What is the stage before open tuberculosis. What is open form of tuberculosis? Symptoms and signs

Anyone can get tuberculosis because the tuberculosis bacillus is transmitted by airborne droplets from a sick person, and then to a contact cough after “irrigating” household items. People who have an open form of tuberculosis are considered potentially dangerous to others, especially children. To protect yourself from infection, you need to know about the symptoms of open tuberculosis and how to protect yourself from it.

Most often, the open form is characteristic of the pulmonary form of tuberculosis.

If you don’t finish eating, you’ll constantly be in stressful situation And nervous tension, then if the tuberculosis bacillus gets in, signs of tuberculosis will develop, which often lead to fatal outcome.

The number of cases is likely to increase. Outbreaks of infection are recurring due to an increase in the number of HIV-infected patients in whom this disease manifests itself as a complication.

What is open form of tuberculosis?

In addition to HIV-infected patients, the risk group for the disease includes elderly people, medical workers, patients with reduced immunity due to concomitant or past diseases, children, as well as people living in poor social and living conditions. Extremely rarely, infection occurs through consumption of meat, eggs or milk of infected animals.

The open form of tuberculosis has severe symptoms and constantly releases mycobacteria that infect the surrounding space. This is its difference from the closed form of the disease. Tank culture (smear microscopy) in sputum and saliva detects Koch's bacillus, determined by a laboratory staining method.

Open tuberculosis can be primary and secondary:

1. The primary type develops in people who have not previously been in contact with a carrier of the tuberculosis bacillus. Most often it is asymptomatic, characterized by only mild inflammation in the lungs. Then the inflamed focus transforms into a caseous (cheesy) node, being replaced by fibrous growth and forming calcifications, which are detected on x-rays of the lungs.
2. Secondary pulmonary tuberculosis develops in patients who previously had tuberculosis and is called miliary. With this type, the primary lesion is scarred and calcified, but under certain conditions, it can break through lung tissue or spread mycobacteria with blood to other organs and systems of the body (bones, brain, spleen, liver). The infection is called miliary because the tissue of organs affected by tuberculosis resembles millet grains in appearance. This is very clearly visible on an X-ray of the lungs.

Open tuberculosis is not subject to self-treatment, which in any case will be ineffective. It involves therapy in a specialized department of a tuberculosis dispensary for six months (with the help of 4-5 different types medications), which can take years. If you consult a doctor in a timely manner and follow all instructions, the prognosis for open tuberculosis is favorable. Otherwise, the patient may die from complications.

The disease is confirmed by x-rays and computed tomography.

Symptoms

Clinical manifestations increase gradually. At first, the symptoms are not felt and do not cause discomfort to the patient, but over time, a constant dry cough appears, which then becomes wet. The duration of the cough symptom is three or more weeks. It is the main danger factor of the open form (with wet coughing), since the sputum contains microbes.

The patient quickly loses weight, loses his appetite, and may experience hemoptysis. The temperature rises in the evenings to low-grade levels, weakness and lethargy are present. The miliary form of secondary tuberculosis progresses over several months. The aggressive course of the disease begins, characterized by the following symptoms:

• high fever up to 39°C;
• night sweats;
• incessant dry cough, especially in the morning and at night;
• pain in the joints and behind the sternum;
• pale skin.

Then the overall tone of the body decreases and gastrointestinal disorder occurs.

After contact with a patient with tuberculosis, you need to pay attention to changes in your general condition, come for a consultation with a TB specialist, especially if the communication has been long.

In order not to become infected, you need to eat rationally, not smoke, increase your immunity, take vitamins, avoid close contacts with tuberculosis patients, and also do not refuse annual medical examinations and do fluorography. Advice from an experienced TB doctor: it is advisable to eat a hearty meal before visiting public places. Koch's bacillus more easily infects the body of people who forget to eat on time (“loves hunger”).

Signs of open tuberculosis

The time from the time Mycobacterium tuberculosis enters the body until the development of signs of the disease is approximately 2-3 months. The diagnosis is confirmed by fluorography, x-ray, CT.

