Infectious Disease
Tuberculosis: Signs and Treatment

Tuberculosis (TB) remains a major global health threat, with about 1.5 million deaths annually. Understanding modern detection and treatment is crucial for control.
**Comprehensive TB Guide:**
1. **Transmission & Risk Factors:**
- Airborne spread (coughing/sneezing)
- Close contact with active TB case
- Immunocompromised (HIV, diabetes, etc.)
- Healthcare workers
- Travelers to high-burden countries
2. **Types of TB:**
- Latent TB (infection without symptoms)
- Active TB (symptomatic, contagious)
- Pulmonary (lungs) vs. extrapulmonary (other organs)
- Drug-resistant strains (MDR/XDR-TB)
**Symptoms Recognition:**
- Persistent cough (>3 weeks)
- Chest pain
- Coughing up blood
- Fatigue
- Fever/chills
- Night sweats
- Weight loss
- Specific symptoms for extrapulmonary sites
**Diagnostic Methods:**
- Tuberculin skin test (TST)
- Interferon-gamma release assays (blood tests)
- Chest X-ray
- Sputum tests (smear, culture, molecular)
- Drug susceptibility testing
**Treatment Protocols:**
1. **Latent TB:**
- 3-4 month rifamycin-based regimens preferred
- Prevents progression to active disease
- Especially important for high-risk individuals
2. **Active TB:**
- 6+ month multidrug regimens
- Directly observed therapy (DOT) recommended
- First-line drugs: Isoniazid, rifampin, ethambutol, pyrazinamide
- Weekly monitoring initially
3. **Drug-Resistant TB:**
- Longer treatment (9-24 months)
- Second-line medications
- Newer drugs (bedaquiline, delamanid)
- Often requires hospitalization initially
**Public Health Aspects:**
- Mandatory reporting of cases
- Contact investigations
- Isolation precautions
- Travel restrictions during contagious phase
- Community education
**Prevention Strategies:**
- BCG vaccine (variable effectiveness)
- Infection control in healthcare
- Prompt identification/treatment
- Treatment of latent TB in high-risk
- Nutritional support
**Emerging Developments:**
- Shorter treatment regimens
- New diagnostic tools (molecular tests)
- Vaccine research
- Improved drugs for resistant strains
- Digital adherence technologies
**Special Populations:**
- Children
- Pregnant women
- HIV coinfection
- Elderly
- Those with liver/kidney disease
TB requires careful medical supervision - never self-treat or stop medications early. With proper treatment, most cases can be cured, though monitoring for relapse is important.
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