How can tuberculosis be detected? How to recognize tuberculosis and determine the symptoms of the disease. Damage to the genitourinary organs

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Main number of cases tuberculosis is detected during the patient’s initial visit to general practitioners. The patient, feeling unwell, does not immediately seek help from a doctor. A low-grade fever of up to 37.5 C appears and is maintained constantly. After some time, a dry cough develops, sometimes with sputum production ( heavy smokers most often do not pay attention to it, citing their bad habit). That's when you should worry, it's time to see a doctor. Every doctor knows about the widespread prevalence of tuberculosis, therefore, when a patient presents with characteristic symptoms, he should ask the patient control questions, such as:

• Has the patient previously had tuberculosis?
• Did his relatives have tuberculosis?
• Has he been in contact with tuberculosis patients?
• Is the patient registered with an anti-tuberculosis institution due to hypersensitivity to tuberculin?
• Did you pass ( and when) patient fluorography of the lungs
• Whether the patient was in prison or in contact with people who were previously in prison
• Is he a migrant, homeless, living in unfavorable conditions, etc.

Communication with the patient plays a very important role in diagnosing tuberculosis. From the patient’s story, you can learn some key points of the disease, for example, repeated respiratory infections he had previously suffered or some signs of latent tuberculosis intoxication, which the patient indicates.
After collecting anamnesis and a thorough examination of the patient, laboratory and instrumental studies begin.

Tuberculin diagnostics

It is an important method for diagnosing tuberculosis, complementing the clinical examination of the patient. It indicates the presence of increased specific sensitivity of the body caused by the BCG vaccine or the causative agent of tuberculosis ( mycobacterium tuberculosis). To carry out a tuberculin test, tuberculin is used - a water-glycerol extract isolated from a culture of the pathogen. Tuberculin does not cause sensitization in a healthy body, and is also not capable of developing immunity against tuberculosis. A response to tuberculin develops only in children previously sensitized by the BCG vaccine or the causative bacterium.

Mantoux test

A small area of ​​skin on the inner surface of the forearm, namely its middle third, is treated with ethyl alcohol. The needle is inserted intradermally, parallel to the surface of the skin, with the needle cut upward. 0.1 ml of tuberculin is administered, which is one dose. At the site of tuberculin injection, a small ( diameter 7-8 mm) whitish-colored bubble in the form of a lemon peel. It is very important that the Mantoux test is performed by a specially trained nurse, since if the technique is performed incorrectly, the results become unreliable. The test results are assessed 72 hours after the test. The assessment is carried out by a doctor or a specially trained nurse. First, the forearm is examined at the site of tuberculin injection. This way you can detect the absence of external signs of a reaction, the presence of redness of the skin or the accumulation of infiltrate.

Redness of the skin should not be confused with infiltration. To do this, it is necessary to compare the thickness of the skin fold of the forearm over the healthy area, and then at the site of needle insertion. The difference is that with redness the folds remain the same thickness, but with infiltration, the fold above the site of tuberculin injection thickens. After an external examination, the diameter of the reaction is measured using a transparent ruler.

There are three types of response to tuberculin:
1. Negative reaction – characterized by a complete absence of skin redness and infiltration ( 0 – 1 mm).
2. Questionable reaction – redness of the skin of varying sizes or the presence of an infiltrate with a diameter of 2 – 4 mm/
3. Positive reaction – mandatory presence of infiltrate with a diameter of 5 mm or more.

In turn, positive reactions can also be divided into several types, depending on the diameter of the infiltrate:

• Weakly positive – 5 – 9 mm.
• Medium intensity – 10 – 14 mm.
• Pronounced – 15 – 16 mm.
• Hyperergic – in children and adolescents 17 mm or more, and in adults from 21 mm. Vesiculonecrotic reactions on the skin also fall into this category.
• Intensifying - a reaction accompanied by an increase in infiltrate by 6 mm or more compared to the previous sample.

Laboratory methods for detecting Mycobacterium tuberculosis

1. Sputum collection and processing: the procedure is carried out in a specially prepared room, away from unauthorized persons. The most common method is to collect material from the larynx using a swab. Mucus is collected during coughing or expectoration. The swab is placed in a special sealed container and immediately sent for microbiological examination. Materials are also collected during the study of bronchial and/or stomach lavage waters, the study of cerebrospinal fluid, pleural fluid, bronchoscopy, pleural biopsy, and lung biopsy.

