Tuberculosis (TB)

• Symptoms: Feeling weak, weight loss, cough, cough with blood, fever, and night sweats
• Causes: Caused by the bacterium Mycobacterium tuberculosis, it spreads from one individual to another.
• Risk Factors: Individuals with diseases that weaken the immunity system, individuals who have recently been infected with TB, individuals who stay in close proximity to those affected with the virus
• Severity: Mild to severe
• Which doctor to consult: Infectious Disease Specialist, Pulmonologist

Overview:

The word 'tuberculosis' comes from the Latin word 'tuberculum', which means slight swelling or lump.

Tuberculosis (TB), caused by the bacteria Mycobacterium tuberculosis, is a bacterial infection that affects the lungs as well as other body parts, including the brain, abdomen, bones, kidneys, and spine.

The disease spreads through tiny droplets released into the air through coughing or sneezing by affected individuals. If a person comes in contact with the infected droplets, he/she is at risk of contracting TB. People of all ages can be affected by the infection.

TB usually manifests in two primary ways -

• Latent TB: This happens when the individual is infected with the TB virus but does not show any apparent symptoms. This type of TB is not contagious, and individuals may never show signs of TB.But in individuals with a weak immune system, the bacteria become active.
• Active TB: This is the most common type where individuals have the active virus and exhibit symptoms, and the disease can spread to others if they come in contact with the infected person.

Since the disease develops slowly, it can take weeks or months for symptoms to start appearing. The patient may have been exposed to the virus a long time back but may notice signs of TB, years later.

TB is a serious condition that can lead to morbidity in individuals. It was the leading cause of death at one time in developing countries around the world. But today, there are treatments for the disease. The proper treatment can help the individual return to their feet within a few months.

When to Consult a Doctor?

If an individual suspects that he/she has TB, visiting a general physician for a check-up is a must. Most primary healthcare providers can identify and diagnose tuberculosis.

TB’s warning signs commonly include:

• A feeling of sickness or weakness
• Weight loss without any reason
• Severe cough for more than two to three weeks
• Spotting blood in cough
• Chest pain
• Fever and night sweat
• Chills
• Loss of appetite

Coughing is the most common symptom, often confused with a cold or common cough. In most cases, individuals with TB cough up blood. In common cough, the phlegm or mucus produced by the body is clear, but in the case of TB, the colour is slightly green or yellow.

Specific individuals are more at risk of getting TB. They should get tested frequently. These individuals include:

Individuals who have come in recent contact with someone diagnosed with TB
Individuals with HIV or any medical condition that weakens the immunity system
Individuals coming from an area where TB is common

Diagnosis

General physicians may recommend an individual to an Infectious Disease specialist if they suspect the person has TB. The doctor performs chest X-rays and laboratory tests and considers health and medical history before diagnosis.

• Lab Tests: Doctors usually administer two types of lab tests to detect the virus in the body and establish the diagnosis.
• TB Skin Test (TST): This is the most common test to diagnose TB. The doctor injects a substance called tuberculin into the skin. The patient will feel a slight prick. If the injected site is swollen within a day or two, it indicates the individual has the virus in the body. This is also called the Mantoux test.
• Blood Test: Since a TST test only reveals if a person has been infected with TB, a blood test is followed to identify the type of TB infection. Blood tests identify the body's reaction to the infection. It can confirm if the infection is latent or active TB.
• Sputum Test: In this test, sputum is collected from cough and placed under the microscope to look for germs of TB. If the test comes positive, it usually indicates TB of the throat or lungs.
• Imaging Tests: X-rays are used in the diagnosis of TB. A chest X-ray can reveal if the TB bacteria has caused any damage. Sometimes, the X-ray can show white spots in the report indicating the damage done by the virus.

Treatment:

TB can be completely cured with a proper treatment plan. Depending on the severity of the disease and the patient's medical history, the doctor recommends the most effective treatment regime. Treatment of TB can take several months.

Home Care: Similar to other diseases, TB requires adequate home care for the patient to recover completely and lead a healthy life.

Following are some home care tips for TB patients:

• An individual should take the dose of antibiotics as prescribed and completing the entire medicine course without missing a single dosage.
• Regular antibiotics often cause gastric issues. Patients are advised to stay hydrated and take gastric medicine daily with lunch.
• Patients can drink peppermint, ginger, and tulsi tea to ease congestion and cough, and clear the mucus in the lungs.
• Diet is an essential component of recovery. So patients are advised to eat a balanced diet rich in all vitamins and protein.
• Patients should avoid going out in public areas until the doctor provides clearance. Wearing a mask is advised if the patient has to step out during an emergency.
• Getting plenty of rest and sleep is recommended for every patient.

Medication: The usual treatment for TB is administering antibiotics for the first few months. Common drugs are isoniazid, rifampin, pyrazinamide, and ethambutol or streptomycin.

Surgical Treatment: Although surgery is not the most preferred choice for TB patients, doctors might perform thoracic surgery to treat pulmonary TB.

Alternative Management: Individuals with TB must take several medicines as part of their treatment course. But there are different alternative management techniques that, when accompanied by primary treatment, can yield great results.

• Homoeopathy: Many studies and research have shown the effectiveness of homoeopathy in treating and managing the symptoms of TB effectively. Experts of homoeopathy usually adopt multiple treatments for tuberculosis.Calcarea carbonica and Arsenicum album are commonly used for treating cough, chest discomfort, chills, night sweats and other similar symptoms.
• Yoga and Meditation: Yoga does not cure tuberculosis. But it can help maintain overall health and prevent the infection from causing further damage to the body.Several yoga poses can help improve respiratory health or neurological functioning and strengthen the body's immune system. Meditation improves mental health and can help in managing stress related to the disease. Patients can develop a positive outlook on their health condition through these practices.
• Acupuncture: Acupuncture is one of the ancient Chinese medicine techniques that improve the overall physical and mental health in individuals.

Risks & Complications if Left Untreated:

If not treated properly, TB can be fatal. While TB is generally known to affect the lungs, it also affects other body parts, including the kidneys, spine, and brain, over the years. Also, it can cause long-term lung damage if treatment is not started early. It will cause significant morbidity in every individual.

Additional Information

Prevention of Tuberculosis:

There are no tested ways to prevent TB. But several measures can be adopted that can increase protection against TB.

Individuals must avoid going near sick or infected TB patients as the disease is contagious. This can protect both the individual and the community from the illness.

If an individual thinks he/she has been exposed to the virus in recent times, the ideal thing to do is to isolate. If symptoms appear during this time, it is advised to visit a doctor and get tested for TB.

Other than testing, following basic hygiene practices like covering the mouth while sneezing or coughing and washing hands is recommended.

Many countries have adopted vaccines for tuberculosis (TB) disease. Bacille Calmette-Guérin (BCG) is one such vaccine. At present, this is the only licensed vaccine. Usually, babies are given a dose of the vaccine soon after birth. The effects of the vaccine can last up to 15 years.

In addition, early screening and treatment can prevent the further spread of infections.