system

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

Malnutrition

Very young or advanced age

Traveling or living in certain areas

Poverty and substance use

Lack of medical care.

Use of IV drugs or excessive alcohol

Tobacco use.

Health care work. Regular contact with people who are ill.

Living or working in a overcrowding and poor ventilation area.

Living in or emigrating from a country where TB is common. Like

Eastern Europe

Asia

Russia

Latin America

Caribbean Islands

Symptoms

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.

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 despite medications, 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.
Diagnosis

History taking

Physical exam,

The most commonly used diagnostic tool for tuberculosis is a simple skin test. A small amount of a
substance called PPD tuberculin is injected just below the skin of your inside forearm.

Within 48 to 72 hours, a health care professional will check arm for swelling at the injection site. A hard,
raised red bump means likely to have TB infection.

The TB skin test isn't perfect.A false-positive test may happen if you've been vaccinated recently with
the bacillus Calmette-Guerin (BCG) vaccine.

False-negative results may occur in certain populations — including children, older people and people
with AIDS — who sometimes don't respond to the TB skin test.

Blood tests may be used to confirm or rule out latent or active tuberculosis.

Chest X-ray or a CT scan.

Sputum tests

Treatment

For active tuberculosis, patient must take antibiotics for at least six to nine months. The exact drugs and
length of treatment depend on age, overall health, possible drug resistance and the infection's location
in the body.

first line drugs

Isoniazid 5 (mg/kg body weight) maximum (mg) 300

Rifampicin 10 (mg/kg body weight) maximum (mg) 600

Pyrazinamide 25 (mg/kg body weight)

Ethambutol 15 (mg/kg body weight)

If patient have drug-resistant TB, a combination of antibiotics called fluoroquinolones and injectable
medications, such as amikacin or capreomycin (Capastat), are generally used for 20 to 30 months.

Second line drugs

Group A :

levofloxacin (Lfx)
moxifloxacin (Mfx)

Ciprofloxacin

bedaquiline (Bdq)

linezolid (Lzd)

Group B :

clofazimine (Cfz)

cycloserine (Cs)

terizidone (Trd)

Group C :

ethambutol (E)

Linezolid

delamanid (Dlm)

pyrazinamide (Z)

imipenem-cilastatin (Ipm-Cln)

meropenem (Mpm)

amikacin (Am) (streptomycin)

Kanamycin

Ofloxacin

ethionamide (Eto) or Prothionamide (Pto)

p-aminosalicylic acid (PAS)

Medication side effects

Nausea or vomiting

Loss of appetite

A yellow color to your skin (jaundice)

Dark urine
Prevention

Stay home. Don't go to work or school or sleep in a room with other people during the first few weeks of
treatment for active tuberculosis.

Ventilate the room. Tuberculosis germs spread more easily in small closed spaces where air doesn't
move. If it's not too cold outdoors, open the windows and use a fan to blow indoor air outside.

Cover the mouth. Use a tissue to cover the mouth anytime during laugh, sneeze or cough. Put the dirty
tissue in a bag, seal it and throw it away.

Wear a mask. Wearing a surgical mask when you're around other people during the first three weeks of
treatment may help lessen the risk of transmission.

Finish entire course of medication

Vaccinations

Infants often are vaccinated with bacillus Calmette-Guerin (BCG) vaccine because it can prevent severe
tuberculosis in children.

Complications

Spinal pain.

Joint damage.

Swelling of the membranes that cover your brain (meningitis).

Liver or kidney problems.

Heart disorders.