2. Sputum microscopy:
It is the fastest and cheapest method for detecting Mycobacterium tuberculosis. The method is based on the ability of mycobacteria to retain their color even after treatment with various acid solutions. So, they are detected using a microscope in stained sputum smears. Along with simple microscopy, fluorescence microscopy is also used, which is based on the use of ultraviolet rays to identify mycobacteria.

Molecular genetic methods for diagnosing Mycobacterium tuberculosis

1. Polymerase chain reaction: consists of deciphering the genetic material of Mycobacterium tuberculosis. Designed to detect pathogens in sputum and recognize types of bacteria. The method has particular sensitivity and specificity.

2. Determination of pathogen drug resistance
Those strains of Mycobacterium tuberculosis on which the drug has a bacteriostatic or bactericidal effect in a minimum concentration are considered sensitive to any particular drug.
Resistant or resistant to a given drug are those strains of mycobacteria that are able to multiply when exposed to the drug in a minimum or increased concentration.

3. Serological methods for diagnosing tuberculosis
Serological methods for studying blood plasma components are based on the detection of numerous antigens related to tuberculosis, as well as a variety of immune responses caused by various forms of tuberculosis.

4. Blood analysis
Hemoglobin and red blood cells in most cases remain unchanged, except in cases accompanied by acute blood loss. An indicator indicating the presence of an active tuberculosis process is the erythrocyte sedimentation rate. Accelerated ESR is characteristic not only of fresh active tuberculosis, but also of exacerbation of a chronic process.
Other blood test parameters vary greatly depending on the nature of the lung damage.

5. Analysis of urine
In the urine analysis of a patient with pulmonary tuberculosis, there are no noticeable deviations from the norm. Changes appear only with tuberculosis damage to the kidneys and urinary tract.

6. X-ray diagnostic methods
The most commonly used methods for diagnosing pulmonary tuberculosis are:

• Radiography
• X-ray
• 
  Fluorography
• Tomography

7. Endoscopic methods for diagnosing tuberculosis

• Tracheobronchoscopy
• Bronchoscopic lavage
• Thoracoscopy ( pleuroscopy)
• Transbronchial biopsy
• Transthoracic needle biopsy
• Pleural puncture and puncture biopsy of the pleura

All these research methods are available only in specialized medical institutions.

Timely and late detected tuberculosis

For a complete and rapid cure of tuberculosis, its timely detection is very important. Early diagnosis at the initial stages of the disease allows you to prevent its further spread, and is also the most important link in the prevention of tuberculosis infection. Tuberculosis detected in the later stages of development is very difficult to treat. In addition, such patients become epidemically dangerous to others.

A person can be a carrier of the tuberculosis pathogen for years and not suspect the presence of infection. In some cases, the symptoms of the disease appear similar to a common cold. Therefore, in the early stages it is quite difficult to identify the presence of the disease. In this material we will try to find out how tuberculosis is defined and what treatment methods should be used to eliminate the problem.

What is tuberculosis?

Tuberculosis is an acute infectious disease caused by microscopic bacteria known as Koch bacilli. The disease develops when immunity decreases as a result of damage

Tuberculosis bacteria are most often transmitted from a carrier of the disease to a healthy person by airborne droplets, which leads to the sedimentation of the tuberculosis pathogen in the lungs. Infection can also occur through household contact with bacteria, when the latter enters directly into the digestive tract.

The probability of infection is only 5% for a healthy person with good immunity. People with weakened bodies are much more likely to become infected.

The risk group includes young children and adolescents. Women under 35 years of age are much more likely to become infected with the tuberculosis pathogen compared to young men.

Factors that contribute to the development of the disease

Among the risk factors it is worth noting:

1. Prolonged contact with objects on which the causative agent of the disease is located.
2. Frequent contact with a carrier of the disease.
3. Regularly being in a dirty, unventilated, closed area.
4. A decrease in the body's protective functions as a result of poor nutrition, constant stress, alcohol abuse and smoking, and excessive physical activity.