Signs of open tuberculosis are: clinical (symptomatic), laboratory (the pathogen is detected in tests) and radiographic (all the signs of tuberculosis are present - darkening, the presence of cavities different sizes, increased pulmonary pattern).

Signs are detected using the tuberculin Mantoux reaction. At negative reaction, and a year later it is positive, with an increased size of the papules, they talk about infection. In the presence of weakness, persistent low-grade fever, noticeable by the patient, we can talk about signs of tuberculosis intoxication. The open form may well pass almost unnoticed with an inactive flow. But with severe fever, sweating and persistent cough, a more active phase of infection begins.

The open form of tuberculosis has the following main signs, confirmed laboratory tests sputum for the presence of bacilli or bronchoscopy:

1. Cough, persistent, dry, then with sputum.
2. Hemoptysis, which may be complicated by pulmonary hemorrhage.

If you suspect a disease after contact with a tuberculosis patient, you can suspect an infection by early stage. If you consult a doctor in a timely manner, tuberculosis is curable. If the patient delays treatment, then in the future it will be much more difficult to cope with the infection. The earlier treatment is started, the higher the recovery rate.

Health to you!

Humanity has known about tuberculosis for a long time; it used to be called consumption. Just a couple of centuries ago, almost all patients died from tuberculosis. But, despite the availability of anti-tuberculosis drugs, tuberculosis is still considered a dangerous and very common disease.

According to the latest data, about 9 million cases of illness are registered annually around the world. The increase in tuberculosis patients is associated with an increase in the number of people with HIV infection, because it is they who most often develop tuberculosis as a complication of the underlying disease.

How can you become infected with tuberculosis? The causative agent of this infectious disease is the tuberculosis bacillus, which is also called Koch's bacillus. Tuberculosis (in open form) is transmitted from a sick person to a healthy person through the air. Most often, transmission of infection occurs through contact with infected people, as well as through shared household items. The immune system of a healthy person can destroy the pathogenic bacillus, however, too frequent contact with a sick person increases the likelihood of infection even with an active immune system.

With a weakened immune system, any infections penetrate the body faster and multiply faster in it. So the risk of infection is high for both strong and weakened organisms.

Open form

What is the open form of tuberculosis? There are several types of tuberculosis, among which open and closed forms can be distinguished. The open form of tuberculosis, unlike the closed form, is transmitted from a sick person to a healthy one. In the closed form, the disease is not contagious, since in this case the disease occurs without the release of the pathogenic bacillus into the external environment. The open and closed forms of the disease are most often determined by tuberculosis of the lungs, but there is also tuberculosis of the intestines, genital organs, and so on. All of them are accompanied by the release of bacteria into environment.

The incubation period of open tuberculosis is about a month from the moment of infection; after this period of time, vivid symptoms begin to appear.

The mechanism of development of tuberculosis is quite complex; once the bacillus enters the body, it will never leave it. The development of the disease depends entirely on hereditary predisposition and from environmental factors. As mentioned above, strong immunity resists infection, and a person with weak immunity or someone who is predisposed to this disease becomes ill.

The causative agents of the disease have a very complex metabolism, so they are very stable and changeable as a result. external conditions, and to conditions within a person.

Open tuberculosis is divided into primary and secondary. From the terminology it is clear that the primary form develops in a person who has not previously had tuberculosis and has not been in contact with the tuberculosis bacillus. The secondary form is a recurrent disease. In this case, the lesion that existed previously is scarred, and another lesion develops.

Open form symptoms

How does the open form of tuberculosis manifest? Symptoms do not increase immediately; at first they do not cause discomfort to the patient, but after incubation period ends, the patient develops a cough. At first the cough is dry, but over time it becomes wet. This symptom can last for a month or more. At this moment (with a wet cough), open tuberculosis can be transmitted to healthy people. The rods are transmitted through the air or through household objects. They are contained in huge quantities in the patient’s sputum, and accordingly, they end up not only in the air, but also on surrounding objects.

