Most patients can be cured without having to "talk about nuclear discoloration" | World TB Day

140 years ago today, German microbiologist Robert Koch declared that Tuberculosis bacillus is the pathogen of tuberculosis, thus opening up the mystery that causes tuberculosis and providing a treatment for tuberculosis that has plagued mankind for thousands of years. To commemorate the discovery of TB bacteria and to further promote global TB prevention and control campaigns, the World Health Organization has designated 24 March as World TB Day.

This year is the 27th World Tb Day, the National Health Commission set "life first, national action, sharing health, end tuberculosis" as the theme of this year's publicity activities, aiming to highlight the mainland's adherence to the concept of life first, strengthen the broad participation of all sectors of society, and call on the whole society to actively take action to end the tuberculosis epidemic and jointly defend the health of the people.

Mycobacterium tuberculosis does not only infect the lungs

Deng Ying, chief physician of the Department of Infection of Qingyuan People's Hospital, introduced that tuberculosis is a chronic infectious disease caused by tuberculosis bacillus infection. Tuberculosis bacteria can invade various organs throughout the body, but tuberculosis infection of the lungs is the most common, called tuberculosis.

Tuberculosis is mainly transmitted through the respiratory tract through droplets, and patients with tuberculosis who excrete bacteria spread droplets with tuberculosis bacteria into the air when coughing, sneezing and talking loudly, and the surrounding people may be infected by inhaling bacterial droplets. In densely populated schools, factories, welfare institutions, etc., tuberculosis transmission and cluster disease may result from untimely detection of infectious tuberculosis patients.

"In addition to infecting the lungs, TUBERCULO bacteria also infect other organs." Deng Ying introduced that according to the location of the lesion, there are tuberculosis and extrapulmonary tuberculosis. Tuberculosis occurs in the tuberculosis of lung tissue, trachea, bronchi and pleura, and can be divided into primary tuberculosis, blood group disseminated tuberculosis, secondary tuberculosis, tracheobronchial tuberculosis, tuberculous pleurisy and so on.

When the body's resistance is reduced, the tuberculosis bacteria that first invade the human body through the respiratory tract or digestive tract often form the primary lesion in the lungs or intestinal wall, which is primary tuberculosis. When the body's resistance is reduced, a large number of TB bacteria invade the blood circulation one or more times to cause blood-type disseminated tuberculosis. Secondary pulmonary tuberculosis is caused by the re-ignition of potential lesions left in the lungs during primary infection or re-infection of Mycobacterium tuberculosis.

Extrapulmonary tuberculosis refers to tuberculosis that occurs in organs and parts outside the lungs, including osteoarticular tuberculosis, tuberculous meningitis, tuberculous pericarditis, intestinal tuberculosis, liver tuberculosis, pelvic tuberculosis, skin tuberculosis and so on.

Cough lasts more than 2 weeks, be on high alert

Patients with early or mild TB may have no symptoms or mild symptoms that are neglected, and if the lesion is in the active progression stage, symptoms such as low-grade fever, general weakness, weight loss, and night sweats may occur. Women can cause irregular or menopausal periods.

Deng Ying introduced that the location of tuberculosis infection is different, and there will be different clinical manifestations. Patients with tuberculosis often present with respiratory symptoms, cough and sputum are the most common early symptoms of tuberculosis, and some patients can also be accompanied by sputum with blood or even hemoptysis, chest pain, dyspnea and other symptoms. Patients with long-term cough and sputum production should generally be vigilant against tuberculosis.

Tuberculous meningitis is clinically manifested as headache, vomiting, fever, convulsions, limb paralysis, cervical resistance, and positive neurologic pathologies. Most of them also have tuberculosis. Tuberculous pleurisy presents with chest pain, shortness of breath, fever, and signs of pleural effusion on examination.

Deng Ying reminded that the cough lasts for more than 2 weeks, and it is necessary to be highly vigilant against tuberculosis and to go to the local tuberculosis designated medical institutions in time. If it cannot be diagnosed and treated in time, it can cause serious complications at the site of infection, such as respiratory failure, hemoptysis, renal failure, meningitis, infertility, etc.

"A positive tuberculin test indicates tuberculosis infection, but it does not necessarily indicate illness." Deng Ying explained that the tuberculin test is only of reference value for the diagnostic nature of tuberculosis. A positive tuberculin test indicates tuberculosis infection, but it is not necessarily diseased. A strong positive skin test often suggests an active tuberculosis focus in the body.

A negative tuberculin test indicates the absence of TB infection, but several conditions are still excluded. After a tuberculosis infection, it takes 4 to 8 weeks for the allergy to be fully established, so the test can be negative for the colonization in the early stages of allergy. In patients with immunosuppressants such as glucocorticoids, malnutrition and measles and pertussis patients may temporarily disappear the nodal reaction. There are also lymphatic immune system deficiencies, such as leukemia, sarcoidosis, and the nodumin response in the elderly are often negative.

Clinically, the patient's sputum, lavage fluid, or other parts of the body fluid are usually made into smears, and the presence of tuberculosis bacteria is detected under the microscope, and the tuberculosis bacteria can be found to confirm the diagnosis of tuberculosis. However, in areas where it is difficult to collect bacterial specimens such as bones and joints, the diagnosis is often based on symptoms, signs, and characteristic manifestations of imaging.

There is no need to "talk about nuclear discoloration"

In general, all people are susceptible to tuberculosis. Tuberculosis and tuberculosis are preventable and treatable, and there is no need to "talk about nuclear discoloration". Deng Ying introduced that before determining the treatment principle and choosing therapy, the doctor will determine the type of tuberculosis and the progression of the lesion at this stage, and check whether there is active tuberculosis in other parts of the lungs.

"Treatment follows the five principles of early, appropriate amount, combination, regularity, and full medication to ensure thorough treatment." Deng Ying said that the vast majority of tuberculosis patients can be cured, but if the treatment is not standardized, they stop and change drugs without authorization, which is easy to produce drug-resistant tuberculosis. Once drug resistance occurs, the cure rate is low, the cost of treatment is high, and the duration of treatment is longer. Therefore, the use of drugs can not be interrupted at will, we must adhere to the whole process, the purpose is to completely eliminate tuberculosis bacteria and prevent recurrence.

The usual treatment method for tuberculosis patients is home treatment, patients try to live separately from others, develop good hygiene habits, open windows and ventilate, do not spit on the ground, cough and sneeze to cover their mouths and noses, minimize going out, wear masks when going out, and reduce the risk of tuberculosis transmission.

Deng Ying said that although all people are susceptible to tuberculosis, people with low resistance are at greater risk of disease. Whether a healthy person can develop the disease after infection with Tuberculosis bacteria depends on the strength of the infected person's physical resistance and the virulence of the bacteria. Strengthening exercise, regular work and rest, reasonable diet, maintaining a healthy attitude, strengthening physical exercise, and enhancing self-resistance are effective means of prevention.

[Reporter] Liu Qiuyi

[Media Assistant] Chen Zhiyu

[Correspondent] Peng Keming

【Author】

【Source】 Southern Press Media Group South + client