Signs of the development of the disease in the early stages

How to identify tuberculosis at home? If the disease occurs in a latent form, it is extremely difficult to identify it in advance, since the course of the disease occurs without obvious signs. If you feel that something is wrong in the body, you should pay attention to the presence of the following symptoms:

• a strong feeling of fatigue without objective reasons;
• feeling of general physical or mental malaise;
• having a weak appetite;
• sharp weight loss with a rich, healthy diet;
• slight increase in body temperature.

Microscopic diagnostics

How to detect tuberculosis at an early stage? If the above symptoms are detected, you should go to the hospital for a sputum smear. The composition of the resulting sample is examined under a microscope in the laboratory.

It is worth noting that negative test results do not always indicate the absence of the disease. Quite often, the development of the disease at an early stage does not allow the detection of microscopic bacteria in a smear of sputum from the lungs. It is for this reason that if there are obvious ones, it is important to repeat the studies after some time.

Fluorography

How is tuberculosis defined? In the initial phase, a chest x-ray helps identify the disease. In terms of prevention, experts recommend resorting to the procedure once a year. The resulting image allows you to see foci of inflammation and notice the first signs of bacterial damage to the lung tissue.

Sputum culture

The diagnostic method involves collecting a sputum sample and then growing a bacterial culture in the laboratory. How is tuberculosis determined using this method? Such an analysis may take several months, since during tests specialists check the sensitivity of microorganisms in culture to the effects of various antibiotics. However, the study makes it possible to identify the causative agent of the disease with high accuracy.

Sputum culture is also a good way to determine the resistance of a certain type of Koch bacillus to the effects of certain medications. At the moment, there are no alternative research methods that would allow us to obtain this information.

Extrapulmonary form of tuberculosis

If the body is infected with the causative agent of the disease not through airborne transmission of infection, the development of an extrapulmonary form of tuberculosis is likely. In this case, infection may occur in the mucous membrane of the eyes, joints and bones, gastrointestinal tract, meninges, central nervous system, and genitourinary tract.

How are shapes determined? The first signs of the development of such a disease are:

• sleep disturbance, general irritability as a result of the influence of a pathogen on the central nervous system;
• increased sweating due to massive tissue intoxication by pathogenic bacteria;
• unhealthy pallor, uneven blush;
• a decrease in the level of leukocytes and erythrocytes in the blood, which is accompanied by the development of conditions characteristic of anemia.

How to determine tuberculosis in a child?

Detection of the disease in the early stages in children is part of a mandatory preventive program in educational institutions aimed at preventing epidemics. The main goal here is to identify children who are at high risk. These categories include:

1. Children who have related, family, or residential contacts with infected people.
2. Infected, which has more than 6 mm in diameter.
3. Children who suffer from nonspecific, chronic respiratory diseases.
4. HIV-infected.
5. Children who did not receive BCG vaccination at an early age.

How to identify a child with tuberculosis? For this. In addition to hyperergic injection tests, fluorography methods are used from the age of 15. If there are obvious symptoms of the disease, sputum culture is performed.

Finally

The initial stage of tuberculosis development is not easy due to the nature of the disease. The symptoms of the disease can easily be confused with the symptoms of a common cold or flu. To avoid damage to the body by the causative agent of tuberculosis, do not forget about the factors that can lead to infection. In terms of prevention, it is necessary to periodically resort to diagnostic procedures.

There are especially high risks of contracting this disease in the fall and spring.

• You can get infected with tuberculosis anywhere. It is enough that you have weak protective functions of the body and a patient with an open form of the disease sneezes on you. Then a huge amount of Koch bacilli will enter your body.
• There is a high risk of contracting this disease in people who have: the body will not be able to resist the infection.
• Excessive and physical exertion greatly weakens the body.
• The most favorable environment for bacteria to grow is damp, dark, unventilated rooms. These include prisons, places for the homeless, hospitals and even rented apartments.
• Bad habits: alcoholism, drug addiction, smoking.
• Immunity to tuberculosis is reduced by medications taken for lung diseases, as they saturate the body with toxins.

