What is open form of tuberculosis? The first signs of open tuberculosis, how to detect and how to cure

Open form of tuberculosis – dangerous disease, which primarily affects the lungs and poses a threat to human health and life. The pathology is quite common and is diagnosed in people different ages, floors and social groups. Particularly dangerous high degree contagiousness of the disease. The mortality rate from the disease is also quite high, which is often due to the patient’s late seeking of medical help.

Causes and routes of transmission

The acute form of tuberculosis primarily affects the lungs, but generalized pathology can infect any internal organ, including the brain. The causative agent of the disease is Koch's bacillus, which is resistant to disinfection with alkalis and acids. The bacterium remains active for a long time even outside a living organism (on the soil, in a sink or clothing). This is due to the high contagiousness of the disease.

Transmission of infection occurs in two ways. In airborne infections, bacteria are transmitted through saliva. This can happen when you sneeze, cough, or kiss. This way the infection spreads instantly, and infection is inevitable. Less commonly, the open form of tuberculosis is transmitted through household contact, for example, through common objects (dishes, towels and other things).

The disease is dangerous for all people, but the following categories are at particular risk.

HIV-infected. Tuberculosis develops as a complication of the underlying disease.

Doctors. Due to their professional activities, they are forced to come into contact with patients, including those diagnosed with an open form of the disease. To protect yourself, you must use gauze bandage and gloves during patient contact.

Elderly people, which is due to a decrease in the body's defenses as a result of aging and the activation of degenerative processes.

Homeless people who live in constant unsanitary conditions do not receive good nutrition and medical care.

People with weakened immune systems as a result serious illness, for example, cancer, diabetes, alcohol or drug addiction.

Symptoms

Clinical picture pathology is similar to the manifestations of some other diseases viral etiology. Below are the distinctive symptoms open form tuberculosis.

• Persistent severe cough that gets worse during physical activity and at night. Hemoptysis is often observed, which contributes to the maximum spread of bacteria among others.
• Copious secretion of sputum with high content Koch's sticks. The daily secretion of biological fluid can reach 100 ml.
• General weakness, drowsiness and complete apathy.
• Increased sweating, which is especially acute at night.
• High temperature, which often reaches febrile levels.
• Apathy, absence vitality and loss of interest in previous hobbies.
• Sharp weight loss without changes in diet and without increasing physical activity.

Initially, the clinical picture is blurry, there are practically no symptoms. Main danger This condition is that the patient is unaware of his pathology and continues to lead a socially active lifestyle: he goes to work, shops and visits public places. This risks spreading the infection and infecting others.

The open form of the disease is characterized by the spread of infection in the upper respiratory tract. The lungs weaken, which leads to complications, most often pneumonia. The infection spreads through the bloodstream throughout the body, affecting the liver, bones, spleen and other organs. The disease progresses rapidly and can lead to fatal outcome.

Diagnostics

A number of specialized tests are performed to identify the disease. They are aimed at identifying the disease at an early stage.

The Mantoux test is performed once a year. Tuberculin is injected under the skin. If after the test the size of the papule increases by more than 5 cm, this may indicate the presence of a pathogen.

The Diaskin test is an alternative to the Mantoux test. This type of research is very effective and accurate. The test is carried out to obtain more detailed information if the papule after Mantoux is in doubt.

X-ray examination of the lungs reveals fibrous compactions in the image.

For rate general condition the patient undergoes classical laboratory tests: general and biochemical analysis blood tests, urine tests and liver tests.

Treatment

During treatment of open tuberculosis, the patient is isolated from society in a specialized dispensary. This safety measure is necessary to prevent the spread of infection to others. The patient is given long-term sick leave. Without treatment, patients rarely live more than 6 months.

To prevent the spread of infection, separate utensils and hygiene products should be used. Paper tissues containing the patient's biological fluid are burned. Sputum must be spat into specialized containers that are tightly closed with a lid. It is strictly forbidden to spit on the ground, into a sink or a handkerchief. The room where the patient stays is constantly ventilated and disinfected.

