Tuberculosis - infection known since ancient times and called "consumptive" as sick languished in his eyes, withered.This disease is a chronic infection with a specific type of bacteria (Mycobacterium tuberculosis), which usually affects the lungs.TB infection is not transmitted as easily as the other airway infectious disease, because in order to put a sufficient number of bacteria in the lungs must be repeated and prolonged exposure to the particles emitted during coughing or sneezing patient.An important risk factor is the presence in crowded areas with poor sanitary conditions and frequent contact with TB patients.
tubercle bacilli have considerable stability in the external environment.In a dark place in the sputum, they can survive for many months.Under direct sunlight mycobacteria are killed within a few hours.They are sensitive to high temperatures, the activated solution of bleach, bleach.How to cure this disease folk remedies, see here.
Infection has two stages.First, the bacteria enter the
active stage of the disease starts when bacteria get out of the tubercles and affect other areas of the lungs.The bacteria can also enter the bloodstream and lymphatic system and spread throughout the body.Some people active stage comes a few weeks after the initial infection, but in most cases, the second stage begins in just a few years or decades.Factors such as aging, weakened immune system and poor nutrition, increase the risk that the bacteria will come out of the tubercles.More often than not, with active tuberculosis bacteria destroy lung tissue and make it very difficult breathing, but the disease can also can affect other parts of the body, including the brain, lymph nodes, kidneys and gastrointestinal tract.If TB is not treated, it can be fatal.
Sometimes the disease called white plague because of the ashen faces of its victims.Tuberculosis is the leading cause of death worldwide, despite the development of effective drug treatment.
source of infection is a sick man, sick pets and birds.The most dangerous form of tuberculosis patients open light emitting agents with phlegm, mucus droplets when coughing, talking and so on. D. Less dangerous in epidemiological terms, patients with tuberculous lesions of the bowel, urinary and other internal organs.
Among animals the greatest importance as a source of infection is cattle, releasing agents with milk and pigs.
transmission paths are different.Most infection occurs by droplets through the phlegm and saliva secreted sick when coughing, talking, sneezing, and by inhalation of dust.
plays an important role and contact-household path of infection directly from the patient (stained sputum hands), and through a variety of household items contaminated with sputum.Food can infect a person with TB;In addition, the infection can be transmitted from infected animals tuberculosis through their milk, dairy products and meat.
absolute susceptibility to tuberculosis.The course of infection depends on the state of the body and its resistance, nutrition, housing conditions, working conditions and so on.
for tuberculosis is characterized by non-sterile immunity, t. E., It is saved as long as the body has a pathogen.Along with the development of immunity there is increased sensitivity to the pathogen.
past infectious diseases, especially measles, whooping cough, flu, mental trauma, starvation, hard labor and living conditions reduce the intensity of immunity against TB.Living conditions - the degree of crowding, home hygiene, nutrition, specific features of the production, and other household and professional reasons affect the incidence of tuberculosis and within.
In tuberculosis particular season is not observed, but the number of relapses and exacerbations increases in early spring.
big role in increasing the number of patients with tuberculosis (including tuberculosis resistant to drugs) was the fact that patients do not seek treatment.Medications in a certain combination must be taken for six - nine months to cure the disease.These drugs are weak first kill most bacteria, stronger and resistant bacteria survive, and must deal with them for some time.However, because the symptoms disappear after a few weeks, many people do not pass the full course of treatment.This may lead to repetition and even the development of a more dangerous form of the disease.After treatment in a matter of weeks or months, the strongest survive bacteria as a result of which there is an infection that is resistant to some or even to all drugs.To effectively combat tuberculosis and prevent the growth of drug-resistant strains of bacteria, it is necessary to complete a full course of treatment.Therapy under the supervision of health worker gives a higher percentage of recovered and reduces the resistance levels of the drug.
Another important factor in the resurgence of tuberculosis, AIDS was an epidemic.Weakened immune system of patients with AIDS contributes to the rapid spread of bacteria after infection.
• Persistent cough, possibly with bloody sputum.
• Chest pain.
• Shortness of breath.
• Sweating at night.
