Tuberculosis symptoms and treatment

Tuberculosis is caused by bacteria, (Mycobacterium tuberculosis), that most often affect the lungs. Tuberculosis is curable and preventable.
Tuberculosis is spread from person to person through the air. When people with lung tuberculosis cough, sneeze or spit. A person needs to inhale only a few of these germs to become infected.
Common symptoms of active lung tuberculosis are:
a bad cough that lasts 3 weeks or longer
pain in the chest
coughing up blood or sputum (phlegm from deep inside the lungs).
Other symptoms of TB disease are
weakness or fatigue
weight loss
no appetite
sweating at night.
About one-quarter of the world's population has a Tuberculosis infection, but which means people have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit it.
But they have lifetime risk about 5-10 % to become ill with tuberculosis.
People who have latent TB infection:
do not feel sick,
do not have any symptoms, and
cannot spread TB to others.
When a person develops active TB disease, the symptoms (such as cough, fever, night sweats, or weight loss) may be mild for many months. This can lead to delays in seeking care, and results in transmission of the bacteria to others.
Without proper treatment, around 45 % people with tuberculosis will die.
Skin test. This is also known as the Mantoux tuberculin skin test. A technician injects a small amount of fluid into the skin of your lower arm. After 2 or 3 days, they’ll check for swelling in your arm. If your results are positive, you probably have TB bacteria.
The results can be false negative, saying that you don’t have TB when you really do, if you have a very new infection. You might get this test more than once. Sometimes it can also be false positive.
Blood test. These tests, also called interferon-gamma release assays (IGRAs), measure the response when TB proteins are mixed with a small amount of your blood.
Acid-fast bacillus (AFB) tests for TB bacteria in your sputum, the mucus that comes up when you cough.

serum hemoglobin level, RBC count and platelet count can be decreased in tuberculosis patients whereas ESR, CRP and WBC count increased when compared with healthy controls. As for the observed WBC count, WBCs increase during infection, due to the increased polymorphonuclear leukocytes and macrophages as a part of the body’s immune defense mechanism to combat the invading bacterial population. The decreased red cell count and the increase in CRP explain the observed anemia in these patients.
Treatment of Active Infection

Treatment of confirmed TB requires a combination of drugs. Combination therapy is always indicated, and monotherapy should never be used for tuberculosis. The most common regimen for TB includes the following anti-TB medications:
First-line treatment:
Isoniazid and Rifampicin follow a 4-drug regimen (usually including Isoniazid, Rifampicin, Ethambutol, and Pyrazinamide) for 2 months or six months. Vitamin B6 is always given with Isoniazid to prevent neural damage (neuropathies).
Tuberculosis antibiotics have serious side effects:
Liver injury (nausea, fatigue, vomiting, malaise, abdominal pain), nausea, rash, numbness, and tingling in extremities, headache.

The only available vaccine as of 2021 is bacillus Calmette-Guérin (BCG). In children it decreases the risk of getting the infection by 20% and the risk of infection turning into active disease by nearly 60%.

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