Antibiotics are used to treat the disease. Typically, Ethambutol, Isoniazid, Rifampicin and Pyrazinamide are used. Therapy continues for at least 6 months, and in particular difficult cases The duration of the course is 2 years (for example, when tuberculosis affects several organs at the same time). For achievement maximum result Doctors combine medications.

Antibiotics that are prescribed during treatment disrupt the intestinal microflora, reduce immunity and worsen general health. After complete cure a long period of rehabilitation is required, which includes taking pro- and prebiotics, restorative drugs and vitamin-mineral complexes.

Prognosis and prevention

With timely treatment, the prognosis is favorable for life and health. Launched form The disease threatens the development of complications (pneumonia, brain damage, etc.), and in particularly difficult cases leads to death.

To prevent the development of the disease or relapse, it is necessary to avoid contact with people who have obvious signs of pathology. You should not visit tuberculosis dispensaries unless necessary. It is important to give up smoking, alcohol and other bad habits which reduce immunity and contribute to the development of the disease. It is useful to lead a physically active lifestyle and play sports.

The question of whether pulmonary tuberculosis can be cured forever is still open to most people. Despite the fact that experts have learned to identify this disease in the early stages, the number of chronic tuberculosis patients still remains high. This turns the disease in the eyes of most people into the most dangerous disease, which is almost impossible to get rid of. However, it is not. Is it possible to cure tuberculosis completely? It all depends on the stage at which the disease was detected, as well as how effectively the treatment was carried out.

How does infection occur?

Tuberculosis is infectious disease. Its causative agent is Koch's bacillus (or). The peculiarity of this microorganism is its extraordinary vitality in the external environment and its ability to adapt to various unfavorable conditions. There are cases when the Koch bacillus in the body goes into a “dormant” state, which reduces to almost zero the possibility of curing pulmonary tuberculosis until it manifests itself.

Disease infection occurs by airborne droplets. Koch bacilli become airborne when coughing, sneezing, and even when talking to a patient suffering from an open form of tuberculosis. When air is inhaled, microorganisms enter the body of a healthy person and infect the lungs.

Can tuberculosis be transmitted in other ways?

Unfortunately yes. If you exclude complete contact with patients, this will not give a 100% guarantee that a person will not become infected with this disease. Infection can also occur through the use of household items, as well as simply by being in the place where the patient was previously. In the external environment, Koch's bacillus can live for about 30 days. Unprocessed food can become a source of infection. Tuberculosis infection is transmitted in utero: from mother to child.

Throughout life, a person encounters Koch’s bacillus more than once and even becomes infected with tuberculosis. But this may not lead to illness at all and may even go away without a trace. The development of the disease depends on how strong the body and its protective properties are, how aggressive the infection is and how much it has entered the human body.

How does tuberculosis manifest?

Tuberculosis is curable if it shows up early stages. Often the disease is disguised as flu, bronchitis and even allergies. The optimal way to detect tuberculosis is a fluorographic examination, which adults must undergo annually. For children, tuberculosis is diagnosed using the Mantoux tuberculin test. The earlier the infection is detected, the higher the chance of recovery.

You should closely monitor your health and, in case of the first signs indicating illness, consult a doctor immediately. Without timely treatment the disease can develop into severe form. You should not hope that the disease will be “cured” or go away on its own.

Next general symptoms tuberculosis can be observed for 3 weeks:

1. Non-falling heat(above 38°C).
2. Increased sweating.
3. Chest pain and persistent cough with sputum production (sometimes mixed with blood).
4. Sudden loss of body weight.
5. Fast fatiguability.
6. Lack of appetite.

In addition to the lungs, Koch's bacillus can affect other parts of the body, including bones, skin, intestines, eyes, genitourinary system, and liver.

There are two. In the open form, mycobacteria are excreted in sputum during external environment, the patient becomes dangerous to others. In this case, there is a greater chance of recovery. With a closed form, the patient is not dangerous; microorganisms in the sputum are not detected. In this case it is assigned x-ray examination, which identifies the disease and determines subsequent treatment.

Whether tuberculosis can be cured largely depends on how promptly the patient consults a doctor.

Treatment of tuberculosis

You should not hope that the infection will go away on its own, relying only on the body’s immune forces.

