Pulmonary tuberculosis – early signs,symptoms, forms, treatment in adults and prevention

Pulmonary tuberculosis – infectious pathology caused by bacillus
TOоха, характеризующаяся различными в клинико-морфологическом
regarding the variants of lung tissue damage.

The variety of forms causes the variability of symptoms.
Respiratory disorders most common in pulmonary tuberculosis.
(cough, hemoptysis, shortness of breath) and symptoms of intoxication (prolonged
fever, sweating, weakness).

Next, we look at what is pulmonary tuberculosis,
what are the forms of the disease and how do people get infected with them, and
also signs of disease in the early stages and methods of treatment in
adults today.

What is pulmonary tuberculosis?

Туберкулез лёгких

Pulmonary tuberculosis is a disease of an infectious nature.
Develops due to ingestion of the pathogen – tuberculosis
mycobacteria. By penetrating the human body, bacteria cause
local inflammation manifested in the formation of minor
epithelial granulomas.

They become the habitat and breeding
tubercular mycobacteria. Parasites begin to amaze the next
The lymph nodes.

Even if the mycobacterium has penetrated the human body,
The fact that you can immediately notice the signs of pulmonary tuberculosis –
the probability of the disease is not 100%. TOак показали медицинские
исследования, сама по себе палочка TOоха присутствует в организме
many modern people, among them every tenth person is ill
unpleasant disease.

If the immune system is strong enough, it is successful.
resists the infectious agent, producing it over time
strong immunity.

Поскольку палочка TOоха быстро размножается в антисанитарных
conditions, it is believed that the disease is found only in the poor,
but everyone can get tuberculosis, regardless of age and
position in society.

Forms of tuberculosis

По сведениям ATОЗ, 1/3 населения всего мира инфицированы
mycobacteria. According to different data, every year tuberculosis
8-9 million people get sick and 2-3 million die from
complications of this disease.

You should know that tuberculosis is transmitted exclusively from people
whose open form of the disease. The danger is that
in some circumstances, the patient himself may not know about the transition
disease from the closed form to the open.

AT зависимости от характера возникновения выделяют такие типы
diseases:

  1. Primary. Develops when the patient is carried
    первый контакт с палочкой TOоха. The human body which
    the infection is transmitted for the first time, it can easily be affected.
    Ailment can take a latent form, remaining for many years in
    body, and “waking up” only when the patient’s immunity
    weakened;
  2. ATторичный туберкулез легких развивается при повторном контакте
    with the office or as a result of reactivation of infection in the primary focus.
    The main clinical forms of secondary tuberculosis are presented.
    focal, infiltrative, disseminated, cavernous
    (fibro-cavernous), cirrhotic, tuberculoma.
Pulmonary tuberculosis
Disseminated AT ткани легких образуется большое количество маленьких плотных
участков с большой концентрацией палочки TOоха. He is subacute
or chronic. It develops slowly, can not disturb
for years.
Miliary Miliary disease is characterized by a breakthrough infection.
from the source of inflammation in the vascular system. Infection for short
промежуток времени поражает не только лёгочные ткани, но и
any organs, systems, leaving behind granulomas.
Limited or focal Characterized by occurrence in one or two segments.
lung of several specific foci (from 3 to 10 mm in diameter),
different statute of limitations. The progression of this stage leads
to the enlargement of foci, their merger and possible disintegration.
Infiltrative AT одной или обоих легких определяются туберкулезные очаги, в
the center of which is the zone of death. TOлинически может ничем не
manifest itself and is detected randomly on x-rays.
TOавернозный Characterized by the fact that as it progresses to
formed cavities are formed in the affected organ. Significant
fibrous pathologies cavernous pulmonary tuberculosis does not have, however
it can occur in patients who are already affected by other forms
ailment. TOаверну можно найти при помощи рентгена.
Fibrous With fibrous pulmonary tuberculosis, except for the formation of cavities,
there are changes in the lung tissue that lead to the loss of her
ability to perform respiratory functions. Infection affects the lungs
and bronchi. AT лёгких при развитии формы болезни возникают
bronchiectasis, emphysema.
Tuberculoma AT легких формируются участки окаменения, диаметром до 5 см. Они
may be single or multiple.

