Tuberculosis (Tb)

Description

A chronic bacterial infection caused by the bacteria, Mycobacterium tuberculosis . Most people do not have any symptoms when first infected. Tuberculosis is spread through the air from person to person and the bacteria are released into the air when an infected person coughs or sneezes. Some people suffer from infection of the lung, and the majority of these infections do not spread further. The bacteria lay dormant in the body and can become reactivated many years later. This reactivation usually occurs when the immune system becomes depressed. Chronic illness, alcoholism, the use of immunosuppressive drugs, AIDS and cancer can all suppress the immune system leading to the spread of the disease. The initial lung infection can spread to all parts of the body and result in death.

Symptoms

Depends on the organ system involved. Pulmonary (lung) tuberculosis (TB): fever, cough, night sweats, weight loss, cough with bloody sputum, chest pain; tuberculosis (TB) meningitis: headache, vomiting, stiff neck; Disseminated tuberculosis (TB): multiple symptoms including abdominal pain, vomiting, painful urination, bone pain.

Tests

A history and physical exam will be performed. A Mantoux skin test (PPD) will identify previous exposure to tuberculosis (TB). A positive PPD does not necessarily mean one has tuberculosis (TB) but that other tests need to be done. Cultures of multiple body fluids are done as deemed appropriate for the clinical presentation. Imaging studies will done as deemed necessary to evaluate extent of disease.

Treatment

Treatment will require 6-9 months of therapy depending on the location and extent of disease. Standard therapy for active tuberculosis (TB) consists of a 6-month regimen: 2 months isoniazid, rifampin, and pyrazinamide, then 4 months of isoniazid and rifampin. Ethambutol or streptomycin may be added until the drug sensitivity is known. For more information contact: American Lung Association: (800)586-4872 National Jewish Medical and Research Center: (800)222-5864

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