Pulmonary Tuberculosis (TB)

By:    Published: March 1, 2012

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Pulmonary tuberculosis, or TB, is an infection that is caused by bacteria that targets the respiratory tract. It occurs primarily in the lungs, but can sometimes spread to other areas. TB is a contagious illness that can be very serious.

Understanding Pulmonary Tuberculosis

Tuberculosis was once considered a rare disease in the United States and other established countries. Since 1985, reported cases of tuberculosis have been on the rise. Additionally, many cases of tuberculosis have become resistant to the drugs that are commonly used to treat the infection. Individuals who have been diagnosed with TB often have to take a variety of medications over the span of several months to ensure that the disease has been properly treated.

Causes

Pulmonary tuberculosis is caused by a bacterial infection. The bacteria responsible for tuberculosis are Mycobacterium tuberculosis or M. tuberculosis. Tuberculosis is transmitted when an uninfected person breathes in the tiny droplets that are released when a person with an active tuberculosis infection coughs, sneezes, spits or laughs. If you are living or working in close quarters with a person who has pulmonary tuberculosis, you have a greater chance of catching the illness from that person than you do of catching it from a stranger.

Risk Factors

It is possible for anyone to contract tuberculosis. However, there are certain factors that may increase a person’s risk for getting pulmonary tuberculosis. Common risk factors include:

  • Advanced age
  • Newborns
  • Persons with a weakened immune system

Having a weakened immune system increases your risk for contracting pulmonary tuberculosis. A person with a compromised immune system may not have the resistance needed to ward off bacteria. There are a variety of underlying conditions that may cause a weakened immune system including:

  • Diabetes
  • HIV/AIDS
  • Malnutrition
  • Certain medications
  • Chemotherapy
  • End-Stage Kidney Disease

In addition to a weakened immune system, there are other risk factors that may increase your chances of becoming infected with pulmonary tuberculosis. These factors include:

  • Persons who live or travel to countries with increased cases of tuberculosis.
  • Persons with a long-term history of substance abuse.
  • A lack of proper medical care.
  • Persons working in close contact with ill people.
  • Persons working or residing in a prison or nursing home, where illness is more likely to occur due to crowded conditions or reduced ventilation.

Symptoms

If you have a healthy immune system, your body may carry the bacterium that causes pulmonary tuberculosis without you actually becoming sick; this is known as Latent Tuberculosis. Only people with active tuberculosis display symptoms of the illness. If your doctor has diagnosed you with active tuberculosis, this means that you are sick and can pass the illness onto others. Symptoms of active tuberculosis include:

  • Cough
  • Coughing up mucus or blood
  • Sweating and night sweats
  • Fever and chills
  • Tiredness
  • Unexplained weight loss
  • Loss of appetite
  • Chest pain
  • Wheezing or difficulty breathing

Diagnostic Tests

If you think you may be suffering from pulmonary tuberculosis, contact your doctor to schedule an appointment. Your doctor will likely perform a complete physical exam, check for swelling in the lymph nodes and listen to your breathing. Additionally, your doctor will likely give you a PPD test.

The PPD test is a skin test in which a small amount of PPD tuberculin is inserted just under the skin. Approximately 48 hours later, you will need to have the injection site viewed by your doctor. If your forearm has a red, raised, hard bump at the injection site, you likely have been infected with tuberculosis. The PPD test is not fool proof and false-positive as well as false-negative results have been reported. If your doctor suspects that you do have a tuberculosis infection, he may request that further testing be done.

Other diagnostic tests may include:

  • Blood Tests
  • Chest X-ray
  • Sputum Test

Treatment

The treatment of TB usually lasts for several months and requires the infected individual to take a variety of medications. Your doctor will determine what medications you will need as well as your length of treatment depending upon your age, overall health and form of tuberculosis. The most frequently utilized drugs to treat tuberculosis are:

  • Pyrazinamide
  • Ethambutol
  • Rifampin
  • Isoniazid

Once you begin treatment for pulmonary tuberculosis, it is extremely important that you finish all of the medication, even if you are feeling better. Abruptly stopping your medications can result in a stronger, more serious case of tuberculosis.

Complications

Active tuberculosis that is not treated can be deadly. People with advanced tuberculosis may appear to have clubbed fingers and toes. Additionally, tuberculosis left untreated can spread from the lungs to other parts of the body and into the bloodstream. Untreated tuberculosis can spread to areas such as:

  • The bones: Tuberculosis may spread to the ribs, as well as the spine and joints. This may result in severe pain and bone loss.
  • The brain: Tuberculosis infecting the brain can result in death.
  • The liver and kidneys: If your liver and kidneys become infected with tuberculosis, your body’s filtration system will become impaired.
  • The heart: Tuberculosis that invades the heart may cause fluid build-up surrounding the area, thus impairing the heart’s ability to work properly.

Considerations

If you have an active case of tuberculosis, it is important that you try to protect your family and friends from contracting the illness. It will take several weeks of treatment before you are no longer contagious. Continue taking all medications until you have completed the course of treatment.

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