Tuberculosis

It has been estimated that in the early 1900's nearly 80% of the population was infected with this bacterial disease. Since the 1950's there has been a steady decline in the number of new cases and deaths attributable to tuberculosis (TB). Currently, it is estimated that 2-5% of this country's children are infected. These cases are most common among those in the socioenconomically depressed urban areas. A significant number of the cases are seen in African Americans, Hispanics, and Native Americans. This disease has a multitude of presenting symptoms that are based on the location of the tuberculosis infection in the body. Tuberculosis (TB) is best known for its lung infections, but it may also cause meningitis, kidney infections, and blood borne infection (sepsis). There are an increasing number of cases of TB that are proving to be resistant to the current anti-tuberculosis medications. Most of these resistant cases have been found in patients who have AIDS. Standard anti-tubercular drugs have no effect on this new strain. This fact presents a new and serious public health concern. Symptoms are variable and are based upon the "stage" of the disease. Pulmonary (lung) tuberculosis often results in night sweats, fevers, weight loss, bloody cough, and chills. Evaluation of suspected cases involves skin testing for the presence of TB. A positive PPD skin test will require treatment, if there is no history for prior tuberculosis. Once you have TB, your skin test remains positive for life. In most cases, there will be an attempt to culture the bacteria from mucous that is produced from coughing or by suctioning. Chest x-ray and blood studies can also aid in the diagnosis. The key to eradication of this illness is through the identification of those who carry TB (those with positive skin tests that have never been treated). Treatment regimens have been developed which use oral medications (Rifampin, Ethambutol, INH) to eradicate the infection. Treatment is often based on the age of the patient who has a positive PPD (TB skin test). A large percentage of the elderly population will have a positive PPD skin test, but will not have active disease (dormant disease). Those patients with a positive PPD over the age of 40 are generally screened with a chest x-ray for evidence of active tuberculosis. Treatment will be based on the findings. Children with a positive PPD are almost always started on treatment regimens for acute infection. Close medical follow-up is necessary because many of the medications used to treat this problem have associated drug side effects. Any exposure to infected individuals warrants IMMEDIATE skin testing. Persons living in the same household, or those who have been in close contact with infected individuals require skin testing. Tuberculosis is spread through the coughing of infected individuals. Regular skin testing is currently advised. Your family physician or Internist can help you with this problem.

Health Care BLOG || Your Feedback & Suggestions || Fitness