The following are at increased risk:

• Those who often come into contact with patients with “consumption”;
• people who live in terrible sanitary conditions;
• those who live in countries where there are many people suffering from this disease (mainly Africa and Asian countries);
• people with weak immune systems (especially HIV-infected people and cancer patients);
• children;
• diabetics;
• those who are poorly nourished and are often hypothermic;
• people who are treated with intravenous drugs.

Symptoms

Tuberculosis is difficult to identify in its early stages. All this because the symptoms can be very diverse. Sometimes even a therapist does not immediately recognize tuberculosis, but may confuse it with ARVI. We will list the most common first symptoms of the disease.

The very first signs of the disease, when a large amount of infection appears in the human body, will be:

• Reduced performance;
• fast fatiguability;
• weakness (even in the morning).

Infected children will experience decreased school performance, loss of appetite, and sleep disturbances. Often the temperature even rises, especially closer to night. In the evening, a person may experience chills and heavy sweating.

With pulmonary tuberculosis, the primary symptom is a cough that does not go away for a long time. Initially it is dry, worsens at night and in the morning. Then the cough becomes wet and sputum begins to come out.

If blood appears in the sputum, this indicates a severe form of tuberculosis, which can subsequently lead to pulmonary hemorrhage.

In such cases, immediate hospitalization of the patient is necessary. In addition to the above symptoms, there are other, less common:

• The patient may experience pain in the shoulders, joints, under the sternum, pallor, and even digestive disorders.
• Tuberculosis toxins can affect the heart, causing the heart to beat faster - .
• The patient may also begin to complain of a headache and enlarged lymph nodes will be noticeable.
• The body's signal can be causeless weight loss, lack of appetite, shortness of breath and even mood swings.

It is important to know that symptoms do not appear all at once. Often one or two appear. Therefore, if you notice at least one of them, you should not put off going to the doctor and self-medicate. Remember that a disease in the early stages is much easier and faster to cure.

Forms

Many people are mistaken when they think that there is only pulmonary tuberculosis. There are other types that have their own symptoms.

Pulmonary tuberculosis.

Manifests itself in the form of a prolonged cough, chest pain, increased sweating, shortness of breath, and weight loss. If these symptoms appear, see your doctor immediately.

Tuberculosis of the nervous system.

It entails apathy, increased blood pressure, swelling of the brain and fatigue.

Tuberculosis of bones and joints.

It can be identified by increased bone fragility, joint pain and even curvature of the spine.

Tuberculosis of the genitourinary system.

Can easily be confused with ordinary inflammation. Only a qualified doctor can diagnose it.

Intestinal tuberculosis.

There is indigestion. Frequent abdominal pain, diarrhea and bloating appear. This form of the disease is fraught with intestinal obstruction, resulting in bleeding.

Lupus.

Few people know that even skin tuberculosis exists. If you notice that the color of the skin has changed, “pustules” have appeared, or the lymph nodes have enlarged, immediately contact a dermatologist or phthisiatrician.

Diagnostics

Tuberculosis can be correctly diagnosed only after a visit to a phthisiatrician. The most common and easiest way to identify the disease is the Mantoux test.

A person is given an injection in the arm and after 72 hours they look at the mark of the injection. The diameter is measured with a ruler. A deviation from the norm indicates that the body needs to be further examined more thoroughly.
In diagnosing tuberculosis, doctors and patients often resort to X-rays of the lungs. But this method is not always accurate, because in addition to lung disease, there are many other forms of the disease.

It ranks second after AIDS. This insidious disease annually affects millions of working people around the world.

Many people are interested in whether it is easy to become infected with this disease and how to identify tuberculosis?

There are many diagnostic procedures for this, but despite this, the incidence of tuberculosis is steadily increasing every day. Therefore, if you suspect that you are infected with it, it is better to check everything and find out in a timely manner.

Pulmonary tuberculosis is a fairly ancient disease. It has been known since the times of Ancient Greece. Back then, those suffering from this pathology were called phthisis or emaciated.

From this word came the definition of the branch of medicine that studies this problem - phthisiology, and the specialist who treats such patients - phthisiologist. These doctors say that if treatment is started in a timely manner, the chances of recovery are quite high.