Anti-tuberculosis therapy is always long-term and complex. Even with a relatively mild course of the disease, you should strictly follow all the instructions of the attending physician. Interruptions in treatment or its premature cessation can lead to the development of infection resistance to a number of drugs. This type of disease becomes incurable and becomes chronic.

If you have been diagnosed with tuberculosis, then at the first stage you undergo treatment in a hospital, where you are prescribed intensive therapy, which may include taking up to 4-5 anti-tuberculosis drugs. From an epidemiological perspective, inpatient treatment (from 2 to 4 months) is important because the patient becomes safe for others.

The basic principle by which tuberculosis can be cured is continuous use of medications. The average number of tablets is about 10 per day, this is how you can suppress the spread of microbes in the body and subsequently achieve their complete destruction.

Tuberculosis cannot be cured with traditional methods; they can be used as part of auxiliary therapy and strictly under the supervision of a medical specialist.

After returning from hospital treatment, a person who has had tuberculosis should adhere to a number of important recommendations.

For example, carry out special therapeutic exercises prescribed by a doctor; spend as much time in the fresh, clean air as possible, taking walks in parks and green areas; eat healthy food, full of vitamins and microelements. It is necessary to cure tuberculosis only in a complex of measures, so attention should be paid to all aspects healthy image life.

When asked whether tuberculosis is curable or not, modern doctors They answer positively, since the guarantees of recovery for this disease are very high. However, one should remember a number of cases when the disease is advanced. It is impossible to get rid of tuberculosis without treatment, so you should be attentive to any changes in the body and consult a doctor in a timely manner.

Disease prevention

People most at risk of developing tuberculosis are those suffering from alcoholism, diabetes mellitus, and HIV infection. They should especially carefully monitor their health and immediately stop communicating with those who have been diagnosed with a tuberculosis infection.

In order to minimize the risk of tuberculosis, healthy people should adhere to some recommendations that are not at all difficult to implement.

For example, you should spend as much time as possible on fresh air, get out into nature as often as possible, and also play sports; eat only carefully processed foods, especially dairy products; wash your hands frequently; regularly ventilate the room; undergo a fluorographic examination annually in order to early detection possible illness.

A healthy diet and the absence of bad habits will increase immunity and significantly reduce the risk of tuberculosis.

Tuberculosis has long been considered in medicine as one of the most common and dangerous diseases. Despite all the achievements modern science, the disease cannot be defeated, and people continue to die from it every year. The disease is insidious in its unpredictability; it has several behavior patterns.

Depending on the various circumstances tuberculosis infection may go undetected or cause serious problems with health, even death.

Is tuberculosis contagious and how contagious? Let’s look at this in more detail.

The degree of danger depends on the form and stage in which it is determined in a person this disease. The most dangerous is. A disease in a closed form (latent) has less ability to transmit infection to the external environment.

Having invaded the body, mycobacteria may not manifest itself for years. The person is completely unaware that his condition poses a threat to others—his health does not give any signals of an “invasion.” Meanwhile, the infection begins to slowly but methodically spread throughout the internal organs - tuberculosis intoxication of the body occurs.

Harmful bacteria travel through the cells through the bloodstream, choosing the most unprotected organs to stop. human body. Having gained a foothold in convenient location, mycobacteria begin their destructive work.

From this moment on, a person is considered a carrier of tuberculosis, and he becomes especially dangerous to society.

If the body is strong - the immune system mobilizes to fight the aggressor. Weak immunity If you are unable to cope with Koch's wand on your own, you will need long-term and serious treatment.

Tuberculosis begins its development with the formation of primary affect in the affected area. Koch bacilli are captured by macrophages (special cells capable of aggressively capturing other bacteria, particles of dead cells, and other microparticles harmful to the body), penetrating into the lymphatic system.

Mycobacteria have two routes of penetration into organs: lymphogenous or hematogenous.

In the affected areas, a granulomatous process begins to develop: focal necrosis forms in the central part, surrounded by lymphocytes, macrophages, and epithelial cells. The result of granuloma is sclerosis.

In medicine, it is customary to divide the disease into pulmonary and extrapulmonary forms. The first is the most common, the second is numerous and has many variations.

