TUBERCULOSIS

Disease information

TUBERCULOSIS

Tuberculosis.

Also "consumption" is denominated.

The disease produced by the infection by the bacillus of Koch or Mycobacterium Tuberculosis.

It is a chronic, destructive infection, that without treatment lasts all the life. Even after an suitable treatment, it can be reactivated after many years.

It more frequently affects the lungs, but it can affect any part of the body.

Prognosis.

The infection dagnosticada and treated on time usually cures completely, but for it the strict adhesion to the prescribed medicamentoso regime is essential.

The treated tuberculosis is not invariably fatal, although after a long process.

Complications.

The tuberculosis can affect, like or has been indicated, to any organ or corporal system, reason why it can cause any imaginable complication that derives from the destruction of an organ or system.

The infection by the Bacillus of Koch produces immunological alterations, that can facilitate the sobreinfections.

Diagnosis and treatment.

Diagnosis.

The appearance of symptoms, to the being inespecíficos, requires a valuation epidemiologist on the part of the doctor who takes care of the patient (if cases in the near or distant surroundings of the patient have occurred recently, will be more probable, and tests will look for more quickly) Nowadays one is used mainly the cutaneous tests (of the tuberculina) and the study of the esputos for the diagnosis of the primoinfecciones. Thorax x - rays will be always made to discard pulmonary injuries, easily detectable by means of these tests. In specific cases, other more complex tests will be made.

Treatment.

The treatment requires an initial hospitable internamiento, so that not propage the infection, and the taking during a period of six to nine months of several medicines in combination, according to prescribes the doctor to him.

Medication.

The treatment of the tuberculosis is made by means of the combination of several medicines. It is essential that it follows rajatabla the indications of his doctor, without forgetting the medication, under pain to create resistant bacilli to medicines, which begins to be an important problem.

Activity.

Initially it is recommended not to get tired, once recovered can resume its normal activity.

Diet.

Hypercaloric and hiperprotéicas diets are recommended slightly, mainly at the beginning of the disease.

Prevention.

The antitubercular vaccine (BCG) although does not avoid the infection, prepares to the body so that it reacts vigorously before the contact with the bacillus, producing a precocious control of the infection, that can never be reactivated.

To avoid the contact with infected people. For it to them usually it is entered units with respiratory special protection until, thanks to the treatment, let expel becilos (usually a month)

The people who are been in contact with a diagnosed patient of tuberculosis, will have to be made the test of the tuberculina, that she establishes yes have been in contact with the bacillus. If it has been positivizado recently, or she is positive (the recent vaccination with the BCG the positiviza) a treatment lightened with Isoniacida is administered to avoid that the disease is developed (Quimioprofilaxis)

Factors of risk.

One has demonstrated epidemiológicamente that the subfeeding, poverty and hacinamiento are very important factors.

Contact with the respiratory secrecciones of "bacilíferos" patients (whose secrecciones contain bacilli of Koch)

Much more rarely, contact with other contaminated secrecciones, like saliva (on a wound) or lactancia.

Diminution of the defenses in people with latent infections.

Signs and symptoms.

The clinic of the tuberculosis can divide in three stages or phases (in its form commonest, of entrance by the respiratory apparatus)

Phase of "Primoinfección".

When the bacillus penetrates for the first time in the body. The patient usually does not notice anything, only recognizes itself by the "seroconversión"; the passage of a reación to the negative tuberculina to a positive one. The bacillus extends quiet by all the body.

Silente phase.

It can last years, the patient can notice fatigue, febrícula (tenth of fever, nocturnal coverall) pe´rdida of weight and nocturnal perspiration. The bacillus is multiplied in the organs.

Flowery phase.

They appear symptoms of the affectation of the organs. Most frequent it is the cough, initially dry, later productive, classically of well related off - white esputos and. More ahead sanguinolentos or frankly bloody ("hemoptisis ", or to toser blood) They can appear signs and symptoms of the affectation of any organ or system, like hematuria (to tinkle blood) by renal affectation, headaches and convulsions, by affectation of meninges, Disease of Addison (suprarrenal insufficiency) by affectation of these glands. the body try to react to the generalized infection forming "balls" of protective cells, but these die, forming caseomas (like grains of great puses, with the fused interior) that are united and drained, forming the classic caverns.

The tuberculosis also can present / display other evolutions, being the most frequent variations:

the prolonged inactivity of the infection, when the organism is able to contain the multiplication of the bacterium (latent tuberculosis) and.

the extension generalized through the blood (tuberculosis to miliar)

Causes.

The producing microbe of the tuberculosis, transmits itself easily by the air from the patients to healthy people when these tosen or sneeze.

Although almost the totality of people who contact with the bacillus of Koch infects, the answer to the infection depends on many factors; most important it is the state of the immunological system:

when the patient has a good immunological and nourishing situation, usually the bacillus is limited and "sleepy" (pulmonary injury and calcified hiliares lymphatic gánglios, or "primary complex of Gohn")

when the defenses of the organism are debilitated, the bacillus is multiplied when entering the body, producing the clinic characteristic of important pulmonary disease, although only after years.

when in a patient who isolated the infection initially, the defenses diminish, then the tuberculosis is reactivated, being able to produce any type of the same one as of that moment.

With time the infection of multiple organs and systems, or the importance of the pulmonary injury takes, without treatment, to the death, frequently as a result of the erosion of an important blood vessel by the pulmonary injury, suffocating the patient in their own blood (hemoptisis)

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