Unfortunately, people do not always seek qualified help in a timely manner due to its meager symptoms in the initial stages.

There is a fairly common misconception that tuberculosis is an asocial disease that affects homeless people, alcoholics and former prisoners. In fact, almost anyone can get it.

How to recognize this terrible disease?

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis (Koch bacillus) and characterized by the appearance of granulomas in various places in our body. These granulomas are very similar to tubercles - tubercles. Hence the name tuberculosis.

Over time, they can turn into caverns - cavities in the lung tissue. The disease can occur in pulmonary or extrapulmonary types. Pathology can affect literally any organ in our body. Most often it develops, but other organs may also suffer (in this case, the disease is even more difficult to identify).

It is not difficult to become infected with this pathology; the pathogen can enter the body in the following ways:

1. airborne;
2. contact household;
3. food;
4. intrauterine.

The most common method of infection is airborne. A patient releases billions of mycobacteria while talking, coughing, and even breathing. You can “catch” such a microbe in public transport, in a store, and even on the street.

The contact and household route of mycobacteria entering the body is possible through kissing, sharing household items and his things with the patient. But such infection does not occur very often.

It is even less common for people to become infected by eating the meat of sick animals or drinking their milk. But such infection cannot be completely excluded.

If the expectant mother has pulmonary tuberculosis, the child will not necessarily become infected during childbirth, but such an outcome is not excluded.

Clinical manifestations

From the moment the infection enters the body and the disease develops, a certain period passes, it is called incubation. It can last from three to twelve months. At this time, the pathogen spreads throughout the body in the blood, but the immune system actively fights it.

This period is characterized by an asymptomatic course. Such a patient cannot yet infect another person. Diagnostics can also be negative.

If there is a suspicion that a person has pulmonary tuberculosis, then how can it be determined?

To do this, you need to know what the main signs of pathology are.

The first symptoms appear only after all the resources of the immune system to fight the disease have been exhausted.

So how do you know if you have tuberculosis?

The first sign is a long period of increase in body temperature to subfebrile levels. It can last three weeks or more.

The second most important symptom that may indicate the presence of a tuberculosis infection in the body is a cough, which also lasts for at least three weeks. At first it is dry, but over time it becomes moist and phlegm appears. In advanced cases - with an admixture of blood.

Are there other manifestations of the disease?

The most common complaint reported by patients is drenching night sweats. Pulmonary tuberculosis can be confused with the onset of ARVI, as it is characterized by the following symptoms:

• weakness;
• chills;
• dizziness;
• weight loss;
• pale skin;
• nausea;
• chest pain;
• dyspnea.

As for damage to other organs, the symptoms here are even more severe. With tuberculosis of the genital tract, women may experience intermenstrual bleeding, pain in the lower abdomen, deformation of the tubes, and in men - swelling of the scrotum.

Tuberculosis of the urinary system is characterized by blood in the urine - hematuria.

Bone tuberculosis may go undetected for years, as its manifestations are similar to other forms of arthritis, such as rheumatoid arthritis. Other types (tuberculosis of the nervous system, gastrointestinal tract) are even less common, mainly in HIV-infected people.

The most dangerous manifestation is when the pathogen spreads throughout the body, many microgranulomas occur. If you take an X-ray of such a patient, he will look as if he was sprinkled with millet.

Methods for diagnosing tuberculosis

So how to identify tuberculosis?

For a long time, it has been determined using the Mantoux test. Many people call this manipulation grafting. But this is far from it. With its help, the body’s readiness to protect itself from infection is determined. But it is indicative only in relation to children.

In adults it is interpreted somewhat differently. Fluorography, as a method for diagnosing tuberculosis, is used most often. It helps diagnose lung damage. The lesion in tuberculosis is usually located in the upper lobes (like cancer, so differential diagnosis of both pathologies is necessary).

Radiography helps confirm and clarify the presence of a lesion identified on fluorography. It gives a more accurate concept of a granuloma or cavity, but is harmful to the body, which is why it comes in second place after it.

Bacteriological has long been known, but is still popular. Each patient who comes to a medical institution with complaints of cough undergoes a microbiological examination of the smear, where mycobacteria are determined in case of large contamination. In this case, the material to be diagnosed is applied to a glass slide, stained according to a certain principle, and viewed under a microscope.

