**Tuberculosis (TB):**
**1. What is Tuberculosis (TB)?**
Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs but can also affect other parts of the body, such as the brain, kidneys, or spine.
**2. Types of Tuberculosis:**
- **Pulmonary TB:** Affects the lungs and is the most common form of TB.
- **Extrapulmonary TB:** Affects organs other than the lungs, such as the brain (meningitis), spine (vertebral TB), kidneys (renal TB), or lymph nodes (lymphadenitis).
**3. Signs/Symptoms:**
- **Pulmonary TB:**
- Cough that lasts three weeks or longer
- Chest pain
- Coughing up blood or sputum
- Weakness or fatigue
- Fever, chills, and night sweats
- Loss of appetite and weight loss
- **Extrapulmonary TB:**
- Symptoms depend on the affected organ system and may include headaches, neck stiffness (meningitis), back pain (spinal TB), or urinary symptoms (renal TB).
**4. Diagnostic Tests:**
- Tuberculin skin test (TST) or interferon-gamma release assays (IGRAs): Screening tests to detect latent TB infection.
- Chest X-ray: To identify abnormalities in the lungs suggestive of TB, such as cavitations or infiltrates.
- Sputum culture: Definitive test to confirm the presence of Mycobacterium tuberculosis bacteria.
- Molecular tests: Polymerase chain reaction (PCR) tests to detect TB DNA in sputum samples.
**5. Clinical Examination and Diagnosis:**
- Clinical diagnosis: In resource-limited settings, TB may be diagnosed based on clinical symptoms, chest X-ray findings, and response to empirical treatment.
- Physical examination: Assessment of respiratory symptoms, lymphadenopathy, and signs of extrapulmonary involvement such as neurological deficits or spinal deformities.
**6. Treatment:**
- Antibiotic therapy: Treatment with a combination of antibiotics (isoniazid, rifampin, ethambutol, and pyrazinamide) for a specified duration based on the type of TB and drug susceptibility testing.
- Directly observed therapy (DOT): Supervised administration of TB medications to ensure adherence and treatment completion.
- Surgical intervention: May be required for some cases of extrapulmonary TB, such as draining abscesses or removing affected tissue.
**7. Complications:**
- Disseminated TB: Spread of the infection beyond the lungs to other organs, particularly in immunocompromised individuals.
- Drug-resistant TB: Resistance to first-line anti-TB medications, requiring treatment with second-line drugs that are often less effective and more toxic.
- Tuberculous meningitis: Infection of the membranes covering the brain and spinal cord, which can lead to neurological complications and death if untreated.
**8. Prevention:**
- Tuberculosis vaccine (BCG): Vaccination with Bacillus Calmette-Guérin (BCG) is recommended in countries with a high TB burden to prevent severe forms of TB in children.
- Infection control measures: Implementing measures to prevent the transmission of TB in healthcare settings, including proper ventilation, use of personal protective equipment, and isolation of infectious patients.
**9. Patient Education:**
- Adherence to treatment: Educating patients about the importance of completing the full course of antibiotics to prevent drug resistance and treatment failure.
- Infection control: Providing information on measures to prevent the spread of TB to family members and close contacts.
- Symptoms monitoring: Teaching patients to recognize and report symptoms suggestive of TB recurrence or treatment side effects.
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