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Pulmonary tuberculosis
Methods of Tuberculosis Examination
The examination methods for tuberculosis are now quite numerous, but achieving a diagnosis is still relatively difficult. The most commonly used method is still chest imaging, mainly X-rays and CT scans. Additionally, there are bacteriological examinations, such as examining sputum or other samples like pleural effusion under a microscope after staining. Culturing Mycobacterium tuberculosis, with sputum being the most commonly used sample, followed by pleural effusions and bronchoalveolar lavage fluid, is also common. A newer method is molecular biology examination, also known as Mycobacterium tuberculosis DNA nucleic acid testing. Then there is the pathological examination of tuberculosis, commonly referred to as biopsy, which involves taking a small piece of tissue from the lesion for observation. Moreover, some new immunological tests have emerged, including the traditional tuberculin skin test, still relevant today, and the gamma interferon release assays, along with traditional tests like Mycobacterium tuberculosis antibody tests. Additionally, some patients might require more invasive examinations, such as bronchoscopy, which allows direct observation of the trachea and bronchi and can be used for brush tests or biopsies at the lesion site.
How is tuberculosis diagnosed?
To diagnose tuberculosis, it's important to understand that tuberculosis is an infectious disease caused by the Mycobacterium tuberculosis, also known simply as the tuberculosis bacillus. This condition affects the main bronchi, bronchi, and pleura in the lungs. In 2017, new industry standards were formulated for diagnosing tuberculosis, which can be complex for those without a medical background to fully comprehend, as the diagnostic criteria in these standards span four chapters of A4-sized papers. Generally, the diagnosis of pulmonary tuberculosis is primarily based on etiological examination, combined with epidemiology—whether the patient has a history of exposure to tuberculosis—as well as clinical manifestations and chest imaging such as X-rays and CT scans. Additional laboratory tests like pathological and immunological assessments (e.g., T-SPOT.TB skin test, Mycobacterium tuberculosis antibody, bronchoscopy) are also considered for a comprehensive evaluation. The main basis for a definitive diagnosis still lies in the results of etiological and pathological examinations. "Etiological" here refers to detecting the presence of Mycobacterium tuberculosis through various methods, primarily bacteriological examination. This involves observing the bacteria under a microscope using samples such as sputum or pleural effusion. A positive observation confirms the presence of the bacteria. Mycobacterium tuberculosis can also be cultured from samples, though this process is lengthy, often taking several weeks or more. Recently, molecular biological tests, such as nucleic acid tests for Mycobacterium tuberculosis, have been introduced. Pathological examinations, which involve taking a biopsy from the lesion site and observing it under a microscope, can confirm the diagnosis if characteristic tuberculous changes, like caseous necrosis, are observed. However, most patients with pulmonary tuberculosis may not meet these strict criteria and are often diagnosed based on clinical symptoms, chest imaging, and supplementary tests. In such cases, most physicians will initiate a diagnostic anti-tuberculosis treatment for one month. If the patient's condition improves or stabilizes after this period, anti-tuberculosis treatment will continue. If the condition worsens or does not stabilize, tuberculosis might be ruled out, necessitating further examination.
Can tuberculosis be cured?
Can tuberculosis be cured? First, we need to understand that tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. In recent decades, many drugs have been developed for anti-tuberculosis treatment. As long as one strictly follows the doctor's advice and adheres to the medication schedule, the vast majority of tuberculosis cases can be completely cured. However, it is crucial to recognize that the treatment duration for tuberculosis is lengthy. Typically, patients need at least six months, while those with recurrent tuberculosis might need eight months. Some patients with multidrug-resistant tuberculosis may even need to take medication for two years. Therefore, it is essential to undergo standardized anti-tuberculosis treatment. Nevertheless, some patients, due to non-adherence to medical advice, irregular medication intake, or discontinuation of treatment on their own without completing the full course, may face treatment failure. In severe cases, this can lead to multidrug resistance, significantly prolonging the treatment duration and drastically reducing the cure rate, and may even cause infertility. Additionally, some patients may experience severe adverse reactions to tuberculosis drugs, such as significant liver and kidney damage, or have comorbidities like diabetes, liver cirrhosis, or HIV/AIDS. Others may develop severe complications, such as cardiopulmonary disease or respiratory failure, which greatly reduce their chances of recovery and can even lead to death.
