Tuberculosis of the lungs is the most common form of tuberculosis. This is due to the fact that the main mechanism of transmission of tuberculosis air drop, and mycobacteria initially enter the lungs.
It should be understood that it was patients with pulmonary tuberculosis are the main source of infection for those around them (smear).
Pulmonary tuberculosis may be asymptomatic for a long time or a chance to show up and malosimptomno during fluoroscopy, chest x-ray, Mantoux test formulation. Often the symptoms of pulmonary tuberculosis is difficult to distinguish from the symptoms of bronchitis, pneumonia or SARS. The main warning sign is persistence of symptoms for a long time and the lack of improvement against the standard treatment of these diseases.
The main symptoms of pulmonary TB include:
- Cough or cough with sputum, possibly with blood;
- Long-term increase in temperature up to 37-37,5 degrees;
- Fatigue and the appearance of weakness;
- Lack or loss of appetite, weight loss;
- Excessive sweating, especially at night;
- The appearance of shortness of breath at low physical activity.
When you save at least one of the above symptoms within three weeks of an urgent need to address the therapist or doctor TB specialist. Suspicion of tuberculosis patients sent to the TB dispensary, where they spend all the necessary examination and confirmation of diagnosis, prescribe treatment.
Diagnosis of pulmonary tuberculosis involved the therapist (or pediatrician) at the place of residence, and TB doctors in the tuberculosis clinic, or hospital specialist. Depending on the age of the patient's diagnostic plan will include a variety of studies. Children have a key role in the diagnosis is Mantoux test. This is a specific response to intradermal administration of tuberculin (a substance that is a product of the activity of mycobacteria). Mantoux test is conducted annually for all children in the absence of contraindications. In the event of a positive reaction or hyperergic pediatrician may refer the child to the TB clinic for further examination. However, it should be understood that such a positive reaction may be a manifestation of both infectious Allergy and postvaccinal. In evaluating the results of n rinimayut into account the period elapsed since vaccination or revaccination, the nature and dynamics of the previous reactions. There are strict criteria on which the doctor can distinguish between primary infection of postvaccinal allergy. If you suspect an infection with Mycobacterium prescribed additional examination, which is generally similar to the survey of adults:
- The holding bsledovanie sputum microscopy and bacteriology;
- Radiography of the lungs;
- Complete blood count (may be revealed mild increase in erythrocyte sedimentation rate, leukocytosis with a small shift to the left leukocyte counts, eosinophilia, lymphopenia).
If necessary, designate a CT scan or MRI of the lung, bronchoscopy, lung biopsy, X-ray of spine, joints, abdominal ultrasound and other tests.
If the diagnosis indicates the localization of lesions, the phase of the pathological process, and complications. Presence or absence of patient selection tubercle bacillus tuberculosis is characterized as BK (+) or BC (-). BK + patients are active and smear-able to infect the people around them airborne.
In some cases, for the initial assessment and treatment of patient hospitalization is recommended. Treatment of TB doctor spends with a physician (pediatrician) and doctors of other specialties. The mainstay of treatment is a causal chemotherapy. Treatment of TB patients long-term (6-18 months) and includes several stages (hospital-sanatorium tuberculosis dispensary).
Begin chemotherapy immediately after diagnosis, a long-term and continuous. Usually prescribed combination of two or more drugs (this includes drugs such as isoniazid, rifampicin, ethambutol, streptomycin, pyrazinamide, and others). Also spend a set of non-specific measures aimed at strengthening the body's defenses (clinical nutrition, vitamin therapy, physiotherapy, exercise therapy, etc.).
Medicinal anti-TB drugs have several side effects and require strict adherence to the application. At the same time, Mr. epravilnoe or inadequate treatment of converts easily curable form of the disease in hard-curable drug-resistant tuberculosis. That's why you should strictly follow all the recommendations of the doctor and the suspicious timing of treatment. If untreated, death from active TB up to 50% within one to two years. In the remaining 50% of untreated cases of tuberculosis, a chronic form. Chronic patient continues to provide fast bacilli and infect others.