The following signs of open tuberculosis are weight loss, hemoptysis and low-grade fever, which most often rises in the late afternoon.

With secondary open tuberculosis, the symptoms are somewhat different:

• the temperature rises to critical levels;
• the patient suffers greatly profuse sweating at night;
• the cough is painful and almost incessant, most of all it bothers the patient at night and in the morning;
• chest pain and joint aches occur;
• the skin turns grey.

Diagnosis of the disease

Open tuberculosis is diagnosed by laboratory examination of the patient's pulmonary discharge or by bronchoscopy. Bronchoscopy is the removal of a small sample of lung tissue to determine the presence of an infectious agent. In addition, the patient must have an x-ray of the lungs.

In some cases they do tuberculin test(Mantoux test). Most often this research is carried out on children. This test makes it possible to identify the degree of infection and tissue reactivity.

If there is a suspicion of a non-pulmonary form of the disease, a Koch test is performed. Ultrasound, CT, consultation with a neurologist, gastroenterologist, dermatologist and other specialized specialists may be prescribed as additional diagnostic measures.

Treatment of the disease

First of all everything therapeutic measures aimed at destroying bacteria. Four groups are used for this antibacterial drugs. Treatment is usually carried out inpatient, after the release of bacteria into the sputum, and from it into the environment, stops, the patient can continue treatment on an outpatient basis. Treatment is long-term – it can take a year or more. After the therapeutic course, the patient is recommended to undergo treatment in sanatoriums that specialize in the treatment of tuberculosis.

Bed rest is prescribed to those patients whose lung destruction is very severe. For everyone else, on the contrary, vigorous activity is highly recommended - walking, therapeutic exercises, and so on.

If therapeutic treatment has no effect, may be prescribed surgery. Most often, incomplete resection of the lung is performed, as well as removal of segments that have been affected. The main problem in treating the disease is the extreme resistance of the bacillus to drugs. In addition, with such long-term treatment, the patient may experience various side effects antibacterial therapy.

As for the life expectancy of a patient with tuberculosis, this is very individual. It all depends on the correctness of the chosen therapy, the patient’s lifestyle, and the form of the disease. Modern medicine cannot completely defeat tuberculosis. Everyone around the patient needs to undergo a diagnostic examination twice a year, and if necessary, they are prescribed treatment to prevent the disease.

Complications of the disease

Tuberculosis is dangerous disease, which can cause serious complications and consequences. As a result of lack of therapy or failure to comply with all medical recommendations The following conditions may develop:

• pulmonary hemorrhage;
• oxygen deficiency – respiratory failure;
• inflammation of the outer membrane of the lungs - pleurisy;
• air may accumulate in the pleural area; this phenomenon is possible when the alveoli or the bronchus itself rupture;
• heart failure, which develops as a result of pathological processes in the pulmonary system;
• TB infection can spread to other organs.

Prognosis for the disease

If the disease is detected on time and the patient strictly follows all the doctor’s instructions, then the prognosis can be called favorable. After the tuberculosis lesions heal and the symptoms disappear, they speak of clinical recovery.

If there is no treatment, death from tuberculosis occurs in 50% of cases. The risk of death increases in HIV-infected people, older people, and people with diabetes.

Disease prevention

The most effective prevention of tuberculosis today is vaccination. The child receives the first vaccine within the walls of the maternity hospital. As for adults, they are vaccinated according to indications.

Knowing how tuberculosis is transmitted, it is necessary to take preventive measures. The main prevention of tuberculosis is compliance with sanitary standards and annual preventive examination. Besides, preventative measure is to improve immunity.

If a person follows simple prevention rules, the risk of infection is noticeably reduced, and, consequently, the prevalence of this terrible disease in society is reduced.