Tuberculosis at the beginning of its journey: how contagious is the initial form of the disease?

There is an opinion that in the embryonic state the infection is quite harmless and tuberculosis infection cannot occur - the bacilli are still too weak and have a short-term effect on the body. However, this is not entirely true. It all depends on the form of manifestation of the disease, which regulates the degree of its contagiousness.

An unambiguous answer to the question of whether tuberculosis is transmitted to initial stage, No. First of all, it is necessary to understand which phase is considered the initial one: the actual introduction of mycobacteria into organs, or its infiltrative form.

If the definition means the first option, the starting point of tuberculosis is not terrible. In addition, the disease may not manifest itself in any way throughout the life of the infected person.

Another thing is the infiltrative phase. This stage is highly contagious because hallmark This phase is characterized by a cough that sprays droplets of sputum into the environment.

The initial stage, even in its most harmless form - serious reason pay attention to your own health so as not to miss the possible moment of overflow of harmless, “dormant” tuberculosis into active form with the most serious consequences.

“Risk groups”: who is at risk from Koch’s wand

Just a few years ago, it was believed that only disadvantaged segments of the population get sick with tuberculosis - prisoners in prison, people without a fixed place of residence and other citizens leading an asocial lifestyle.

The disease in such cases had an open, long-standing form and was maximally contagious to the environment of the carrier.

The disease was often detected in people living in difficult living conditions, with low incomes, and socially unprotected people. However, recently mycobacteria have begun to be diagnosed in quite healthy people. It turned out that no one is protected from tuberculosis - the disease is so tenacious and omnivorous.

Diabetics, people with gastrointestinal diseases, as well as in the case of constant hormonal treatment should be especially attentive to the possibility of “acquiring” the disease.

The most “infectious” forms of the disease

If the diagnosis is accurately established, the first thing that interests the sick person and his everyday environment is whether the detected disease is contagious or not, how successfully it is cured.

Open pulmonary tuberculosis is one of the most dangerous diseases. This variety poses a health threat not only to the carrier itself, but also to everyone who somehow comes into contact with him in everyday life.

In this case, the highest ability of mycobacteria to infect everyone within a radius of several tens of meters from the owner of the Koch bacillus is observed.

Transmission of a pulmonary infection occurs through airborne droplets when a sick person coughs or sneezes.

It “distributes” many tiny tuberculosis bacilli into the environment and soil from infected sputum, which is spat out by the carrier of the disease.

Tuberculosis is insidious and infectious, having “made a nest” in other organs: kidneys, bone tissue, lymphatic system, genitals. The number of people infected with extrapulmonary species is somewhat less than those with pulmonary tuberculosis, however, even here frequent results are severe complications and death.

Infection can be avoided: measures to prevent tuberculosis

Unfortunately, even the most experienced and titled doctor is unable to guarantee protection against tuberculosis infection - the area of ​​spread of the infection is too large. However, several useful knowledge help take measures to protect against this serious disease.

Firstly, try to avoid direct contact with carriers of open tuberculosis. If contact is unavoidable (in case of illness among family members), it is not always possible to completely eliminate the risk of infection. In this case, you must carefully follow the recommendations of the doctor treating the sick relative.

The room must be ventilated and disinfected—mycobacterium tuberculosis retains its ability to infect for quite a long time. The patient must be provided with dishes and personal hygiene items for individual use.

Second rule - V in public places It is necessary to stay away from fellow citizens who are coughing or sneezing, especially if saliva is freely sprayed into the air.

The listed measures can reduce the possibility of contracting an infection, but a more significant guarantee is timely vaccinations against tuberculosis, regular visits to the fluorography room and timely treatment of detected tuberculosis.

Tuberculosis is a specific infectious process caused by tuberculosis bacillus(Koch's wand). The forms of tuberculosis (types of manifestation of the disease) can be very different. The prognosis of the disease, the type of treatment, the risk to the patient’s life, and much more depend on the form of tuberculosis. At the same time, knowledge of the features various forms tuberculosis will help to better navigate the mechanisms of disease development and understand the complexity of the specifics of tuberculosis as a disease.

