TB: Symptoms, Diagnosis, and Management
🌿 Understanding Pulmonary Tuberculosis (TB)
Pulmonary Tuberculosis (TB) is a contagious bacterial infection caused by Mycobacterium tuberculosis. It primarily affects the lungs but can spread to other organs. TB is transmitted through airborne droplets when an infected person coughs, sneezes, or talks. Early diagnosis and treatment are crucial to controlling its spread.
⚠️ Signs & Symptoms of TB
TB symptoms develop gradually over weeks or months.
🩺 Respiratory Symptoms
- ✔ Persistent cough lasting more than 2 weeks
- ✔ Coughing up blood (Hemoptysis)
- ✔ Chest pain
- ✔ Shortness of breath
🩺 General Symptoms
- ✔ Unexplained weight loss
- ✔ Fever and night sweats
- ✔ Fatigue and weakness
- ✔ Loss of appetite
🔴 If you experience these symptoms, consult a doctor immediately.
📋 Diagnostic Workup for TB
1️⃣ Clinical Evaluation
- ✔ History of symptoms: Prolonged cough, fever, night sweats
- ✔ Contact history: Exposure to TB patients
- ✔ Risk factors: Immunosuppression (HIV, diabetes, malnutrition)
2️⃣ Laboratory Tests
- 📌 Sputum AFB Smear: Detects acid-fast bacilli (AFB)
- 📌 GeneXpert MTB/RIF: Detects TB DNA and rifampicin resistance
- 📌 Sputum Culture: Confirms TB but takes several weeks
- 📌 Tuberculin Skin Test (TST) / Mantoux Test: Used for latent TB detection
- 📌 Interferon-Gamma Release Assays (IGRAs): Blood tests like Quantiferon-TB Gold
3️⃣ Imaging
- 📌 Chest X-ray (CXR): Upper lobe infiltrates, cavitations, or miliary pattern
- 📌 CT Scan (if needed): Better visualization of lung damage
4️⃣ Additional Tests for Complications
- 📌 HIV Test: TB is common in HIV-positive patients
- 📌 Liver and kidney function tests: Before starting medications
📖 Management Protocol for TB
1️⃣ First-Line Anti-TB Treatment (Standard 6-Month Regimen)
TB treatment follows the WHO-recommended Directly Observed Treatment, Short-course (DOTS) strategy.
🔹 Intensive Phase (2 months)
- ✔ Rifampicin (R) – 600 mg
- ✔ Isoniazid (H) – 300 mg
- ✔ Pyrazinamide (Z) – 1500 mg
- ✔ Ethambutol (E) – 800 mg
🔹 Continuation Phase (4 months)
- ✔ Rifampicin (R) + Isoniazid (H)
2️⃣ Drug-Resistant TB (MDR-TB, XDR-TB)
- ✔ Requires second-line drugs like Bedaquiline, Linezolid, and Fluoroquinolones
- ✔ Treatment duration: 9-24 months
3️⃣ Supportive Care
- ✔ Nutritional Support: High-protein diet
- ✔ Monitor Liver Function: Avoid alcohol and hepatotoxic drugs
- ✔ Adherence to Therapy: Directly observed treatment (DOTS)
4️⃣ Preventive Measures
- ✔ BCG Vaccine: Given at birth in endemic areas
- ✔ Infection Control: Wearing masks, proper ventilation, cough etiquette
- ✔ Latent TB Treatment: Isoniazid for 6-9 months in high-risk individuals
💬 Frequently Asked Questions (FAQs)
- 1️⃣ How is TB transmitted?
✔ TB spreads through airborne droplets when an infected person coughs, sneezes, or talks.
- 2️⃣ Is TB curable?
✔ Yes, TB is curable with a complete 6-month treatment regimen.
- 3️⃣ Can TB be prevented?
✔ Yes, through BCG vaccination, early diagnosis, and proper treatment.
- 4️⃣ What happens if TB is left untreated?
✔ Untreated TB can lead to lung damage, spread to other organs, and death.
- 5️⃣ Can I continue my daily activities while on TB treatment?
✔ Yes, but avoid crowded places and wear a mask until you are non-infectious.
- 6️⃣ What are the side effects of TB medication?
✔ Rifampicin: Red-orange urine, liver toxicity
✔ Isoniazid: Peripheral neuropathy, liver toxicity
✔ Pyrazinamide: Joint pain, liver toxicity
✔ Ethambutol: Eye toxicity (optic neuritis)
- 7️⃣ Can TB recur after treatment?
✔ Yes, reinfection or incomplete treatment can cause relapse.
- 8️⃣ Can I get TB from a vaccinated person?
✔ No, the BCG vaccine does not transmit TB.
- 9️⃣ What is MDR-TB?
✔ MDR-TB (Multi-Drug Resistant TB) is resistant to Rifampicin and Isoniazid, requiring longer and stronger treatment.
- 🔟 How long should I take TB medications?
✔ At least 6 months, but drug-resistant TB may require up to 2 years.