No less popular is enzyme immunoassay. The analysis does not provide too much information about how far the process has progressed. It is useful in that it allows you to determine the presence of a pathogen in the body, which makes sense for identifying extrapulmonary forms.

– the process is complex and not always promising. To do this, chemotherapy is used, which is very toxic and has many side effects. In addition, it is necessary to undergo symptomatic therapy.

In some cases, surgical treatment is used if medications do not bring the desired effect.

Often the efforts of doctors do not bring the expected result, most often this is due to the advanced state of the disease. Therefore, at home, it is better not to try to determine whether a person has tuberculosis.

Or mycobacterium, of the respiratory system and is the cause of pulmonary tuberculosis. More than 1 million children and about 9 million adults on the planet are infected annually, and according to the World Health Organization, 3 out of 10 people are already its carriers. That is why it is so important for everyone to undergo an annual thorough examination for tuberculosis, regardless of age, social status and gender. Modern methods of diagnosing pulmonary tuberculosis make it possible to timely determine the form, severity, predict the consequences of the disease, and prescribe full-fledged intensive treatment. And you shouldn’t think that being diagnosed with tuberculosis is a death sentence. Early detection of tuberculosis and the capabilities that medicine has today contribute to the recovery of more than 70% of all patients who apply.

The modern Koch bacillus and its numerous strains, of which there are more than 74, are very different from the previously discovered mycobacterium. The ability of a virulent bacillus to penetrate healthy host cells and remain undetected in the human body, viability and resistance to acidic environments and disinfectants make the task very difficult for doctors and laboratory staff.

Diagnosis of pulmonary tuberculosis requires more and more new capabilities in order to conduct a full-fledged study. This also applies to people who are in a special risk group and have a predisposition to the occurrence of tuberculosis: HIV-infected patients or diagnosed with AIDS, with dependence on alcohol, drugs and nicotine products, with diabetes mellitus, bronchial asthma and hereditary factors. Newborn children from an infected mother, minors and adolescents under 17 years of age, people of retirement and old age also need medical supervision.

There is another category of potential carriers of the disease - infected prisoners. But “prison” tuberculosis, the causative agents of which are mainly resistant new strains of the Koch virus, and its diagnosis with subsequent treatment can prevent the spread of the disease and the danger of infecting others after a person leaves prison.

How does pulmonary tuberculosis manifest?

The danger posed is that at an early stage, detection of the disease is not always possible due to the absence of pronounced symptoms. In other cases, the disease actively progresses. How to diagnose tuberculosis and what signs you should pay attention to:

1. dry prolonged cough or with sputum production, wheezing;
2. constant body temperature 37°C;
3. pale complexion and tired appearance;
4. decreased appetite and weight loss;
5. shortness of breath and pain in the side;
6. profuse sweating.

In women, the causes are menstrual irregularities and frequent headaches; from the urinary system, cystitis or bloody discharge in the urine is possible.

Early diagnosis of tuberculosis in children and adolescents

Older people are able to objectively assess their health status and monitor it, and seek help from specialists. Minor children do not yet understand the full danger of infectious diseases, therefore, in preschool and educational institutions, measures are constantly being taken to prevent tuberculosis.

Clinical examination is the main primary type of examination. A pediatrician or phthisiatrician is obliged to listen to the complaints of a small patient and carefully read his medical record to determine congenital pathologies of the respiratory system and chronic diseases of the thyroid gland. An important role is played by the integrity and color of the skin, normal temperature - 36.6°C - 36.7°C and the absence of wheezing or shortness of breath when listening with a stethoscope.

If the general condition is assessed by the doctor as satisfactory, further methods for early diagnosis of tuberculosis in a child include mandatory Mantoux test and BCG vaccination once a year. Parents do not trust the composition of the vaccine and refuse to give their child tuberculin. In this case, they are obliged to provide as soon as possible the results of the tuberculosis test, which was done instead of Mantoux.