Open and closed form of tuberculosis

As is known, tuberculosis is infectious disease, and as with many other infectious diseases, people with tuberculosis may or may not be contagious. Unlike other infectious diseases (for example, hepatitis B or C) for which the patient’s infectiousness is maintained almost throughout the entire course of the disease, in the case of tuberculosis the patient’s status (infectious/non-infectious) may change depending on the stage of development of the disease and the effectiveness of the treatment undertaken. The term open tuberculosis means that the patient releases microbes that cause tuberculosis into the environment. This term is applied mainly to pulmonary tuberculosis, in which germs are released when coughing and expectorating sputum. Open tuberculosis also called BC+ (or TB+) - this means that when microscopic examination A smear of the patient's sputum revealed the bacteria that cause tuberculosis (Koch's bacillus, TB, tuberculosis bacillus). In contrast to the BC+ form of tuberculosis, there is a BC- (or TB -) form, which means that the patient does not release germs into the environment and is not infectious. The term “closed tuberculosis” is rarely used; its equivalents BC- (or TB-) are more often used.
A patient with closed form of tuberculosis cannot infect other people.

Primary and secondary tuberculosis

It is customary to speak of primary tuberculosis when the disease develops during the patient’s first contact with microbes. In the case of primary tuberculosis, the patient’s body is not yet familiar with the infection. Primary tuberculosis ends with the formation of fossilized foci of inflammation, in which “dormant” microbes remain for a long time. In some cases (for example, with a decrease in immunity), the infection may reactivate and cause a new episode of the disease. In this case, it is customary to talk about secondary tuberculosis. In the case of secondary tuberculosis, the patient’s body is already familiar with the infection and therefore the disease proceeds differently than in people who have contracted tuberculosis for the first time.
Pulmonary tuberculosis can take various forms:

Primary tuberculosis complex (focus of tuberculous pneumonia + lymphangitis + mediastinal lymphadenitis)
- isolated lymphadenitis of the intrathoracic lymph nodes.

Based on the prevalence of pulmonary tuberculosis, there are:

Disseminated pulmonary tuberculosis

Disseminated pulmonary tuberculosis is characterized by the presence of multiple specific foci in the lungs; at the onset of the disease, a predominantly exudative-necrotic reaction occurs, followed by the development of productive inflammation. Variants of disseminated tuberculosis are distinguished by pathogenesis and clinical picture. Depending on the route of spread of Mycobacterium tuberculosis, hematogenous and lymphobronchogenic disseminated tuberculosis are distinguished. Both variants can have a subacute or chronic onset of the disease.
Subacute disseminated tuberculosis develops gradually, but is also characterized severe symptoms intoxication. With hematogenous genesis of subacute disseminated tuberculosis, the same type of focal dissemination is localized in the upper and cortical parts of the lungs; with lymphogenous genesis, foci are located in groups in the hilar and lower parts of the lungs against the background severe lymphangitis with the involvement of both the deep and peripheral lymphatic network of the lung in the process. Against the background of foci in subacute disseminated tuberculosis, thin-walled cavities with mild perifocal inflammation can be detected. More often they are located in symmetrical areas of the lungs; these cavities are called “stamped” cavities.

Miliary pulmonary tuberculosis

Miliary pulmonary tuberculosis is characterized by the generalized formation of foci, mainly of a productive nature, in the lungs, liver, spleen, intestines, meninges. Less commonly, miliary tuberculosis occurs as a lesion of only the lungs. Miliary tuberculosis most often manifests itself as acute disseminated tuberculosis of hematogenous origin. According to the clinical course, a typhoid variant is distinguished, characterized by fever and severe intoxication; pulmonary, in which the clinical picture of the disease is dominated by symptoms of respiratory failure against the background of intoxication; meningeal (meningitis, meningoencephalitis), as manifestations of generalized tuberculosis. At x-ray examination dense dissemination of the same type is determined in the form of small foci, often located symmetrically and better visible on radiographs and tomograms.

