Tuberculosis

The time period Tuberculosis turned into entered through Laenneck, originating from the
Latin word, withinside the translation of this means that a «hump». In 1882, the German
researcher Robert Koch, because of clinical labour, gave exhaustive evidence of infectious
nature of tuberculosis. He decided on and defined the supply of the disease. It is widely
wide-spread to call Koch`s bacterium (KB) or mycobacterium of tuberculosis the exciter of
tuberculosis (MBT). It is consultant of big organization of mycobacterium, own circle of
relatives loving vegetable organisms, - to the effluent mushrooms.
Nowadays, there are three techniques of publicity for tuberculosis: tuberculin diagnostics,
fluorographic technique and bacteriological investigations of sputum.
Tuberculin diagnostics is used for kids and teenagers to 15 years old. For the ones pastimes
precise intra-pores and pores and skin tuberculin probe of Mantu is utilized. The cease end
result of a glance is predicted in seventy hours. The dimensions of infiltrate is determined
thru an apparent line. A reaction can be negative, doubtful, positive, poorly positive, middle
intensity and brightly expressed. Negative assessments are determined for healthful human
beings now not infected through tuberculosis.
By the basic method of prophylactic reviews of population from 15 years old and more
senior there is fluorographic examination.
Chemotherapy - treatment of patients by anti-tuberculosis preparations. It takes a leading
seat in treatment of patients with tuberculosis.
Classification
1. Tuberculosis of breathing organs:
• Focal tuberculosis of lungs
• Tuberculosis inwardly breast of lymph nodes
• Tuberculoma of lungs
• Tubercular intoxication
• Infiltrative tuberculosis of lungs
• Cavernous tuberculosis of lungs
• Fibrosis-cavernous tuberculosis of lungs
• Cirrhotic tuberculosis of lungs
• Tuberculosis of overhead respiratory tracts, a bit, bronchial tubes.

2.Tuberculosis of breathing organs, combined with the dust professional diseases of lungs.
Tuberculosis of lymph nodes:
• Tuberculosis of peripheral lymph nodes
• Tuberculosis of mesenterial lymph nodes
3.Bone-joint tuberculosis:
• humeral joint
• elbow joint
• hip joint
• knee-joint
4-Tuberculosis of brain
5-Tuberculosis of eye
6-Tuberculosis of larynx
7-Tuberculosis of urethra and privy parts
8-Tuberculosis of adrenal glands
9-Tuberculosis of intestine
10-Tuberculosis of skin

Clinical Classification
• Primary tuberculosis.
Primary tuberculosis develops after the contact of microorganisms with mycobacteria of
tuberculosis. Mainly it is pulmonary tuberculosis.
• Secondary tuberculosis.
Secondary tuberculosis- of humans which carried primary tuberculosis in the past can arise
in both an endogenous manner and because of the repeated (exogenous) infecting of
organism
Clinical signs of tuberculosis.
For all of organs and structures, the lungs are most usually damaged by tuberculosis, and
the harm of other organs pretty regularly develops as complication of pulmonary system.
Early exposure to tuberculosis is one of important obligations of doctor. For youngsters,
external lymph nodes (neck, submaxillary, arm-pits, inguinal), and additionally lymph nodes
of pectoral and belly cavities, are regularly struck by tuberculosis. With the development of
tubercular system in cleaning one in every sign of ailment, there may be an increase in
temperature. An excessive temperature can stay up for 2-3 weeks, after which it moves right
all the way down to 37,2-37,4degC. From the fever of the lungs, tuberculosis decline in
temperature does now no longer conduct declension to convalescence, and for patients, all
or the referred signs and symptoms remain determined. Deep issues of alternate tactics
that are in organism-issues of digestion, disintegration of albumins to the finished goods in
their time table and dying of tissue, are reasons for thinning and loosening an organism to
pulmonary tuberculosis.
Laboratory diagnostics.
Laboratory diagnostics of tuberculosis includes,
• bacteriological and bacterioscopic methods of investigations,
• conducting of biological and allergic reaction.
• serologic reactions are offered also, but practical application was not found.
• A chest x-ray is indicated to rule out or rule in the presence of active disease in all
screening test positive cases.
• Acid Fast Staining-Ziehl-Nielsen
• Nuclear Amplification and Gene-Based Tests
 Treatment of Active Infection
Treatment of confirmed TB calls for an aggregate of drugs. Combination remedies
are usually indicated, and monotherapy must by no means be used for tuberculosis.
The most usual routine for TB consists of the subsequent anti-TB medications:

First-Line Medications, Group 1

• Isoniazid-Adults (maximum): five mg / kg (300 mg) daily; 15 mg / kg (900 mg) once,
two times, or 3 instances weekly. Children (maximum): 10-15 mg / kg (300 mg) daily;
20 - -30 mg / kg (900 mg) two times weekly (3). Preparations. Tablets (50 mg, 100
mg, 300 mg); syrup (50 mg/5 ml); aqueous solution (100 mg / ml) for IV or IM
injection.
• Rifampicin-Adults (maximum): 10 mg / kg (600 mg) daily, two times weekly, or 3
instances weekly. Children (maximum): 10-20 mg / kg (600 mg) once each day or
twice a week. Preparations. Capsules (150 mg, 300 mg)
• Rifabutin- Adults (maximum): 5 mg / kg (300 mg) each day, two times, or 3 instances
weekly. When rifabutin is used with efavirenz, the dose of rifabutin needs to be
improved to 450 - -600 mg both each day or intermittently. Children (maximum):
Appropriate dosing for kids is unknown.
Isoniazid and Rifampicin comply with a 4-drug regimen (generally such as Isoniazid,
Rifampicin, Ethambutol, and Pyrazinamide) for two months or six months. Vitamin B6
is usually given with Isoniazid to prevent neural damage (neuropathies).

Second-Line Anti-tuberculosis Drugs, Group 2 Injectables aminoglycosides and injectable

polypeptides
• Injectable aminoglycosides
1. Amikacin
2. Kanamycin
3. Streptomycin
• Injectable polypeptides
1. Capreomycin
2. Viomycin

Second-Line Anti-Tuberculosis Drugs, Group 3, Oral and Injectable Fluoroquinolones

• Fluoroquinolones
1. Levofloxacin
2. Moxifloxacin
3. Ofloxacin
4. Gatifloxacin
Second-Line Anti-tuberculosis Drugs, Group 4
1. Para-amino salicylic acid
2. Cycloserine
3. Terizidone
4. Ethionamide
5. Protionamide
6. Thioacetazone
7. Linezolid

Third-Line Anti-Tuberculosis Drugs, Group 5

These are medications with variable but unproven efficacy against TB. They are used for
total drug-resistant TB as drugs of last resort.
1. Clofazimine
2. Linezolid
3. Amoxicillin/clavulanic acid
4. Imipenem/cilastatin
5. Clarithromycin

Complications
Most sufferers have a notably benign course. Complications are more often visible in
patients with the threat elements. Some of the headaches related to tuberculosis are:
• Damage to cervical sympathetic ganglia leading to Horner's syndrome.
• Acute respiratory distress syndrome
• Empyema
• Pneumothorax
• Systemic amyloidosis
• Extensive lung destruction