• Loss of appetite and weight.
Primary tuberculosis occurs as a result of primary infection occurring in the first penetration of the tubercle bacillus in humans of any age.Since the primary infection usually occurs in children and adolescents (under 18 years), the primary forms of tuberculosis mainly sick members of these age groups.Nevertheless, the primary forms of the disease may be ill adults, if they are up to a certain time, have not met with Mycobacterium tuberculosis.When it enters the body of an adult also develop primary TB.
for primary forms of tuberculosis are characterized by the following features:
great importance for the development of primary forms of tuberculosis is the presence of direct contact with patients.
The primary forms are:
When tubercle bacilli enter the body of the child, comes predallerichesky incubation period - the time from the moment of introduction into the body of the tubercle bacillus, when there are no complaints or clinical signs of disease, until the first positive reaction to PPD.The duration of this period is an average of 6-8 weeks, depending on the child's age, individual resistance to TB infection, and the number of fallen into the organism and the virulence of mycobacteria (aggressiveness).After about 2 months after infection, the child first appears positive reaction to the tuberculin by Mantoux test.
This change in sensitivity to tuberculin, ie the transition before a negative Mantoux test with 2 TE in the positive is called superelevation.Virage is the most reliable sign of early and the come of infection with Mycobacterium tuberculosis.To identify the bend in our country for all children starting at 12 months of age, were vaccinated with BCG in the maternity ward, you must put the Mantoux test with 2 TE annually, and children are not vaccinated with BCG, Mantoux test with 2 TE put even 2 times a year.
If a turn is detected late, or after its detection is not carried out the necessary lechebnoozdorovitelnye event, the process progresses, and after some time (3-6 and sometimes 12 months) the child may appear pathological changes in the lung tissue or in the hilar lymph nodes- so developing local tubercular process.
Later tubercular process reaches its maximum, and if at this point the diagnosis and prescribed treatment starts reverse the development process.It takes 6 to 12 months and leads to a complete clinical recovery.Thus, the whole cycle of development of tubercular process in an average of 12-18 months.
important condition for the timely detection of a bend is a systematic statement of tuberculin test (Mantoux test with 2 TE).The fact that the turn occurs almost asymptomatic, unobtrusively, without impairment and local manifestations, and is expressed only in the sensitivity to tuberculin (tuberculin sensitivity turn) change.Children with superelevation tuberculin sensitivity of the subject to careful clinical and radiological examination in a TB dispensary in order to avoid local tuberculosis and tuberculosis intoxication.
In the absence of local changes and functional disorders of children should receive preventive treatment (chemoprophylaxis) tubazid (ftivazid) for 3 months, will come to the infection is not passed to the local disease tuberculosis.Practice shows that the conduct of a full chemoprophylaxis - TB treatment - in the period of turn of tuberculin sensitivity in almost all cases, prevents the development of the local tuberculosis.Children with a diagnosis of "banked" can attend any pre-school and school institutions, but scheduled immunizations they can do only 6 months after diagnosis.
tuberculous intoxication. Approximately 10% of children have not undergone prophylactic treatment during the period of turn, develop a condition called tuberculous intoxication.This diagnosis is made only for children and adolescents.Even a thorough X-ray examination with the diagnosis does not reveal local manifestations of tuberculosis.Tuberculous intoxication is characterized by a variety of functional disorders, such as fever, poor appetite, changes in behavior of the child, schoolchildren -. Reduction in performance, etc. The temperature often does not exceed 3.7,3-37,5 ° C lasts from a few days to 3 weeks-4 months or more.The temperature rises preferably between 16 and 17 hours.
In young children may experience dyspepsia (regurgitation, vomiting, bowel dysfunction), to decrease the rate of weight gain.It changes the behavior of children: there is irritability, touchiness, tearfulness, lethargy, fatigue, decreased ability to concentrate - hence the decline in school performance.Sometimes children complain of headaches, pain in the heart and stomach.There are sleep disturbance, sweating, decreased muscle tone.
characteristic feature of tuberculous intoxication are changes in peripheral lymph nodes: they are multiple, determined in 6-9 groups of different sizes (from small to bean size) and density (from myagkoelastichnyh to very dense "stones-glands"), painless.It is necessary to emphasize the change in lymph nodes above and subclavian, thoracic, and in elbow creases, as these groups rarely lymph nodes are involved in the process at nonspecific inflammatory diseases.In children with tuberculous intoxication usually reveals high sensitivity to tuberculin.