Focal (limited) pulmonary tuberculosis

Focal pulmonary tuberculosis is characterized by the presence of a few foci, predominantly of a productive nature, localized in a limited area of ​​one or both lungs and occupying 1-2 segments, and low-symptomatic clinical course. Focal forms include both recently emerged, fresh (soft-focal) processes with a focal size of less than 10 mm, and older (fibrous-focal) formations with clearly expressed signs of process activity. Fresh focal tuberculosis is characterized by the presence of weakly contouring (soft) focal shadows with slightly blurred edges. With significantly pronounced perifocal changes that have developed along the periphery of the lesion in the form of broncholobular merging foci; they should be defined as infiltrative pulmonary tuberculosis. Fibrous focal tuberculosis is manifested by the presence of dense foci, sometimes with the inclusion of lime, fibrous changes in the form of cords and areas of hyperneumatosis. During an exacerbation, fresh, soft lesions may also be detected. With focal tuberculosis, intoxication phenomena and “chest” symptoms, as a rule, occur in patients during the period of exacerbation, in the phase of infiltration or decay.
When identifying fibrous focal changes using X-ray fluorography, it is necessary to conduct a thorough examination of patients to exclude the activity of the process. In the absence of pronounced signs of activity, fibrous-focal changes should be regarded as cured tuberculosis.

Infiltrative pulmonary tuberculosis

Infiltrative tuberculosis lungs is characterized by the presence of inflammatory changes in the lungs, predominantly exudative in nature with caseous necrosis in the center and relatively rapid dynamics of the process (resorption or decay). Clinical manifestations infiltrative tuberculosis depend on the prevalence and severity of infiltrative-inflammatory (perifocal and caseous-necrotic) changes in the lungs. The following clinical and radiological variants of infiltrative pulmonary tuberculosis are distinguished: lobular, round, cloud-shaped, periocissuritis, lobitis. In addition, infiltrative tuberculosis includes caseous pneumonia, which is characterized by more pronounced caseous changes in the affected area. All clinical and radiological variants of infiltrative tuberculosis are characterized not only by the presence of a nonfiltrative shadow, often with decay, but also by bronchogenic contamination. Infiltrative pulmonary tuberculosis can occur inaperceptively and is recognized only by X-ray examination. More often, the process occurs clinically under a host of other diseases (pneumonia, protracted influenza, bronchitis, catarrh of the upper respiratory tract, etc.), in most patients there is an acute and subacute onset of the disease. One of the symptoms of infiltrative tuberculosis may be hemoptysis in the general satisfactory condition of the patient).

Caseous pneumonia

Caseous pneumonia is characterized by the presence of lung tissue inflammatory reaction according to the type of acute caseous decay. The clinical picture is characterized serious condition patient, severe symptoms of intoxication, profuse catarrhal symptoms in the lungs, a sharp left shift in leukocyte formula, leukocytosis, massive bacterial excretion. With the rapid liquefaction of caseous masses, a giant cavity or multiple small cavities are formed. Caseous pneumonia can be an independent manifestation of the disease or as a complicated course of infiltrative, disseminated and fibrous-cunning pulmonary tuberculosis.

Pulmonary tuberculoma

Pulmonary tuberculoma unites encapsulated caseous foci of various origins, more than 1 cm in diameter. There are tuberculomas of the infiltrative-pneumonic type, homogeneous, layered, conglomerate and the so-called “pseudotuberculomas” - filled cavities. On an x-ray, tuberculomas are revealed as a round shadow with clear contours. In focus, a crescent-shaped clearing due to decay, sometimes perifocal inflammation and a small number of bronchogenic foci, as well as areas of calcification, can be determined. Tuberculomas can be single or multiple. There are small tuberculomas (up to 2 cm in diameter), medium (2-4 cm) and large (more than 4 cm in diameter). 3 highlighted clinical variant course of tuberculoma: progressive, characterized by the appearance at some stage of the disease of decay, perifocal inflammation around the tuberculoma, bronchogenic seeding in the surrounding lung tissue, stable - the absence of radiological changes during observation of the patient or rare exacerbations without signs of progression of tuberculoma; regressive, characterized by a slow decrease in tuberculoma with the subsequent formation in its place of a focus or group of lesions, an induration field or a combination of these changes.).