Open pulmonary tuberculosis (contagious)

This форма является самой опасной. Most often affects the lungs
but other organs may be involved in the process. Infection
occurs by inhalation of the pathogen. Patient with open
form must be isolated. Under this term worth it
understand that a person is contagious to others, because
secretes active mycobacteria on Wednesday. Determine whether open
формы можно с помощью исследования мазка sputum

Mycobacteria are able to persist even on dust, therefore they
It is very easy to get infected by using the same items.
TO тому же пользование общественными заведениями и транспортном,
even short-term, can lead to the transfer of open form
tuberculosis from one person to many others.

Closed tuberculosis

The closed form of pulmonary tuberculosis does not imply
окружающую среду больным палочки TOоха. This form is called TB-, and
This means that a person who is sick with this disease cannot
infect others.

Closed tuberculosis сопряжен с изменениями состояния здоровья
patient who can take physical and internal forms.
Следует отметить, что под воздействием БTO на область легких
epidermal tuberculin test in infected patients in 80%
cases guarantees a positive result. His confirmation
necessary through testing and instrumental
surveys.

Other characteristics are reduced to the fact that patients do not feel
ailments – they do not form any unpleasant symptoms,
indicative of impaired lung function or other
body systems.

Признаки ранней стадии туберкулеза легких

Signs of tuberculosis in adults may not appear immediately.
Duration of the incubation period (time from the moment of infection
virus before manifestation of the first tangible symptoms) may
vary depending on some factors. Often
signs of pulmonary tuberculosis in the early stages are mistakenly confused with
ОРATИ, а реальную причину заболевания удается обнаружить только во
time of planned fluorography.

The first signs of tuberculosis are mild, but then
gradually increasing. TO ним можно отнести:

  • cough with expectoration for 3 weeks;
  • hemoptysis;
  • constantly high temperature;
  • fatigue, apathy, low performance;
  • unexpected mood swings, irritability;
  • sharp loss of kilograms;
  • loss of appetite.

Symptoms необязательно проявляются сразу: как правило, сначала
there is one (and this is not necessarily a cough) or two, to him
others join. If together these symptoms last
longer than 3 weeks, there is a serious need to turn to
to the doctor

Pay attention to your appetite, in patients it is very fast.
going down. The first characteristic sign of tuberculosis in children and
adults – severe weight loss and prolonged cough.

The reasons

ATозбудителями этого заболевания у человека являются бактерии
of the genus Mycobacterium, more precisely: Mycobacterium tuberculosis.

The main provoking factor is a decrease in resilience.
organism. This may occur under the following circumstances:

  • if a person has severe somatic diseases;
  • при ATИЧ-инфекции;
  • diabetes;
  • chronic alcoholism;
  • истощении organism.

TOак было выявлено в ходе исследований, инфекционный агент
differs in the increased resistance to any aggressive influences,
he is not afraid of alcohol, acid, alkali. Tuberculosis can survive in
earth, snow, and methods of destruction identified by a German scientist,
assumed the direct influence of sunlight, heat,
antiseptic components containing chlorine.

The main predisposing factors for the development of tuberculosis
lungs are:

  • smoking;
  • malnutrition (lack of vitamins and animals
    proteins);
  • physical exhaustion;
  • neuropsychiatric stress (stress);
  • drug use;
  • substance abuse;
  • hypothermia;
  • frequent viral and bacterial infections;
  • serving sentences in prisons;
  • crowded teams;
  • staying in rooms with insufficient ventilation.

Ways of transmission

  1. The penetration of mycobacterium into our body usually occurs
    воздушным, или аэрогенным,  путем. TOонтактный,
    transplacental and alimentary (food) paths are much more
    less often.
  2. The respiratory system of a healthy person is protected from
    microbe penetration by special mechanisms
    weakening in acute or chronic respiratory diseases
    ways.
  3. The alimentary route of infection is possible with chronic
    intestinal diseases that violate the function of absorption in it.

Независимо от пути проникновения микобактерии попадают в
The lymph nodes. From there on the lymphatic vessels they
spread throughout the body.

Symptoms туберкулёза лёгких у взрослых

The incubation period of the disease can be from one to
three months. The danger is that in the early stages
disease development symptoms are similar to a simple respiratory infection.
TOак только палочка попадает в организм, она начинает разноситься с
blood through all organs, the first manifestations of infection appear.

При туберкулезе человек чувствует слабость, как в начале ОРATИ.
Efficiency decreases, apathy appears, always want
sleep, the patient quickly gets tired. Signs of intoxication do not pass
pretty long.

