Posted: August 12th, 2013
Tuberculosis refers to an infectious disease, lethal in many cases, caused by Mycobacterium. Primarily, Tuberculosis normally affects the lungs but is capable of affecting other parts, as well. The disease spreads through the air when an infected person sneezes, coughs, or transmits saliva through the air. Most Tuberculosis infections are latent and asymptomatic. However, statistics suggested that about ten latent infections go to develop to the disease that kills more than half of the infected individuals when left untreated. In 2007, chronic cases of the disease numbered about thirteen million and eight million in 2010 (Landis, 42). Ultimately, advancement in technology as well as informed population has contributed to the reduction of infection case. Currently, majority of those who contract the disease do so due to compromised immunity.
About five-ten percent of individuals infected with HIV are opportunistically infected with tuberculosis. Tuberculosis is capable of affecting any part of the body, but infection normally takes place in the lungs and is referred to as pulmonary tuberculosis. General signs and symptoms include night sweats, fever chills, fatigue, loss of appetite, and weight and finger clubbing may occur. When infection takes place, ninety percent of cases involve the lungs. Specific symptoms include prolonged coughing that produces sputum and chest pains. However, it is important to understand that about twenty-five percent of infected individuals may not exhibit symptoms (Landis, 64). In some cases, the infected person may cough blood, and in extremely rare cases, the pulmonary artery may be eroded leading to massive bleeding. When the illness becomes chronic, the upper lobes of the lungs have a higher propensity if being scarred compared to the lower lobes. The reason in this case is yet to be made clear. It may be due to poor drainage of lymph fluid or better flow of air.
Diagnosing tuberculosis based on mere signs and symptoms is not easy as is diagnosing it among people with suppressed immunity. However, diagnosis of tuberculosis should be considered when lung disease signs or constitutional symptoms last longer than a fortnight. Primarily, an X-ray of the chest and sputum tests to detect bacteria involves part of the initial evaluation. With the progress in technology and medical field, tuberculin skin tests and assays on interferon-y release have been rendered to limited use. In contrast, IGRA (interferon gamma release assay) exhibits similar limitations in the case of HIV infected individuals (Koch, 29). A definitive diagnosis of Tuberculosis is currently done through tests undertaken on a clinical sample including pus, tissue biopsy, or sputum. Nevertheless, the slow growing organisms of the mycobacterium as well as their differing culture process imply that conclusive tests are done two to six weeks after infection.
However, current trends in diagnosis are conclusively fast as compared to previous ages thus treatment normally takes place before serious infection takes place (Grunberg, 37). Tests on Adenosine deaminase and nucleic amplification currently allow rapid tuberculosis diagnosis. However, these tests are not routinely recommended since they have a tendency of affecting the treatment process of the infected person. Since blood tests are designed to detect antibodies and are not highly sensitive and specific, they are therefore not highly recommended compared to tests that look for the causal bacteria (Koch, 53). In cases of latent tuberculosis, the tuberculin skin test is used for screening people with high TB risk. In this case, however, people immunized against Tuberculosis have a higher chance of exhibiting false positive results. On the other hand, this test may lead to false negative results among people with malnutrition, Hodgkin’s lymphoma, and sarcoidosis.
The current trends in Tuberculosis diagnosis have been facilitated by the advancement in technology. In this case, current tools are capable of detecting fluorescence in oxygen enriched liquid sample medium, thus indicating whether the Tuberculosis bacterium is present or not. The growth of the bacteria in the sample requires oxygen thus making it fluorescent when put under ultra violet light. Methods of testing susceptibility for drugs involve the same procedure only that two samples are used, one incorporated and the other without the drug. If the sample with the drug becomes active against Tuberculosis bacteria, then diagnosis is made positive. For the manual system, the technician in charge identifies the fluorescence using an ultra violet lamp. On the other hand, automatic systems are advanced enough to detect more than 900 cultures from a single test (Grunberg, 74).
Treatment of Tuberculosis is normally done with antibiotics that attack and kill the mycobacterium. However, effective treatment of the disease is difficult because of the mycobacterium’s unusual chemical and structural composition. This hinders drug entry, making antibiotics less effective. Antibiotics commonly used include rifampicin and isoniazid, and treatment is prolonged, lasting several months. Treatment of latent Tuberculosis is done using a single antibiotic and active tuberculosis is treated using several antibiotics. The main objective is to prevent the bacterium from developing resistance to antibiotics. Directly observed therapy is recommended by the World Health Organization as an effort of ensuring proper taking of the treatment antibiotics.
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