Cavernous pulmonary tuberculosis

Cavernous tuberculosis lungs is characterized by the presence of a formed cavity, around which there may be a zone of small non-rifocal reaction - lack expressed fibrotic changes in the lung tissue surrounding the cavity and possible presence a few focal changes both around the cavity and in the opposite lung. Cavernous tuberculosis develops in patients with infiltrative, disseminated, focal tuberculosis, with the disintegration of tuberculomas, with late detection of the disease, when the disintegration phase ends with the formation of a cavern, and the signs of the original form disappear. Radiologically, a cavity in the lung is defined as a ring-shaped shadow with thin or wider walls. Cavernous tuberculosis is characterized by the presence in the patient of an elastic, rigid, and less commonly, fibrous cavity.

Fibrous-cavernous pulmonary tuberculosis

Fibrous-cavernous pulmonary tuberculosis is characterized by the presence of a fibrous cavity and the development of fibrous changes in the lung tissue surrounding the cavity. Foci of bronchogenic dropout of varying duration are characteristic both around the cavity and in the opposite lung. As a rule, the bronchi draining the cavity are affected. Other morphological changes in the lungs also develop: pneumosclerosis, emphysema, bronchiectasis. Fibrous-cavernous tuberculosis is formed from an infiltrative, tricky or disseminated process with the progressive course of the disease. The extent of changes in the lungs can be different; the process can be unilateral or bilateral with the presence of one or multiple cavities.
The clinical manifestations of fibrocavernous tuberculosis are diverse; they are caused not only by tuberculosis itself, but also by changes in the lung tissue around the cavern, as well as developed complications. There are three clinical variants of the course of fibrocavernous pulmonary tuberculosis: limited and relatively stable fibrocavernous tuberculosis, when, thanks to chemotherapy, a certain stabilization of the process occurs and there may be no exacerbation for several years; progressive fibrous-cavernous tuberculosis, characterized by alternating exacerbations and remissions, and the periods between them can be different - short and long; during the period of exacerbation, new areas of inflammation appear with the formation of “daughter” cavities, sometimes the lung can be completely destroyed, in some patients with ineffective treatment the progressive course of the process ends with the development of caseous pneumocia; fibrous-cavernous tuberculosis with the presence of various complications - most often this option is also characterized by a progressive course. Most often, such patients develop pulmonary heart failure, amyloidosis, frequent repeated hemoptysis and pulmonary hemorrhage, nonspecific infection (bacterial and fungal) worsens.

Cirrhotic pulmonary tuberculosis

Cirrhotic pulmonary tuberculosis is characterized by the proliferation of coarse connective tissue in the lungs in the pleura as a result of involution fibrous-cavernous, chronic disseminated, massive infiltrative pulmonary tuberculosis, pleural lesions, tuberculosis of the intrathoracic lymph nodes, complicated by bronchopulmonary lesions. Cirrhotic tuberculosis should include processes in which tuberculous changes in the lungs persist with clinical signs activity of the process, a tendency to periodic exacerbations, periodically there is scanty bacterial excretion. Cirrhotic tuberculosis can be segmental and lobar, limited and widespread, unilateral and bilateral, it is characterized by the development of bronchiectasis, pulmonary emphysema, and symptoms of pulmonary and cardiovascular failure.
Cirrhotic changes, in which the presence of a fibrous cavity with bronchagonal elimination and repeated long-term bacterial excretion is established, should be classified as fibrous-cavernous tuberculosis. Pulmonary cirrhosis, which is a post-tuberculosis change without signs of activity, should be distinguished from cirrhotic tuberculosis. In the classification, pulmonary cirrhosis is classified as residual changes after clinical cure.

Tuberculous pleurisy

Tuberculous pleurisy often accompanies pulmonary and extrapulmonary tuberculosis. It occurs mainly in the primary tuberculosis complex, tuberculosis of the intrathoracic lymph nodes, and disseminated pulmonary tuberculosis. Fibrous-cavernous pulmonary tuberculosis is characterized by the presence of a fibrous cavity, the development of fibrous changes in the pulmonary tissue surrounding the cavity. Foci of bronchogenic dropout of varying duration are characteristic both around the cavity and in the opposite lung. As a rule, the bronchi draining the cavity are affected. Other morphological changes in the lungs also develop: pneumosclerosis, emphysema, bronchiectasis. Fibrous-cavernous tuberculosis is formed from an infiltrative, tricky or disseminated process with the progressive course of the disease. The extent of changes in the lungs can be different; the process can be unilateral or bilateral with the presence of one or multiple cavities. Tuberculous pleurisy can be serous, serous-fibrinous, purulent, and less commonly hemorrhagic. The diagnosis of pleurisy is established by a combination of clinical and radiological signs, and the nature of pleurisy is determined by puncture pleural cavity or pleural biopsy. Pneumopleurisy (the presence of air and fluid in the pleural cavity) occurs with spontaneous pneumothorax or as a complication of therapeutic pneumothorax.

