Tuberculosis

 

Tuberculosis (TB) is a contagious bacterial infection caused by Mycobacterium tuberculosis. It primarily affects the lungs (pulmonary TB), but it can also involve other organs (extrapulmonary TB). TB spreads through airborne droplets when an infected person coughs, sneezes, or speaks.

1. Types of Tuberculosis

A. Based on Infection Status:

  • Latent TB Infection (LTBI):

    • Bacteria are present but inactive
    • No symptoms, not contagious
    • Can reactivate if immunity drops

  • Active TB Disease:

    • Bacteria are actively multiplying
    • Causes symptoms and is contagious

B. Based on Location:

  • Pulmonary TB – Lungs (most common form)
  • Extrapulmonary TB – Outside lungs, e.g.:
    • Lymph node TB
    • Spinal TB (Pott’s disease)
    • Miliary TB – Disseminated form
    • TB meningitis
    • Genitourinary TB
    • Gastrointestinal TB

2. Method of Diagnosis

  • Clinical suspicion: chronic cough, weight loss, fever, night sweats

  • Sputum Tests:

    • AFB stain (Ziehl-Neelsen) – detects acid-fast bacilli
    • GeneXpert (CBNAAT) – detects M. tuberculosis DNA and rifampicin resistance
    • Culture (Löwenstein–Jensen) – gold standard, takes weeks

  • Chest X-ray/CT scan – for pulmonary involvement

  • Tuberculin Skin Test (TST/Mantoux) – for latent TB

  • Interferon Gamma Release Assay (IGRA) – blood test for latent TB

  • Biopsy and Histopathology – for extrapulmonary TB

  • Ultrasound/MRI/CT – for organ-specific disease

3. Prevention

  • BCG Vaccine (Bacillus Calmette–Guérin) – given to infants in high-risk countries
  • Early diagnosis and treatment
  • Isolation of active TB cases
  • Screening of high-risk populations (HIV, immunocompromised)
  • Proper ventilation and mask use in high-risk settings

4. Treatment

  • First-line drugs for drug-sensitive TB:

    • Intensive phase (2 months): HRZE
      • H = Isoniazid
      • R = Rifampicin
      • Z = Pyrazinamide
      • E = Ethambutol
    • Continuation phase (4 months): HR

  • Total duration: usually 6 months

  • Drug-resistant TB:

    • MDR-TB: resistant to H and R
    • Requires longer treatment (18–24 months) with second-line drugs like fluoroquinolones, bedaquiline

  • Adherence is critical – DOTS (Directly Observed Therapy, Short-course) ensures compliance

Would you like a visual summary or TB-related radiology images (e.g., chest X-ray showing TB lesions)?

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