Talking about TB (Tuberculosis)

We all more or less have in our minds that tuberculosis is a disease of the lungs. True, but not only.

Tuberculosis is caused by the bacterium Mycobacterium tuberculosis and other bugs of mycobacterioum family. The transmission of the disease is usually airborne through droplets, less often through the consumption of unpasteurized milk or contact with animals. Transmission occurs from human to human, but also from animals to humans.

Phagocytosis is the first line of defense. Usually, our immune system can hide a mycobacterium infection for many years without any obvious symptoms, however our lymphatic system helps the mycobacterium spread throughout the body, resulting in enlarged lymph nodes. Immunosuppression (due to steroid use, HIV/AIDS infection, malignancy, diabetes, old age, etc.) can trigger mycobacterium and contribute to the activation of the disease.

The main and characteristic symptoms are fever, night sweats, visible weight loss and loss of appetite, lethargy and malaise. Due to the fact that tuberculosis can affect various organs, the corresponding symptoms also occur. A productive cough with sputum, hemoptysis, and dyspnea for pulmonary tuberculosis, with imaging changes in the apices of the lung parenchyma. In addition to the lungs, the CNS can be affected in the form of meningitis, the eyes, the skin, the lymph nodes, the cardiovascular system in the form of pericarditis, the gastrointestinal tract, the urinary system and the musculoskeletal system.

Risk factors are contact with a patient with pulmonary tuberculosis, HIV/AIDS infection, immunosuppression such as steroids, chemotherapy, travel to countries with an increased prevalence of tuberculosis, people who have stayed in institutions for a long time such as prisons, homeless people, etc.

Diagnosis involves identification of Mycobacterium tuberculosis in at least 3 laboratory sputum samples, either by microscopy, culture, or PCR. Bronchoscopy, CT scan, microscopy and sample culture are ways to detect and confirm tuberculosis.

The Mantoux test is a screening method and not a diagnostic method. Treatment is long-term at about 6 months for pulmonary TB, while treatment for multidrug-resistant TB can last up to 2 years.