Detection of pulmonary tuberculosis in adults

Frequent colds or exacerbations of chronic diseases, infections and inflammatory processes that are provoked by hypothermia, heavy physical work or low immunity can cause tuberculosis in the older generation. The Mantoux test is an underpowered test for adults. Vaccination is used after treatment of tuberculosis infection or in the presence of pronounced signs of the disease. There are diagnostic examination methods for recognizing tuberculosis in adults.

Most often, during an annual medical examination, doctors prescribe fluorography or x-ray of the lungs. An overview method of chest imaging gives an idea of ​​the state of the respiratory organs in the form of a black and white image, on the basis of which a focus of tuberculosis can be detected. Suspicion by a radiologist or detected pathologies of the respiratory system will require additional examination.

Tuberculin diagnostics

In order to prevent the spread of the disease among the younger generation, a subcutaneous injection or Mantoux test is used, which is carried out every year. The child receives the substance tuberculin or a strain of the tuberculosis pathogen created in artificial laboratory conditions. The weakened mycobacterium should cause a reaction from the immune system at the injection site. Evaluate the result of the Mantoux test after 72 hours:

1. negative - up to 1 mm
2. doubtful - 2-5 mm;
3. positive - more than 6 mm;
4. weakly positive - 5-9 mm;
5. average intensity level - 10-14 mm;
6. pronounced - up to 16 mm;
7. hyperergic. In children and adolescents - more than 17 mm, in adults - more than 21 mm.

In addition, there are also false indicators. Previous data is also taken into account. Even a negative result does not guarantee the absence of Koch's bacillus in the body. But even with such shortcomings, the Mantoux test is the most common prevention and diagnosis of tuberculosis in children and adolescents in the early stages. Vaccination is unacceptable for allergies and bronchial asthma, inflammation and diseases of the digestive system, and diabetes.

Tests for tuberculosis

Traditional methods of prevention and early detection of tuberculosis can be replaced with the help of an enzyme-linked immunosorbent blood test, which is often used instead of the Mantoux test. The principle of this study is the immune response of the body, antibodies to the IgG and IgM antigens of the pathogen, mycobacteria. During the analysis process, protective cells containing a staining substance are placed in a medium containing suspected M. Tuberculosis bacilli, which interact with the source of infection and transfer part of the enzyme to the virus.

"Diaskintest". A trial attempt to replace an existing tuberculin test. The main active ingredient is not a weakened strain of mycobacterium of the human and bovine type, as in tuberculin, but a protein with an antigen of the causative agent of tuberculosis, unique to humans. Diaskintext limits the number of false positives and detects only the active virus. At the beginning of the disease it gives negative results.

PCR diagnostic method. For laboratory testing, it is better to use sputum. When exposed to high temperature, foreign DNA is released. In order to identify mycobacteria or their strains, the sample is compared with those already obtained previously. Diagnosed tuberculosis can be obtained within 5 hours after the delivery of the starting material. The procedure is often used for children with contraindications for tuberculin diagnostics or to confirm the diagnosis.

X-ray examination

It is prescribed during an annual medical examination for representatives of the older generation. Children are not allowed to undergo the procedure due to the high dose of radiation for the immune system that is not yet strong enough. Radiation diagnostics is intended for screening chest organs, searching for foci of tuberculosis and preventing other pathologies.

X-ray and fluorography of the chest organs. Using a special screen, X-rays pass through the body of the person being examined, the shadow image is processed and transferred to film. Development takes a few minutes. Digital fluorography displays a finished image on the monitor, which is printed in black and white on a printer or saved electronically. The fluorography image shows focal, infiltrative and chronic lesions in the form of foci.

Computed and magnetic resonance imaging of the lungs. Methods of a more informative nature for the accurate detection of tuberculosis, which make it possible to accurately determine the size of lesions and fluid accumulations, pathologies. The sensitivity is 100 times higher than fluorography and x-rays.

General blood test for tuberculosis

Studying the composition and quantitative indicators of liquid connective tissue, which, one way or another, encounters the M. Tuberculosis bacillus, is important for early diagnosis of the disease. With tuberculosis, the patient experiences moderate anemia, the hemoglobin level in men is below 130, in women less than 120. During the period of exacerbation of the pulmonary form, the granularity of leukocytes changes and their number increases from 20% to 50%, the number of eosinophils, young immune cells, decreases.

