Introduction(not isulat)

Tuberculosis (TB) is one of the most prevalent infections of human beings and
contributes considerably to illness and death around the world. It is spread by
inhaling tiny droplets of saliva from the coughs or sneezes of an infected person.it is
a slowly spreading, chronic, granulomatous bacterial infection, characterized by
gradual weight loss.

Definition
Tuberculosis is the infectious disease primarily affecting lung parenchyma is most
often caused by mycobacterium tuberculosis it may spread to any part of the body
including meninges,kidney,bones and lymphnodes.

Types (wag isulat ang nas aloob ng parenthesis)

 PULMONARY TUBERCULOSIS 
 AVIAN TUBERCULOSIS( MICROBACTERIUM AVIUM ;OF BIRDS) 
 BOVINE TUBERCULOSIS(MYCOBACTERIUM BOVIS ;OF CATTLE) 
 MILIARY TUBERCULOSIS / DISSEMINATED TUBERCULOSIS

Risk factors (wag na isama nasa loob ng parenthesis)

 CLOSE CONTACT WITH SOME ONE WHO HAVE ACTIVE TB.
 IMMUNO COMPROMISED STATUS (ELDERLY,CANCER)
 DRUG ABUSE AND ALCOHOLISM
 PEOPLE LACKING ADEQUATE HEALTH CARE PRE EXISTING MEDICAL CONDITIONS
(DIABETES MELLITUS,CHRONIC RENAL FAILURE)
 IMMIGRANTS FROM COUNTRIES WITH HIGHER INCIDENCE OF TB.
INSTITUTIONALISATION(LONG TERM CARE FACILITIES)
 LIVING IN SUBSTANDARD CONDITIONS
 OCCUPATION(HEALTH CARE WORKERS)

Signs and symptoms

 Night Sweats
 Fever
 Chills
 Weakness or fatigue
 Weight loss
 No appetite
 Cough lasting longer than
3 weeks
 Pain in
the chest
 Coughing up blood or sputum (phlegm from inside the lungs)

Diagnostic Exams
 Radiology
 Tuberculin skin test
(Explanantion
A TB skin test requires two visits with a health care provider.
On the first visit, the skin test is placed by injecting a small amount of fluid (called
tuberculin) into the skin on the lower part of the arm. The skin will react if there are
TB germs in the body.
A person given the tuberculin skin test must return within 48–72 hours to have a
trained health care worker look for a reaction on the arm. The result depends on the
size of the raised, hard area where the skin reacted.

The result depends on the size of the raised, hard area or swelling.

Positive skin test: This means the person’s body is infected with TB germs. Additional
tests are needed to determine if the person has latent TB infection (LTBI) or TB
disease.
Negative skin test: This means the person’s body did not react to the test, and that
latent TB infection or TB disease is not likely.)

 Direct sputum smear microscopy

(Explanation
Your sputum specimen will be spread on a microscope slide. A staining dye is added
to the cells of the specimen and then washed in an acid solution. The cells are then
examined under a microscope.

If the cells retain the stain, this means mycobacterium are present. Mycobacteria are
usually acid-fast, which means they hold onto the dye when washed in an acid
solution.

A culture is another kind of test that may be done.

The sputum specimen is placed into a culture medium, which contains nutrients. The
specimen is allowed to grow at room temperature for several days. This makes it
possible to see a greater number of bacteria cells to confirm the results.)

Treatment (name lng ng gamot isulat fren tas ang rest tayo na mag basa pra abla
sabe ta)
PULMONARY TB is treated primarily with antituberculosis agents for 6 to 12 months.
Pharmacological management 
First line antitubercular medications
Streptomycin 15mg/kg 
Isoniazid or INH(Nydrazid) 5 mg/kg(300 mg max perday) 
Rifampin 10 mg/kg 
Pyrazinamide 15 – 30 mg/kg 
Ethambutol(Myambutol) 15 -25 mg/kg daily for 8 weeks and continuing for up to 4
to 7 months  
Second line medications 
Capreomycin 12 -15 mg/kg 
Ethionamide 15mg/kg 
Paraaminosalycilate sodium 200 300 mg/kg 
Cycloserine 15 mg/kg 
Vitamin b(pyridoxine)

TB-DOTS
(Tubercolosis Directly Observed Treatment, Short-Course)
 A strategy in which the Tb patient is being watched by the treatment partner
take the medicines everyday during the whole course of treatment.
 A TB-DOTS Center is a facility that is capable of delivering DOTS services.

Multiple-drug therapy
It is to treat TB means taking several different antitubercular drugs at the same time.
The standard treatment is to take isoniazid, rifampin, ethambutol, and pyrazinamide
for 2 months.
Treatment is then continued for at least 4months with fewer medicines