Tuberculosis is causing many deaths worldwide to the globe. A dangerous type of this disease is the open form of tuberculosis. A person with this disease a short time infects a large number of people nearby. In this form of the disease, the causative agent of the infection, the tuberculosis bacillus (Koch bacillus), is excreted by its carrier with sputum. Distinctive feature Pathogenic microbes are considered to be tenacious and resistant to acidic and alkaline environments, and even some types of antibiotics.

When ignored elementary rules hygiene The open form of tuberculosis, the symptoms of which are difficult to distinguish from signs of other diseases, is spread by airborne droplets, household or contact methods. Pulmonary tuberculosis, the open form of which is treated exclusively in inpatient conditions, has become so widespread among the population. The open form of tuberculosis, the risk of which is increased for people leading an asocial lifestyle, is also dangerous for other, prosperous categories of the population.

What is open tuberculosis

An open form is determined when bacteriological research sputum or other secretions from the patient. In contrast to the results of the study of the closed form, Koch's bacillus is detected. In the case when a repeated study showed that there are no bacteria in the discharge, it means that the patient has a closed form of the disease.

These two terms are more often used for pulmonary tuberculosis. But bacterial excretion also accompanies other types of tuberculosis, for example, intestines, lymph nodes or organs of the reproductive system. Bacterial excretion (MBT+) is an important indicator that indicates the level of infectious danger of a sick person. After all, they “catch” the disease when communicating with a person who secretes tuberculosis mycobacteria. The open form of tuberculosis has an incubation period of 3-4 weeks, after which the symptoms become severe.

Photo 1. The open form of tuberculosis is transmitted by airborne droplets from person to person

In some cases, insufficient power laboratory research does not allow the detection of mycobacteria in the sputum of patients with open tuberculosis. As a result, being medical indications non-contagious, they are dangerous for people around them.

Photo 2. Inflammation lymph nodes in some cases, contribute to the development of an open form of tuberculosis

Symptoms of the disease

The development of an open form of primary pulmonary tuberculosis is observed in those who have not been in contact with the pathogen. The nature of the course of the disease is characterized by secrecy, and in those places where the infection has penetrated, inflamed areas appear. The lesion becomes caseous (cheesy) and after some time becomes calcified. This pathological process determined by x-ray of organs chest.

The secondary open form of tuberculosis is characterized by scarring and calcification of the lesions. There are patients in whom the pathology occurs with pneumonia or enters through the bloodstream into other organs. Because the organs resemble millet, this form is also called “miliary tuberculosis.” Milium is "millet" in Latin. In such cases, the brightness and variability of symptoms is observed. After several months, the disease reaches its peak.

Photo 3. Miliary tuberculosis(Latin Milium - “millet”) on an x-ray, so named because of its external resemblance.

The open form of tuberculosis is expressed by symptoms:

• prolonged cough, which cannot be cured either with medication or folk remedies, coughing up blood;
• elevated temperature body (37.1-37.8 degrees);
• lack of appetite, and, as a result, weight loss;
• painful sensations during inhalation;
• night sweats;
• weakness and shortness of breath.

Photo 4. Promotiontemperature accompanied by fever and cough - a common primary symptom of tuberculosis

If the infection strikes a child, then, in addition to the listed symptoms, he becomes irritable and lethargic. In addition, his performance at school decreases, insomnia and digestive system disorders appear.

Photo 5. Children are at risk for open form of tuberculosis; the disease is accompanied by increased moodiness and fatigue

Diagnosis of open form of tuberculosis

Diagnostics can be laboratory or instrumental. The first is to study sputum, blood and urine. The second involves the use of endoscopy and radiography. Fluorography is a mass screening method instrumental research. It is valuable because with a slight X-ray load, using this method, a clear result is obtained about the condition of the lungs and intrathoracic lymph nodes. Fluorography is performed once every two years. However, for high-risk groups, annual testing is recommended.

Photo 6. Diagnosis of tuberculosis by analyzing sputum in the lungs. Before doing this, do three deep breaths and exhalation

For advanced diagnostics, they are made x-rays chest cavity(in 2 projections). To clarify the density of formations and their localization, in some cases they resort to computed tomography.