Early symptoms of tuberculosis
In the early stages of tuberculosis, as the condition is relatively mild, many patients have no symptoms or only mild symptoms. Typical symptoms include coughing, expectoration, night sweats, fatigue, low-grade fever, poor appetite, and weight loss, but these are not specific to tuberculosis. If these symptoms persist for more than two weeks, tuberculosis should be suspected, and a chest x-ray or other examinations should be performed for further clarification. If the x-ray suggests tuberculosis, further tests such as a tuberculin skin test should be conducted to confirm the diagnosis.
Tuberculosis is transmitted through the air.
The transmission of tuberculosis primarily depends on understanding its causative agent, which is the tubercle bacillus, also known simply as the tuberculosis bacillus. The main source of infection in tuberculosis is from patients who test positive for tuberculosis bacillus in their sputum. The respiratory tract is the principal route of transmission for tuberculosis patients. When patients who test positive for bacillus in their sputum cough, expel sputum, sneeze, or even speak loudly, they generate a large amount of droplets containing the tuberculosis bacillus. These bacteria can remain suspended in the air for a relatively long time. In poorly ventilated indoor environments, they may stay airborne for up to five hours. Healthy individuals can contract respiratory infections upon inhaling these bacteria. Furthermore, a very small portion of patients are infected through consuming milk or other dairy products from cows with tuberculosis.
Can people with tuberculosis drink alcohol?
Patients with tuberculosis should not drink alcohol. They need to rest well, enhance their nutrition, and abstain from smoking and drinking. Systematic and standardized anti-tuberculosis treatment is necessary. With standardized anti-tuberculosis treatment, the tuberculosis bacteria can be effectively suppressed, symptoms can be controlled, and the patient’s weight can increase. It is crucial to abstain from smoking and drinking during treatment, as drinking can lead to poor treatment outcomes and even the development of drug-resistant tuberculosis. With timely and standardized medication and comprehensive treatment, most patients can generally be cured within a six-month course of anti-tuberculosis treatment.
Does tuberculosis cause a runny nose?
Individuals with tuberculosis, if accompanied by a cold and rhinitis, will also experience a runny nose. However, simple tuberculosis, without any upper respiratory infections or rhinitis, does not lead to a runny nose. Therefore, it is important to accurately analyze the issue. Common symptoms of tuberculosis include persistent coughing, coughing up phlegm, low-grade fever, night sweats, bloody sputum, chest tightness, and difficulty breathing, among others. Once tuberculosis is definitively diagnosed, it is essential to commence timely and scientifically sound anti-tuberculosis treatments. Most cases can be completely cured.
Is tuberculosis contagious?
Tuberculosis (TB) is only infectious in some patients who have a large amount of tubercle bacilli in their sputum. In fact, many patients with active pulmonary tuberculosis are not infectious. For more patients with active pulmonary tuberculosis, tubercle bacilli cannot be found in their sputum, so the actual situation must be considered. In fact, to determine if pulmonary tuberculosis is infectious, it is simple: look for acid-fast bacilli in the sputum. If the sputum acid-fast staining is positive, it indicates infectiousness. Infectious pulmonary tuberculosis requires systematic and standardized anti-tuberculosis treatment.
Can tuberculosis be cured?
Tuberculosis can actually be completely cured, primarily through anti-tuberculosis treatment. If it is confirmed to be active tuberculosis, systematic and standardized anti-tuberculosis treatment is required. Through scientific and reasonable anti-tuberculosis treatment and taking medication on time and according to guidelines, most tuberculosis patients can be cured, with a cure rate reaching 85%. The treatment includes an intensive phase of anti-tuberculosis treatment and a consolidation phase, with the total course of treatment being about six months. After being cured, it is not easy to relapse, but it is essential to take medications on time, adjust nutrition, modify work and rest schedules, and rest well.
How is tuberculosis diagnosed?
The diagnosis of tuberculosis primarily involves combining relevant clinical symptoms, such as whether there is cough, expectoration, low fever, night sweats, and blood in phlegm. It also requires considering the patient's chest imaging features, whether there is obvious infection, fresh exudation, cavities, as well as sputum tests. For example, if the sputum stain for acid-fast bacilli is positive, and the sputum culture is positive, using these comprehensive diagnostic methods, tuberculosis can be diagnosed, after which anti-tuberculosis treatment should be initiated.