Tuberculosis: Types, Symptoms, Causes & Treatment

Tuberculosis also known as TB is a hazardous contagious infectious disease caused by bacteria. It most commonly affects the lungs but if not treated can affect various other parts of the body like the brain and spinal cord.

• It is a communicable infection that spreads when an infected person coughs or sneezes. 
• These droplets can be inhaled and the germs can enter the lungs of a healthy individual. 
• According to the World Health Organisation, cases of tuberculosis in 2016 reached 2.79 million, particularly in India. 

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What is Tuberculosis?

The full form of TB is tuberculosis, it is defined as an infectious disease that is caused by Myobacterium Tuberculosis. It spreads via cough, sneeze or spit. Apart from the lungs, it also affects other parts of the body.

• Tuberculosis is also known as ‘white death’ as a person suffering from this disease becomes pale.
• This communicable illness mostly occurs in people suffering from HIV/AIDS as they have a weak immune system.
• Certain antibiotic drugs are used in the treatment of tuberculosis. 

Stages of Tuberculosis

There are primarily three stages of tuberculosis:

1. Primary infection
2. Latent TB infection
3. Active TB disease

Primary

This is the first stage of tuberculosis where the cells of immune system detects and captures the germs.

• The immune system cells destroy some germs but the captured ones can multiply further.
• During this stage, a person may feel tired, and develop mild fever and cough.

Latent TB infection

In this stage, the cells of the immune system forms a barriers around the tissue of lungs along with the germs.

• Although the germs survive, they do not cause harm to the immune system.
• No symptoms are noticed in this stage.

Active TB disease

This disease occurs when the immune system fails to control the infection.

• The infection or germs can spread throughout the lungs and other body organs.
• Active TB symptoms include blood in cough, shivers, fever, chest pain, sweating, and weight loss.

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Types of Tuberculosis

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There are majorly two types of tuberculosis disease namely:

1. Pulmonary Tuberculosis
2. Extrapulmonary Tuberculosis

Pulmonary Tuberculosis

It is a pulmonary infection that is endemic and affects the lungs. Pulmonary tuberculosis is subdivided into the following groups:

• Primary Tuberculosis Pneumonia: Primary tuberculosis is a type of tuberculosis that leads to coughing and high temperature. These are the common symptoms of pneumonia. It can also occur in HIV/AIDS patients.
• Miliary Tuberculosis: This type of tuberculosis is named after a characteristic pattern seen on a chest radiograph, in which many little spots are dispersed throughout the lung fields and resemble millet seeds. The infection can spread to other organs outside of the lungs, such as the spleen, liver, and kidneys.
• Latent Tuberculosis Infection: This infection is most common in persons who have the bacteria in their bodies but do not show any symptoms of the condition. The tuberculin skin test (tst skin test) is the most common way to detect this illness.

Extrapulmonary Tuberculosis

Extrapulmonary tuberculosis occurs when tuberculosis affects more than just the lungs and spreads to other regions of the body. This type of tuberculosis is extremely rare and only occurs in those who have a weak immune system.

• Tuberculosis Meningitis, Lymph Node disease, Renal tuberculosis, etc are the different types of extrapulmonary tuberculosis.
• Symptoms of this type also include fever, chills, loss of appetite, loss of weight, and feeling tired.

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Tuberculosis Symptoms

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Once Mycobacterium tuberculosis, enters the lungs, it multiplies. It has the potential to cause major adverse effects, a few tuberculosis symptoms are mentioned below:

• Coughing up blood and mucus from the lungs' deepest recesses
• A severe cough that lasts at least three weeks
• Weakness or exhaustion
• Sweating at night
• Chest discomfort
• Loss of weight
• Loss of appetite
• Fever and chills

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Causes of Tuberculosis

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Tuberculosis is caused by Mycobacterium tuberculosis. It is a pathogenic bacterial species that mostly consists of four types of tuberculosis-causing bacteria Mycobacterium Bovis, Mycobacterium canettii, Mycobacterium microti, Mycobacterium africanum. Several other causes of tuberculosis are as follows:

• The disease is caused when an infected person sneezes, coughs, sings, speaks, or laughs.
• People who have a weak immune system are more susceptible.
• Diabetes and other metabolic conditions can raise the chance of developing tuberculosis.
• Malnourished individuals especially infants are more prone to such infections.
• Use of tobacco can also cause tuberculosis

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Diagnosis of Tuberculosis

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The World Health Organisation has suggested the use of initial diagnostic tests such as Xpert MTB/RIF Ultra and Truenat assay. The following are some methods for diagnosis of tuberculosis.

Mantoux Tuberculin Test

Mantoux Tuberculin Test is carried out to identify tuberculosis in the lungs. Tuberculin is a toxin produced by Mycobacterium.

• The Mantoux Skin Test was employed in this study where a small amount of old tuberculin is injected into the skin's surface layers.
• If there is redness, scarring, or swelling in the location of the application after 72 hours, the test is positive, and the person is diagnosed with Tuberculosis. 

Culture Test

Tuberculosis that affects organs other than the lungs, such as the brain, spinal cord, joints, bones, gut, kidneys, and so on, is uncommon.

• A sample of bacteria is collected from the lesions created or from the secretions of these lesions to diagnose this condition.

Sputum Test

Testing the patient's sputum for the presence of causative microorganisms can help disclose the disease's condition.

• In this test the patient is asked to cough really hard in order to collect the sputum.
• The sputum is collected in a test tube and is analyzed for tuberculosis disease.

Blood Test

Blood samples are taken and examined in laboratories for the presence or absence of tuberculosis germs in the blood cells.

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Treatment for Tuberculosis

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The treatment for tuberculosis is critical if left untreated can be fatal. Some antibiotics kill the germs while some stay, so it i advised to take medications as advised by the healthcare provider.

• Antitubercular medications such as INH and Rifampicin for 4-6 months. 
• Antibiotic drugs such as isoniazid, rifampin, ethambutol, and pyrazinamide, are given to treat the infection.
• If tuberculosis treatment is stopped before it is finished, the disease may recur and become untreatable.
• It's also critical to keep track of the patient's development during the therapy process.

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Prevention of Tuberculosis

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Tuberculosis is a significant impediment to India's socio-economic progress. The following steps can be taken to avoid it:

• Stay at home and avoid moving out.
• Isolate yourselves completely and spend less time with family members.
• Infected individuals as well as healthy ones are advised to wear masks even at home.
• While coughing or sneezing cover the mouth to avoid spreading of germs.
• Bacille Calmette Guerin vaccine or BCG vaccine is given to three-month-old babies to protect them from the disease.
• Tuberculosis is likely to spread easily in congested areas, it is advised to open windows to move air out.

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Things to Remember

• Mycobacterium tuberculosis, a bacterial infection, causes tuberculosis.
• The effect of the BCG vaccine is thought to endure for up to 12 years.
• The Pulmonary Tuberculosis and Extrapulmonary Tuberculosis are two types of TB disease.
• Streptomycin is also used in the treatment of this infection.
• It can be prevented by social awareness programs and improving the vaccination drives for the same.

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