Definition and Overview
Tuberculosis is a respiratory disease caused by a mycobacterium that thrives in parts of the body where a lot of blood and oxygen can be found. This bacterial infection typically spread through the bloodstream as well as lymph nodes, but it primarily targets the lungs. TB bacteria kill the tissue of the organ they infect making it a life-threatening condition if left untreated.
The following are two types or stages of TB:
Latent TB – This is the inactive form of the disease because the body’s immune system is able to fight the TB bacteria. Persons with latent TB won’t experience any symptoms as long as the disease doesn’t become active. Latent TB is not contagious.
Active TB – Active TB occurs when the bacteria starts winning the battle against the body’s immune defenses and begins causing symptoms. Once the bacteria infect the lungs, active TB can be easily spread to others.
TB is also categorized based on where the infection is.
Pulmonary TB – This is when the bacteria can be found in the lungs. This means that there is a danger of passing the disease to others with every exhalation of breath, every cough, and every time the infected person laughs.
Extrapulmonary TB – If the bacteria grew only in other parts of the body and not in the lungs, it does not spread as easily as in pulmonary cases.
Tuberculosis is caused by slow-growing bacteria called Mycobacterium tuberculosis, which can target people with heightened risk factors such as:
- Patients with disorders that weaken the immune system
- Persons in close contact with an active TB sufferer
- Persons living or working in crowded areas
- Those with little to no access to proper health care
- Drug and alcohol users
- Persons traveling to places where TB cases are rampant
The symptoms of TB depends on the location of the bacteria, i.e. whether it is in the lungs or in other parts of the body. Symptoms of pulmonary tuberculosis are similar to those felt by patients suffering from pneumonia and lung cancer. These include:
- Cough with thick and cloudy mucus that lasts more than two weeks
- Bloody mucus
- Night sweats
- Loss of appetite
- Unexplained weight loss
- Chest pain
- Shortness of breath
Symptoms of extrapulmonary tuberculosis, on the other hand, differ in each case depending on the specific area of the body that is affected by the bacteria. Generally, pain or swelling will occur in the area surrounding the affected body part. For example, if the bacteria grows somewhere near the spine, a person will experience back pain.
Who to See
Your general physician or primary care doctor can help you determine whether your symptoms indicate tuberculosis.
However, once TB is confirmed, you will need to seek specialized treatment from health professionals dealing with infectious diseases or lung-related diseases.
Since TB is contagious, most patients are referred to infectious disease specialists.
Types of Treatments Available
While TB can be treated, the process may take anywhere between six months and two years.
Treatment for active TB consists of:
Combination medications– The use of multiple medications ensure that the bacteria do not become resistant to the antibiotics being taken. This treatment plan usually involves four types of antibacterial medications that are taken continuously for two months. If needed, treatment may extend up to four or nine months depending on test results. If results are not good, drug resistance is possible. Thus, the combination of medications will have to be changed.
Directly Observed Therapy or DOT – In DOT cases, patients are closely watched by their attending doctors every time they take their medications. These special visits help ensure that all antibiotics dosages that are prescribed are being taken. They often become necessary for many TB sufferers because of the long course of treatment of tuberculosis.
Treatment for latent TB involves:
Antibiotics – People with latent TB only need to take one type of antibiotics at a time. Commonly prescribed antibiotics include isoniazid (6-9 months) and rifampin (4 months).
Combination medications – For latent TB, a maximum of 2 types of medications may also be taken together. A Directly Observed Therapy may also be conducted.
The medical specialty that deals with the treatment of tuberculosis, along with other diseases of the lungs, is called pulmonology. Pulmonology encompasses the diagnosis and treatment of tuberculosis, asthma, pneumonia, and emphysema. Doctors who specialize in this field are called pulmonologists, who are trained to determine the state of a person’s lungs by the way they breathe. Various tests, along with special procedures like bronchoscopy, help them determine whether a person is breathing normally or is suffering from a lung problem.
Another specialist that can be contacted for treatment is an infectious disease specialist. These are doctors who specialize in the diagnosis and treatment of diseases caused by complex infections. The list includes tuberculosis and HIV, among many other long-term/chronic disorders.
When to See A Pulmonologist?
Visit a pulmonologist immediately if you:
- Experience the symptoms of tuberculosis
- Have been in close contact with a person suffering from active pulmonary TB
If you recently got a TB skin test, watch for swelling or bruising at the site where the injection was made. Such a reaction is not normal and should be checked out by the diagnosing doctor within three days after the test was conducted.
Pulmonologists can also help TB sufferers deal with the side effects of the medications they are taking. Contact your doctor immediately if you experience vision changes or blurring, jaundice, or abdominal pain while taking tuberculosis medications such as isoniazid and ethambutol.
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- Houston A., Macallan DC. “Extrapulmonary Tuberculosis.” Medicine Journal.
- American Thoracic Society, Centers for Disease Control and Prevention, Infectious Diseases Society of America (2003). “Treatment of Tuberculosis.” American Journal of Respiratory and Critical Care Medicine.
- Pasipanodya J, et al. (2011). “Tuberculosis and Other Mycobacterial Diseases.” Conn’s Current Therapy.
- Keshavjee S., Farmer P. (2012). “Tuberculosis, Drug Resistance, and the History of Modern Medicine.” The New England Journal of Medicine.