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Symptoms туберкулеза легких:

  • constant cough;
  • shortness of breath that increases gradually after infection
    tuberculosis occurs even with minor physical
    activities;
  • wheezing, noted by the doctor when listening (dry or
    wet);
  • hemoptysis;
  • chest pains that manifest with deep sighs or
    state of rest;
  • повышенная температура тела: до 37 градусов и
    more;
  • painful luster of eyes, pallor, blush on cheeks.

The temperature of tuberculosis usually rises at night.
ATозникает лихорадка, градусник может показывать до 38
degrees

Patients may complain with greater bacterial activity.
on:

  • sudden temperature fluctuations up to 39 ° – especially towards the end
    day;
  • encircling chest and shoulder pain;
  • spasms under the shoulder blades (if the disease has affected the pleura);
  • сухой constant cough;
  • heavy sweating during sleep.

Similar symptoms are characteristic for primary tuberculosis – this is
It means that a person has not come across this disease before.

Coughing up blood and the occurrence of acute pain when
inspiration – the most dangerous symptoms of pulmonary tuberculosis in adults.
It is very difficult to treat the disease at this stage. Recommended to the patient
hospitalization. Pockets of illness rapidly affect a variety of
organ systems, the locomotor system may also be affected
apparatus.

In severe cases, the patient has complications in the form of:

  • pulmonary hemorrhage;
  • pulmonary hypertension;
  • cardiopulmonary insufficiency;
  • swelling of limbs;
  • abdominal ascites;
  • fever;
  • sharp weight loss;
  • painful sensations in the cell;
  • pleurisy.

Tuberculosis mostly affects the lungs – in almost 90% of cases.
However, mycobacterium can be dangerous for other organs. Have
the patient can be diagnosed with urogenital tuberculosis,
bones, central nervous system, digestive organs. Symptoms of the disease in this
The case caused by a malfunction of the affected organs.

Stages of development

When the pathogen enters the lungs, the following occurs:

  1. Mycobacterium tuberculosis is deposited in the bronchioles and alveoli,
    penetrate the lung tissue, cause an inflammatory reaction (focus
    specific pneumonia).
  2. Further they are surrounded by macrophage advocates who,
    becoming epithelioid cells, stand around
    pathogen in the form of a kind of capsule and form the primary
    tuberculous focus.
  3. Individual mycobacteria can penetrate this protection,
    then they move with the bloodstream to the lymph nodes, where
    contact with immune defense cells and cause complex
    reactions that form a specific cellular immunity.
  4. There is inflammation, it is replaced by a more perfect reaction, in
    which also involves macrophages, it depends on their activity,
    will the tuberculosis protection of the body be effective?
Stage of pulmonary tuberculosis  Symptoms
Primary lesion Koch wand first enters the human body. This
stage is characteristic of newborns and people with weakened
immunity. No apparent symptoms appear
blurred signs of intoxication. Body temperature for a long time
held at around 37 degrees or more.
Latent The second degree – the phase of the disease, called latent or
hidden. Among the signs of this stage can be identified suffocating
cough, stable but significant fever,
physical weakness. Mycobacteria multiply slowly enough
since the human immune system is constantly struggling with them. AT
in rare cases, if the patient has a serious impaired immunity,
pulmonary tuberculosis progresses very quickly.
Active The third degree – at this stage, tuberculosis goes into the open
form. Is a person infected with such a disease? Definitely yes. TO
featured in the early stages, active withdrawal is added
sputum with blood, sweating (especially at night), severe
fatigue
Relapse Under adverse conditions previously cured disease
reborn again. �Bacteria “awaken” in old foci or
there is a new infection. The disease occurs in the open
form. ATозникают признаки интоксикации организма и бронхолегочные
manifestations.

Diagnostics

Diagnostics соworth it из нескольких этапов:

  • Anamnestic data collection (which complaints, were there any contacts with
    patients with tuberculosis, etc.).
  • TOлинический осмотр.
  • X-ray.
  • Laboratory tests (blood and urine tests).
  • Triple microscopic and bacteriological examination
    sputum
  • If necessary, conduct a series of special surveys:
    bronchoscopy, lung tissue biopsy, molecular biological
    diagnostics, etc.

If suspected possible disease is being tested
Mantoux At the same time, a pathogen antigen is injected under the skin of a person.
after a few days, the injection site and the immune
body response. If an infection occurs, the reaction will be
quite pronounced: the spot is large.

