Basics of TB Disease

Silent Threat of Mycobacterium Tuberculosis

Tuberculosis (TB), an infectious disease known for centuries, remains a significant global health concern to date.  At its core lies a microscopic culprit: Mycobacterium tuberculosis. This hardy bacterium is mostly spread through the air, mainly from one person to another, by the infected droplets that are expelled during coughing or sneezing. Let's discuss the silent threat of Mycobacterium Tuberculosis, the causative organism, its modes of transmission and the diverse clinical presentations it creates should be comprehended to provide effective management and control of this widespread disease.

Causative organism

In the silent threat of Mycobacterium Tuberculosis, a bacteria known as Mycobacterium tuberculosis causes the disease tuberculosis (TB). These bacteria spread through the air from person to person. Tuberculosis is a highly contagious infection, transmitted to other healthy persons by infected droplets generated by coughing or sneezing of patients having active pulmonary Tuberculosis disease. These tiny droplets dry rapidly, and attach themselves to fine dust particles and the smallest of them may remain suspended in the air for several hours.  Only those particles that are less than 10 μm (micron) in diameter reach the pulmonary alveoli of the healthy individual through inhalation resulting in infection.

Spread of Silent Threat of Mycobacterium Tuberculosis

Not everyone exposed to the bacterium becomes infected nor does everybody infected with it develop clinical symptoms. The chance of becoming infected depends mainly on the quantity of infectious droplets in the air and the length of exposure to an infectious person. The closer the infectious person is, and the longer the length of exposure, the higher the risk of infection. When a person inhales TB bacteria, the bacteria can settle in the lungs and start growing. Tuberculosis spreads from the primary lung lesion to other parts of the body via the bloodstream, lymphatic or by direct extension, and in this way may affect any organ in the body.

Signs and Symptoms of Silent Threat of Mycobacterium Tuberculosis

The location of TB infection determines the symptoms. TB disease usually develops slowly; symptoms might not begin until months or even years after the initial infection.

Types of TB Disease

TB is thus classified as pulmonary (Lung’s parenchyma) and extra-pulmonary based on the anatomical site involved.  TB disease in the throat or lungs can be communicable. So, the bacteria can spread to other people. If TB is in other parts of the body, such as the spine or kidney, it is usually not infectious. People having TB disease are most likely to spread it to people with whom they spend time every day. This includes schoolmates, friends, and co-workers or family members. People cannot spread TB through handshaking, sharing drinks or food, touching bed linens or toilet seats, kissing, or sharing toothbrushes.

Pulmonary Tuberculosis

In Pulmonary TB, bacteria usually grow in the lungs. TB in the lungs may cause symptoms as follows:

• cough for more than two or more weeks, or of any duration with the following symptoms
• Pain in the chest
• coughing with blood or sputum (phlegm from deep inside the lungs)

Other symptoms of TB disease are:

• Weakness or fatigue
• Weight loss
• reduced appetite
• chills
• Fever
• sweating at night

 Extra Pulmonary Tuberculosis

 Lymph nodes-Extra-thoracic

Symptoms: Swelling, matted occasionally with pus drainage

Lymph node –Intra thoracic

Symptoms: Broadening of the mediastinum, hilar shadows

Central Nervous system

Symptoms: In the case of TB meningitis- headache, fever, neck stiffness and mental confusion

Osteo articular – Spine

Symptoms: In the case of gibbous and spinal involvement, there is a loss of function in the lower limbs.

Osteo articular – Other than Spine

TB causes pain and swelling when it infects the joints.

Peritoneal/Intra-abdominal

Symptoms: Intestinal TB include abdominal pain and anaemia. Patients may present with symptoms of obstruction, right iliac fossa pain, or mass in the right iliac fossa

Pleural

Symptoms: Pleural effusion (dry cough, shortness of breath, heaviness on the affected side)

Genito-urinary

Symptoms: Infertility in the case of the reproductive tract. Symptoms of urinary tract infection in case of genito-urinary involvement

Miliary /Multiple

Miliary tuberculosis (TB) is the widespread dissemination of Mycobacterium tuberculosis via haematogenous spread, seeding of TB bacilli in the lung, as evidenced by chest radiography.

Treatment of Silent Threat of Mycobacterium Tuberculosis

(TB) disease involves a combination of medications to effectively kill the bacteria and prevent the development of drug-resistant strains. The standard treatment regimen for TB typically consists of a combination of four antimicrobial drugs: isoniazid, rifampin, ethambutol, and pyrazinamide. This combination is known as the first-line treatment for TB.

Directly Observed Therapy (DOT)

Directly Observed Therapy (DOT) is a crucial component of TB treatment. This approach ensures that patients take their medications as prescribed by a healthcare provider. By directly observing the patient taking their medication, healthcare providers can monitor adherence and address any issues that may arise during treatment. By DOT strategy, we can mitigate the silent threat of mycobacterium tuberculosis.

Duration of Treatment

The duration of TB treatment is typically 6 to 9 months, depending on the type and severity of the disease. Patients need to complete the full course of treatment to ensure the bacteria are completely eradicated and to prevent the development of drug resistance.

Monitoring and Follow-Up

TB patients under treatment need frequent follow-ups to measure their responsiveness to therapy and recognize any adverse reactions. Follow-up visits to your healthcare provider are critical for the treatment to work perfectly and provide any additional fine-tuning of the medication regimen.

Drug Resistance: A Silent Threat of Mycobacterium Tuberculosis

In cases of drug-resistant TB, treatment may include second-line medications which potentially are more powerful but may have other serious side effects. MDR-TB needs targeted patient-centred treatment with strict supervision to avoid any complications.

Role Of Nutrition And Assistance

The role nutrition performs in immuno-support through treatment is very significant. The patients will be told to keep a healthy diet consisting of vitamins and minerals to assist in the recovery process. Furthermore, emotional support and counselling will be crucial for the patients of TB to be ready for the challenges they will face during the disease as well as during the treatment.

Public Health Measures

The primary way to check TB makes spread is to control the disease. Conducts public health measures including contact tracing and screening of high-risk populations as well as promoting awareness about TB to enable the reduction of the number of incidents of the disease and its transmission in communities. Through an approach that includes medication adherence, frequent monitoring and supervision, and support to the patients, the risk of spreading the infection to other individuals can be minimized, and the treatments can yield positive outcomes.