Children with such intoxication must undergo a special treatment of the two anti-TB drugs for 4-6 months in a sanatorium.
Primary tuberculosis complex. At a massive and prolonged contact of tuberculous (most often - in the family), the causative agent of tuberculosis via the airways to the lungs, mainly in the top of their departments, there settles and begins to multiply.They point out the waste products of mycobacteria and formed the focus of inflammation in the lung.Outbreaks may be of different sizes: from "pea" (3-4 mm) to "walnut" (10-15 mm).On the X-ray focus is no different from ordinary pneumonia, which certainly complicates the correct diagnosis.
During primary tuberculosis complex are four phases:
Persons with hearth Gon considered relatively healthy.They are free to realize themselves in any profession.Hearth Gon, usually remains in the human lung for life.
Thus, primary tuberculosis complex - is a form of tuberculosis, in which the chest radiograph revealed three components: a lesion in the lung, "track" inflammation of lymphatic vessels, which goes to the root of the lung, and enlarged hilar lymph nodes.
If detected such complex lesions, the correct diagnosis is very likely.
What are the symptoms of primary tuberculosis complex?It is characterized by: general toxicity symptoms, cough (not always), slight fever (37,2-37,8 ° C), weight loss, increase in the number and size of peripheral lymph nodes.While rapping over a portion of the lung lesion is determined blunting of pulmonary sound when listening to these places can be heard crackles.Tuberculin tests are positive, some children - hyperergic.The blood test revealed mild leukocytosis, accelerated erythrocyte sedimentation rate of 25-30 mm / hour.Children with primary tuberculosis complex are rarely isolated sputum mycobacteria have identified infrequently.Duration of course of primary tuberculosis complex is usually 6-8 months.When properly prescribed treatment comes a full recovery, and only in 5-8% of children are formed in the form of residual changes Gon foci.
more often occurs in children a form of local TB as tuberculosis of intrathoracic lymph nodes, where the isolation affects the lymph nodes hilar and mediastinal.The mediastinum easy to distinguish four groups of lymph nodes: paratracheal, tracheobronchial, bronchopulmonary and bifurcation.The most frequently affected bronchopulmonary lymph nodes.
tuberculous process in the lymph nodes is more often unilateral, rarely (in about 4-5%) - two-sided.
begins tuberculosis of intrathoracic lymph nodes, usually gradually.The child appears fatigue, poor appetite, irritability, temperature rises;some children celebrated a cough that is sometimes reminiscent of the cough in whooping cough, and sometimes wears a "bitonal character" when at the same time with a low tone of the cough heard high-pitched sound.This cough is more common in young children.When viewed from the front of the chest under the collarbone and back to the inter-blade space is sometimes possible to observe the expansion of peripheral venous network, which looks like spider veins or varicose veins and the "star" with varicose veins of the lower extremities.When tapping (percussion) is determined by the sound dullness that goes beyond the upper edge of the sternum, with listening, as a rule, no change is observed.
There are three forms of tuberculosis of intrathoracic lymph nodes: tumor (tumoroznuyu), infiltrative and small.The main method of diagnosis is a tomographic study best - computed tomography, an additional method of study - bronchoscopy.Great difficulties in diagnosing create small forms of tuberculosis of intrathoracic lymph nodes.If you suspect that this form of tuberculosis child needs survey in a tuberculosis hospital.
Disseminated tuberculosis pulmonary tuberculosis is characterized by the presence of multiple foci, located symmetrically in both lungs, and sometimes in other organs (kidney, bones and joints).There are acute, subacute and chronic disseminated tuberculosis.
acute disseminated tuberculosis children get sick more often.In the light reveals tiny, the size of a millet grain, hearths, arranged symmetrically in both lungs.