Method laboratory diagnostics refer the sowing to BC. This method- cultural. With his help in nutrient medium Mycobacteria are grown and how sensitive they are to drugs is determined. Whether the body is infected with Koch's bacillus is determined using microscopy. And with the help of PCR diagnostics, a search is carried out in the patient’s biomaterial for DNA or its parts of materials that belong to mycobacteria. In addition, with the help of molecular genetic methods, the sensitivity and resistance of the pathogen to drugs is understood.

Photo 7. To more accurately determine the condition of the lungs, use computed tomography(abbreviated as CT)

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Treatment options

If open tuberculosis is diagnosed, treatment takes place in a special medical institution. Self-medication of the disease is useless and dangerous. If medications are taken uncontrolled, mycobacteria develop resistance to them. As a result, treatment becomes more complicated. Open pulmonary tuberculosis can be treated from six months to two years.

Therapy that suppresses the infection is carried out continuously and systematically. This allows you to stop the progression of the disease. A person with an open form of tuberculosis is treated in a special department of the hospital, where he stays for at least two months. This time is enough to localize the process of active bacterial production.

Photo 8. At first, tuberculosis treatment takes place in a special hospital to avoid infecting others.

The increased risk to others is reduced, and the patient is transferred to outpatient treatment. Anti-tuberculosis therapy consists of using a specific regimen. Its basis are drugs: pyrazinamide, streptomycin, isoniazid, rifampicin and ethambutol. An effective combination of these medicines The doctor selects it individually. This takes into account the state of the person and his immunity.

The table shows daily doses of medications for individuals of different ages

If at the end of the course of treatment desired result failed to achieve, the combination of drugs is subject to adjustment. In addition, the methods of introducing drugs into the body are changing. At the end of treatment, examinations are carried out to determine the patient’s health status. If recovery does not occur, treatment is extended.

Photo 9. Ethambutol, an anti-tuberculosis drug, helps stop the proliferation of bacteria in the body.

Who is at risk?

The open form of tuberculosis is a dangerous disease. The risk of contracting this disease is high in the following categories of the population:

• children with a positive Mantoux test;
• people with weak immune system;
• old people;
• medical workers, those who have contact with a patient with open tuberculosis;
• people who live in unsanitary conditions;
• patients with chronic inflammatory, oncological, autoimmune diseases;
• people who use hormone therapy.

Photo 10. Adults who have reached retirement age are at risk of developing an open form of tuberculosis

The possibility of infection is influenced by the type of contact with the open form of tuberculosis and its duration. For example, a one-time meeting is not as dangerous as short but regular communications. Living in the same house with a person who suffers from an open form of tuberculosis is dangerous for health and life. The risk of infection is 90%.

In rare cases, the source of the disease becomes a large cattle. If an animal is sick, then the milk contains a bovine type of mycobacteria and if it gets into food, the infection is transmitted to humans. As a result, the disease passes into a closed or open form.

How dangerous is the open form of tuberculosis?

If a person has signs of an open form of tuberculosis, which is confirmed by an appropriate diagnosis, he acts as a source of release of bacilli into the environment. The probability of infection of a healthy person depends on the nature of contact with the carrier of the infection. In general, it is high and amounts to about 30%.

Tuberculosis is a serious disease that, in the absence of adequate treatment, develops into serious complications, and in some cases leads to death. In addition to the fact that the infection penetrates other organs and forms extrapulmonary foci, complications include: pleurisy, cardiac and pulmonary insufficiency, meningitis, cirrhosis and others.

Open tuberculosis during pregnancy is dangerous. If present primary signs or active disease progresses, the pregnancy must be terminated. This measure is forced and necessary, since with tuberculosis the fetus becomes infected, and its treatment is toxic. Even if treatment is successful, tissue damage at sites of infection and respiratory tract remain in the form of calcifications and scars. Advanced tuberculosis is the cause of limited ability to work, which leads to disability.

