Disseminated tuberculosis: hidden dissipation
TB - is a common bacterial infection that is spread from person to person by droplet infection.Most people infected TB bacteria are blocked by the immune system and remain in "sleep" state for many years.Approximately 5-10% of infected Mycobacterium lead to overt or active tuberculosis, and only a small number of them developing disseminated tuberculosis.This disease is most prone to people with weak immune systems, such as people with HIV, the elderly and children, patients taking immunosuppressive drugs.
For pulmonary tuberculosis disseminated on light there are numerous tubercular lesions (dissemination translates as "dispersion").Disseminated tuberculosis Tuberculosis - a full recovery is not guaranteed can also affect other organs and tissues, such as:
- bones and joints;
- lymph nodes;
- organs of the urogenital system;
Types and symptoms of disseminated tuberculosis
Disseminated tuberculosis of the lungs can cause the same symptoms as a normal pulmonary tuberculosis, especially in the early stages of the disease.In addition, symptoms dissiminirovannogo tuberculosis depend on its shape.There are the following forms of the disease:
Acute disseminated tuberculosis, or miliary tuberculosis Miliary tuberculosis - when possible death? .This violation may occur symptoms such as fever, cough, fatigue, swollen lymph nodes, liver, spleen, pancreas inflammation, and diarrhea.If untreated, acute disseminated tuberculosis almost always leads to death.Previously, this disease is called galloping consumption, since no modern anti-TB drugs, patients have died within a few months after the first symptoms.
Subacute disseminirovanny tuberculosis.Typical symptoms of the disease are cough, expectoration, sometimes - hemoptysis, fever, wheezing in the chest.This form of disseminated tuberculosis is less dangerous than miliary tuberculosis, but if the patient does not receive timely treatment, it can lead to serious complications.
Chronic disseminated tuberculosis.In patients with this disease there is a decrease of endurance - even after the usual physical activities for them, they may feel extreme fatigue;shortness of breath, a slight increase in body temperature (usually not more than 37.5S), cough.The condition of patients deteriorates very slowly, and the symptoms can fade away for a while and then reappear.Thus tuberculosis gradually leads to the formation of numerous foci in the lungs or other organs and, despite sluggish during disease, it can also lead to the development of certain complications.
Differential diagnosis of disseminated tuberculosis is a challenge because of the similarity of its symptoms to the symptoms of other diseases.In particular, it is necessary to eliminate such violations as pneumonia, sarcoidosis Sarcoidosis - how to protect themselves? , alveolitis, pneumoconiosis, diffuse pulmonary adenomatosis, some types of granulomatosis.
For diagnosis of disseminated tuberculosis, in addition to the tuberculin skin test, blood tests and sputum, bronchoscopy is usually required Bronchoscopy - unpleasant but necessary - it allows you to get more information on the state of the lungs than radiography.In some cases, it may be used and lung biopsy.To diagnose extrapulmonary tuberculosis dissemenirovanny may require computed tomography, magnetic resonance imaging, and biopsy of affected tissue.A complete blood count also helps to get a clear idea of the extent to which disseminated tuberculosis affect the overall health of the patient.
Treatment of disseminated tuberculosis
the treatment of disseminated tuberculosis is always used multiple drugs - it can significantly increase the likelihood that treatment will be effective.If the treatment of disseminated pulmonary tuberculosis start on time, the disease can be cured without any serious consequences for health.
In some cases, such as when a strong pulmonary hemorrhage, which can not be stopped by other means, or with frequent relapses of the disease may require surgery.
most often disseminated tuberculosis treated following drugs: isoniazid, rifampicin, pyrazinamide, ethambutol.In more rare instances, the drugs such as amikacin, ethionamide, moxifloxacin, para-amino salicylic acid, streptomycin.
duration of treatment for patients with disseminated tuberculosis is not less than six months, but in severe cases, medication is necessary to take more than a year.
most deadly of all forms of disseminated tuberculosis is acute disseminated tuberculosis.Despite the fact that in most cases it is well treatable by a die of 15% to 20% of affected children and 25-30% of adults.The main causes of death in this disease are late diagnosis, and a combination of tuberculosis with various diseases that weaken the immune system.
Patients with other forms of disseminated tuberculosis die much less.
Disseminated TB can cause the following complications:
- Respiratory failure;
- acute respiratory distress syndrome;
- relapse of the disease.