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Tuberculosis is an infectious disease caused by a bacteria called Mycobacterium tuberculosis, and if it affects the lungs, then it is called pulmonary tuberculosis. By many criteria, this bacteria behaves differently when compared to other common bacteria. This is why tuberculosis can affect one or more organs and is one of the most severe infectious diseases, even today.

According to data provided by the World Health Organization (WHO), only in 2011, there were nearly 9 million new cases of tuberculosis. This infection has a very opportunistic character, which means that persons with lowered immune response are at higher risk. These include patients with AIDS, patients with some autoimmune diseases subjected to immunosuppressant therapy, etc. Furthermore, vaccination against tuberculosis is often contraindicated in these patients.

How Does Mycobacterium tuberculosis Affect The Lungs?

Unlike most other bacteria, which do not enter human cells and are only present in the intercellular space (the space between the cells), this bacteria inflicts its damage both from the inside of the lung cells and from the intercellular space. The result of that is necrotic areas (areas of dead lung tissue), located at first in the upper lobes of the lungs. In these necrotic areas, the blood vessels are also damaged, which produces bleeding from time to time.

What Are The Symptoms Of Pulmonary Tuberculosis?

Pulmonary tuberculosis rarely presents with the full spectrum of symptoms in developed countries, as it is most commonly diagnosed in the early stage and treated properly. However, in developing countries, there are still many patients experiencing the unpleasant symptoms of tuberculosis. The most common symptoms include productive cough, coughing blood from time to time, breathing difficulties, loss of appetite, and weight loss. A fever is also present, but there is not a high increase in body temperature. Instead, it manifests as sweating, usually during the night. As the disease progresses, higher portions of the lung tissue get affected, resulting in worsening breathlessness, weight loss, a general feeling of illness, and weakness. If left untreated, the outcome of pulmonary tuberculosis is fatal.

How Is Pulmonary Tuberculosis Diagnosed?

The tuberculin skin test is usually the first choice when the pulmonary tuberculosis is suspected. That is a fast and easy to perform test, but it is irrelevant in persons who have received the BCG vaccine or have had active tuberculosis before. Sputum can be taken for bacteriological examination, but the special medium is required for Mycobacterium tuberculosis culturing, and the process may take more than one month. For other types of bacteria, it usually takes less than 24 hours. Chest radiography is very sensitive for the diagnosis of pulmonary tuberculosis because of the characteristic changes in the lung tissue. MRI and CT are also of great help in some difficult cases.

Pulmonary Tuberculosis Treatment

The treatment of pulmonary tuberculosis takes up to 6 months, and it is comprised of a combination of usually 3 powerful antibiotics according to the specific regimen. These antibiotics include rifampicin, isoniazid, and pyrazinamide. There are variations in treatment plans, depending on specific age and the stage of the disease. Supportive treatment is also necessary, such as hydration, resting, and different approaches to strengthening the immune system.

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