To exclude the possibility of contracting this dangerous disease, every year medical examinations, in which fluorography mandatory procedure. With its help, the disease is detected at the beginning of its development. Thanks to timely treatment, you can count on a full recovery in short time.

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Tuberculosis is a dangerous disease that kills many people around the world. Nai great danger carries an open form of tuberculosis. In such cases, the tuberculosis bacillus is easily transferred from a sick person to a healthy person. It is practically unaffected by medications, and is also capable of for a long time survive in unfavorable conditions.

Peculiarities

This form of the disease is an infectious focus that spreads to respiratory organs. The lungs cease to cope with their function, weaken, and the disease begins to actively spread. Together with the blood, it enters other organs and tissues.

A person with an open form of the disease poses a great danger to others. The bacilli are spread through the air by coughing, sneezing, and even talking.

Causes

Tuberculosis microbacteria can survive for a long time in unfavorable environment, therefore the risk of infection is quite high, especially if there is a sick person in your immediate environment. Even the slightest drop of saliva or phlegm can be enough to develop the disease.

This especially applies to the following category of persons:

• Old people.
• Medical staff who frequently come into contact with tuberculosis patients.
• Living in environmentally unfavorable conditions.
• With reduced immunity.
• Children with increasing Mantoux test.
• Constantly undergoing hormonal therapy.
• sick chronic diseases Gastrointestinal tract and respiratory tract.

Symptoms and signs

Any disease can be recognized only by its symptoms. If in the closed form of the disease they are practically not expressed, then tuberculosis in the open form manifests itself very quickly. The following signs are distinguished:

1. Dry or moist cough, in which sputum mixed with blood may be produced.
2. Labored breathing.
3. Slight increase in temperature.
4. Decreased appetite.
5. Sudden weight loss.
6. Frequent headaches.
7. Heavy sweating, especially at night.
8. Chest pain.
9. Shortness of breath even with the slightest exertion.
10. Apathy, sudden changes in mood.

After Koch's bacillus has entered the body, signs of the disease can be noticed after 2-3 months. The diagnosis is made after undergoing fluorography, x-rays and ECG. Signs of the disease can be divided into three groups: clinical (symptoms), laboratory (the presence of the virus in tests), radiographic (when there is a focus of the disease, cavities on the lungs and an increase in the pattern of the lungs).

A person with an open form of tuberculosis simply cannot help but notice the manifestations of the disease. Gradual intoxication of the body will lead to persistent fever, severe cough and hemoptysis.

Danger to others

Tuberculosis in its open form is dangerous for others, because bacteria are easily transmitted from a sick person to a healthy one. For this, a normal conversation, sneezing or coughing will be enough. After hitting healthy body, the virus multiplies quickly, infecting human lungs. This is especially dangerous if a person has a weakened immune system and cannot resist the virus. There is also danger when living in common with a person suffering from tuberculosis.

Transmission routes

The disease can be transmitted in the following ways:

The longer healthy man is near the patient, the greater the concentration of microbacteria in the air. Accordingly, the risk of getting sick increases many times.

Lifespan

If we talk about the development of tuberculosis without appropriate treatment, then life expectancy will depend on the condition of the patient himself, his body, the stage of the disease and complications.

Practice has shown that patients with tuberculosis can live no more than six months without treatment. However, life expectancy will be affected by factors such as:

• Bad habits.
• Reduced immunity.
• HIV or AIDS in a patient.
• Tuberculosis in the elderly and children.

Constant stress can complicate the patient’s condition, poor nutrition and much more.

It is these people who are more susceptible to the active development of the disease and rapid death than others. People leading an antisocial lifestyle, as well as low-income people, suffer the most from the disease.

Only with the help of competent and timely treatment a person can live many more years. Modern medicine can cure or stop the course of even tuberculosis.

Diagnostics

This process consists of several stages:

If necessary, it is also possible additional methods examinations:

1. Bronchoscopy, which makes it possible to view the lungs from the inside. If necessary, a swab is taken from the affected area.
2. Pleural puncture, which indicates the presence or absence of microbacteria.
3. Biopsy. If it indicates the presence of a granuloma, then there is no longer any doubt about the diagnosis; it is tuberculosis.