But the main indicator of tuberculosis activity is the erythrocyte sedimentation rate or ESR. This test shows the ability of red blood cells, whose density is greater than plasma, to settle under the influence of gravity. In a healthy body, the norm for women should not exceed 15 mm/hour, for men - 10 mm/hour. An increase in ESR from 20 mm/h to 80 mm/h indicates a large amount of immunoglobulins and a low level of albumin in the blood, which means the activation of the body's defenses under the influence of foreign cells.

A leukogram is often used, which is based on changes in the protein composition of the blood during an acute inflammatory process. The indicators of leukocytes such as neutrophils, eosinophils, basophils, monocytes and lymphocytes are taken into account. Examination for pulmonary tuberculosis distinguishes three phases of damage to the body’s immune system:

• neutrophilic. Active defensive reaction. The number of neutrophils increases, the level of monocytes and lymphocytes decreases, eosinophils are absent;
• monocytic. Trying to overcome tuberculosis infection. The number of neutrophils is low, single eosinophils are visible, lymphocytes increase;
• recovery. Observed after the patient has recovered. The number of lymphocytes and eosinophils is increased, but their levels return to normal.

In comparison with ELISA and PCR tests, the tuberculosis pathogen itself will not be detected, but changes in blood composition will be enough to suspect the presence of an inflammatory process in the body and continue the examination aimed at finding the source.

Method for detecting acid-fast mycobacteria

A feature of the cell wall of the tuberculosis bacillus is the lack of reaction to chlorine-containing agents and acidic environments. Therefore, diagnostic measures in laboratory conditions are often impossible to perform. Microscopic methods of examining a smear in such cases are replaced by bacterioscopy or staining of sputum.

Microscopy of a smear or material containing AFB is carried out using the Gram method and a staining method known as. The Koch virus is first exposed to the red substance carbol fuchsin, which penetrates the cell membrane, and then is treated on top with a solution of methylene blue. A positive result of the presence of a tuberculosis bacillus will be the presence of red mycobacteria in a smear on a blue background. In modern medicine, auramine-rhodamine is more often used. After exposure to the ultraviolet spectrum, the bacilli acquire a yellow tint.

Bacteriological study of bronchial lavage waters

It is used as an additional method of collecting sputum and a method for identifying the causative agent of tuberculosis in it, when the patient is unable to collect the material on his own or the amount of secretions is not enough to conduct an examination. It is prohibited to prescribe to people of retirement age, with diseases of the cardiovascular system and bronchial asthma, and to children under 15 years of age.

The procedure involves local anesthesia of the respiratory tract and the introduction of a heated saline solution into the larynx using a special syringe to increase the level of secretion. After the manipulations, the patient’s sputum is intensively secreted naturally and collected by medical workers in a test tube for subsequent sowing and cultivation of mycobacteria.

Needle biopsy of the lung

To determine the pathological process occurring in the lungs and obtain an initial sample, invasive diagnostics of tuberculosis in adults is prescribed. It is aimed at studying the causes of coughing up blood, internal pulmonary bleeding, obvious respiratory failure, taking material from the mucous membranes, bronchial secretions or sputum, and obtaining a sample of the affected area.

A prerequisite for puncture biopsy is clear control over the actions performed through an ultrasound machine or using X-rays. The essence of the procedure consists of local anesthesia of the chest area and insertion of a Silverman needle to capture and separate a fragment of lung tissue. After a biopsy, the degree and form of damage to the respiratory system is determined. In advanced cases, they resort to open surgery under general anesthesia.

Bronchoscopy

To study and assess the extent of damage to the pulmonary system, including the trachea, bronchi and mucous membranes, in medical practice they are increasingly giving preference to endoscopic diagnosis of tuberculosis. Indications for the procedure include a prolonged cough that has been observed in a person for more than 1 month, sputum with blood, and previously identified pathologies in the lungs.

During the examination, local anesthesia and muscle relaxants are necessary to ensure free passage of the flexible tube with the light-conducting device into the airway. Taking mucosal material or secretions from the trachea and bronchi helps to study the cytological composition of sputum for the presence of foreign cells of the tuberculosis bacillus.