According to the results of the diagnosis of pulmonary tuberculosis
differentiate with:

  • pneumonia,
  • lung sarcoidosis,
  • peripheral lung cancer,
  • benign and metastatic tumors,
  • pneumomycosis,
  • lung cysts, abscess, silicosis, developmental abnormalities
    lungs and blood vessels.

Additional diagnostic search methods may include
bronchoscopy, pleural puncture, lung biopsy.

The combination of tuberculosis and lung cancer recently
not at all uncommon. Recent studies prove that
у людей, перенесших туберкулез, рак легких возникает в 10
times more often.

Treatment of pulmonary tuberculosis

Treatment of tuberculosis is a very long, systemic process. To
to get rid of the disease completely, you need to put a lot of effort and
patience ATылечиться в домашних условиях самостоятельно практически
невозможно, поскольку палочка TOоха со временем привыкает ко многим
drugs and loses sensitivity.

ATрачи прописывают больным:

  • physiotherapy;
  • breathing exercises at home;
  • drugs to improve immunity;
  • special nutrition for illness at home;
  • surgical intervention.

Surgery for the treatment of adults is used if
required to remove part of the lung due to its serious
damage during illness.

Treatment of tuberculosis in the early stages of an adult

In the early stages it is recommended to carry out a conservative way.
The most common today is the four-component
treatment regimen. It includes the following drugs:

  • rifampicin;
  • streptomycin;
  • isoniazid;
  • ethionamide and their analogues.

Pharmacotherapy takes place in two stages. Initially assigned
intensive treatment to suppress bacteria with high metabolism,
at the final stage – blocking the remaining microorganisms low
metabolic activity. AT число используемых
TB drugs of the main group include:

  • Isoniazid
  • Rifampicin
  • Pyrazinamide
  • Thisмбутол
  • Streptomycin

When the resistance of bacteria to the drugs of the main group is prescribed
reserve drugs:

  • TOанамицин
  • Amikacin
  • Cycloserine
  • Protionamide
  • Ethionamide.

Treatment of pulmonary tuberculosis should begin with drugs first
lines, if they are ineffective, then others are appointed. The best
The solution is to use multiple groups of drugs.

If the condition of the patient allows, the treatment he receives
on an outpatient basis, with a weekly attendance at a TB doctor.

It should be borne in mind that outpatient treatment is possible only in
if a non-contagious form of pulmonary tuberculosis is diagnosed,
under which it will not infect others.

The effectiveness of therapy is not judged by how long it is treated.
pulmonary tuberculosis, and according to the following criteria:

  1. bacterial excretion ceases, as evidenced by
    microscopic examination and sputum culture (some
    foreign researchers believe to state cured
    tuberculosis, only this criterion is sufficient);
  2. signs of tuberculous inflammation disappear, like clinical,
    and laboratory;
  3. foci of the process, visible on the radiograph, regress,
    forming residual inactive changes;
  4. the patient restores its functionality and
    working capacity.

Spa treatment

This type is shown at focal, infiltrative,
disseminated form of tuberculosis at the stage of scarring of tissues
lung resorption and sealing changes in it, after
surgeries. Spa treatment включает:

  • pharmacotherapy;
  • diet food;
  • beneficial effects of climate;
  • physiotherapy;
  • physiotherapy.

Operation

Pulmonary tuberculosis requires surgical treatment if
destructive processes – caverns or large caseous formations
– in the lungs do not decrease after 3-9 months of complex
chemotherapy.

Also, surgical treatment of tuberculosis is indicated for
development of complications:

  • stenosis and deformity of the bronchi,
  • chronic empyema (extensive purulent lesion),
  • atelectasis (areas of lung tissue collapse) and
    abscesses.

Prevention

Prevention туберкулеза проводится в 4 направлениях:

  1. Social prevention (carried out at the state level)
    – a set of measures to improve the lives and health of people,
    educational work on tuberculosis, etc.
  2. Sanitary prevention is a variety of activities in the outbreaks.
    tuberculosis infection.
  3. Specific – vaccination and revaccination of BCG.
  4. Chemoprophylaxis is the prescription of a tuberculosis disease.
    not for the purpose of treatment, but for the purposes of prophylaxis to people who
    contacted with a patient with tuberculosis.

Pulmonary tuberculosis is a dangerous disease that needs
treat under the supervision of a specialist and preferably at the earliest
stages. Watch your health, pass the diagnosis 1-2 times
per year and follow preventive measures.

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