Treatment options

If medications were selected correctly, then the open form of tuberculosis can be cured. For this, a group of 4 drugs is used (listed below). But for a complete recovery, additional medications will be required, since the virus has the ability to quickly develop immunity to antibiotics.

Complex treatment includes:

1. Taking antibiotics.
2. Healthy lifestyle.
3. Proper nutrition.
4. Do breathing exercises daily.

In advanced cases, the disease is treated with surgery.

Scheme drug treatment may be as follows:

• Consisting of 4 components such as Isoniazid, Rifampicin, Streptomycin and Rifabutin).
• Consisting of 5 components, when a fluoroquinolone antibiotic is added to the previous medications.

The doctor also prescribes anti-inflammatory and immunostimulating drugs.

Complications

The worst thing is death from tuberculosis. In the absence of adequate treatment, it occurs very quickly, because bacteria destroy internal organs person, and they cease to perform their functions.

There are complications such as:

• Joint damage, development of bone tuberculosis, severe pain, swelling.
• Bleeding in the lungs.
• Weakening of the immune system, development concomitant diseases, which only worsen the condition of the body.
• Broncholitis, i.e. calcified formations in the lungs.
• Fungal infection of the lungs, damage to the walls of blood vessels, which can cause bleeding.
• Inflammation in the lungs.

If tuberculosis was nevertheless cured, this does not mean that it will not appear again. This is a recurrent disease that can reappear when the immune system is weakened.

This is especially true for pregnant women who have previously suffered from tuberculosis. This may affect mental or physical development unborn child, as well as cause consequences such as frozen pregnancy or death of the child during childbirth.

To prevent development of this disease, you can get vaccinated. For children it is done in the maternity hospital. And in adults this is done according to indications. The most important thing is to comply with sanitary standards and undergo annual examinations. Any signs should prompt you to see a doctor.

The open and closed forms of tuberculosis have a number of differences. With open tuberculosis, the patient is a carrier of bacteria that, when coughing, enter the body of another person. Closed tuberculosis is safe for others, the disease proceeds without severe symptoms, is developing long time. The patient feels a general malaise, similar to a common cold, but mycobacteria cause intoxication of the entire body.

It is important to understand how the forms of infection differ in order to correctly diagnose the disease and prescribe adequate treatment.

Open tuberculosis when affected respiratory system, manifests itself with severe symptoms:

• prolonged dry cough, often accompanied by sputum production;
• general weakness;
• loss of appetite, which leads to sudden weight loss;
• body temperature rises;
• increased sweating, especially during sleep;
• pain in the chest.
• may differ from closed tuberculosis hemoptysis.

The complicated course of the disease is characterized by the penetration of mycobacteria into the blood, which leads to intoxication of other organs: liver, kidneys, spleen, bone tissue. This complication can be fatal, and the situation is especially dangerous for pregnant women. In such cases, the doctor recommends termination of pregnancy, because a course of chemotherapy will lead to damage to the fetus.

Symptoms of the disease require immediate contact medical institution. After a diagnostic examination, the patient is placed in a tuberculosis dispensary and long-term therapy is prescribed. Patients are very dangerous for others, because the infectious agent is easily transmitted; more than 50 people can be infected in a day. After recovery, such a person is registered with a tuberculosis clinic for another two years, and if X-rays confirm the absence of inflammatory foci, he can return to his previous life.

The following persons are at risk:

• elderly people, young children;
• tuberculosis dispensary workers who are in constant contact with infected patients;
• patients with HIV infection, patients with AIDS, diabetes mellitus;
• persons without a fixed place of residence, drug addicts;
• former prisoners.

Such people must regularly undergo fluorography; if the disease is detected, they are placed in a closed institution where appropriate treatment is carried out.

Features of the course of closed tuberculosis

Closed tuberculosis is a more common phenomenon; it occurs without symptoms and can be difficult to diagnose.

Bacilli may remain in the body for a long time, but not show activity, and the person does not feel unwell.

And even on x-ray examination no changes are visible in the lungs, laboratory methods do not show a positive result.

Such patients do not pose a danger to others; experts characterize mycobacteria as inactive, they are called a latent infection. It is observed in people with a good immune system, when the body independently fights the bacilli. But when the immune system is weakened, the Koch bacillus begins to multiply, and certain signs of the disease appear. Therefore, it is important to prevent the body from weakening: eat right, avoid hypothermia, treat colds, infectious diseases, exercise.

Failure to comply with these rules leads to the awakening of the pathogen, the disease takes on an open form, and symptoms appear that require timely treatment.

Therefore even closed tuberculosis requires adequate therapy, it is not dangerous to other people, but can develop into an open form of the disease.

Closed tuberculosis has a number of features:

• there are no signs of illness;
• there is pain in the chest when inhaling;
• a slight weakness to which a person does not attach importance;
• Fluid accumulates in the lungs - pleurisy.

If the disease is detected in a timely manner, the disease can be treated at an early stage, avoiding serious complications.

A number of factors are taken into account when determining the form of pathology:

• volume of affected tissue;
• formation of collapsing areas;
• bronchial patency;
• development of the sternum muscles.

Therefore, there is no clear boundary between the forms of tuberculosis, in different periods an infected person may or may not shed pathogenic bacilli.

Problems of treating tuberculosis

This insidious disease any form requires long-term treatment, which is carried out by a phthisiatrician. The specialist determines the form and degree of organ damage.

The effectiveness of treatment depends on the patency of the bronchi; if there is blockage, it is difficult to identify the tuberculosis bacillus.

It is also important to have developed chest muscles; it is difficult for older people and small children to remove sputum with bacteria from the depths of the lungs, which complicates the treatment process.

But modern equipment, when diagnosing a smear, can determine the presence of infection in the body and extend treatment until complete recovery. But at the same time, it is important to get the test done correctly: you need to separate sputum, not saliva, this will affect the results of the study.

There are a number of problems during treatment of a patient:

1. The duration of therapy takes about six months and requires considerable financial expenditure. Many countries do not provide tuberculosis clinics necessary medications, everything falls on the shoulders of the patient.
2. In small towns, they use an outdated diagnostic technique, which does not make it possible to correctly establish a diagnosis.
3. Most antibiotics have been used for many years, so mycobacteria are resistant to drugs.

These problems negatively affect the effectiveness of therapy and prolong its duration.

The main method of treating tuberculosis is the use of prescribed medications and compliance with all doctor’s recommendations. Refusal of medication leads to severe complications, the infection becomes resistant to antibiotics and affects other organs of the body.

During treatment it is often prescribed complex therapy, which consists of the following drugs: Isoniazid, Ethambutol, Rifampicin, Pyrazinamide. If the medications do not bring results, the course is extended; if the bacilli affect other organs, the treatment is intensified or a different technique is recommended.

If necessary, the sternum is punctured to remove fluid, sometimes it is necessary surgical intervention. It is better to contact experienced specialists - this will help get rid of serious consequences.

Full recovery can be achieved with early detection illness. To do this, it is necessary to undergo fluorography every year; it will identify the infection at the first stage.

Many people ignore this procedure and consider it harmful to the body. Fluorography causes a small dose of radiation, which accumulates each time. But the harm from the procedure is not as bad as the complication from the disease.

Open tuberculosis is very dangerous not only for the patient, but also for those around him. The closed form proceeds hiddenly and may not appear for a long time. But with a weakened immune system, it begins to progress and can become acute.

The risk of infection with Koch's bacillus is high for every person, so it is important to take precautions.

After public places, you should wash your hands thoroughly, healthy image life, give up tobacco products, do gymnastics, often be in the fresh air.

For prevention, newborn babies are given BCG vaccination also in maternity hospital, revaccination is carried out after seven years.