Pleural tuberculosis, accompanied by the accumulation of purulent exudate, is special form exudative pleurisy - empyema. Develops with widespread caveous lesions of the pleura, as well as as a result of perforation of the cavern or subpleural foci, can be complicated by the formation of a bronchial or thoracic fistula and take chronic course. Chronic empyema is characterized by a wave-like course. Morphological changes in the pleura are manifested by cicatricial degeneration, the development of specific granulation tissue in the thickness of the pleura that has lost its function. Empyema should be included in the diagnosis.

Collapse

Tuberculosis is a dangerous disease that kills many people around the world. The greatest danger is the open form of tuberculosis. In such cases, the tuberculosis bacillus is easily transferred from a sick person to a healthy person. It is practically resistant to medications, and is also able to survive for a long time in unfavorable conditions.

Peculiarities

This form of the disease is an infectious focus that spreads to respiratory organs. The lungs cease to cope with their function, weaken, and the disease begins to actively spread. Together with the blood, it enters other organs and tissues.

A person with an open form of the disease poses a great danger to others. The bacilli are spread through the air by coughing, sneezing, and even talking.

Causes

Tuberculosis microbacteria can survive for a long time in an unfavorable environment, so the risk of infection is quite high, especially if there is a sick person in your immediate environment. Even the slightest drop of saliva or phlegm can be enough to develop the disease.

This especially applies to the following category of persons:

• Old people.
• Medical staff who frequently come into contact with tuberculosis patients.
• Living in environmentally unfavorable conditions.
• With reduced immunity.
• Children with increasing Mantoux test.
• Constantly undergoing hormonal therapy.
• Patients with chronic diseases of the gastrointestinal tract and respiratory tract.

Symptoms and signs

Any disease can be recognized only by its symptoms. If closed form While the diseases are practically not expressed, tuberculosis in its open form manifests itself very quickly. The following signs are distinguished:

1. Dry or moist cough, in which sputum mixed with blood may be produced.
2. Labored breathing.
3. Slight increase in temperature.
4. Decreased appetite.
5. Sudden weight loss.
6. Frequent headaches.
7. Heavy sweating, especially at night.
8. Chest pain.
9. Shortness of breath even with the slightest exertion.
10. Apathy, sudden changes in mood.

After Koch's bacillus has entered the body, signs of the disease can be noticed after 2-3 months. The diagnosis is made after undergoing fluorography, x-rays and ECG. Signs of the disease can be divided into three groups: clinical (symptoms), laboratory (the presence of the virus in tests), radiographic (when there is a focus of the disease, cavities on the lungs and an increase in the pattern of the lungs).

A person with an open form of tuberculosis simply cannot help but notice the manifestations of the disease. Gradual intoxication of the body will lead to constant fever, severe cough and hemoptysis.

Danger to others

Tuberculosis in its open form is dangerous for others, because bacteria are easily transmitted from a sick person to a healthy one. For this, a normal conversation, sneezing or coughing will be enough. After hitting healthy body, the virus multiplies quickly, infecting human lungs. This is especially dangerous if a person has a weakened immune system and cannot resist the virus. There is also danger when living in common with a person suffering from tuberculosis.

Transmission routes

The disease can be transmitted in the following ways:

The longer healthy man is near the patient, the greater the concentration of microbacteria in the air. Accordingly, the risk of getting sick increases many times.

Lifespan

If we talk about the development of tuberculosis without appropriate treatment, then life expectancy will depend on the condition of the patient himself, his body, the stage of the disease and complications.

Practice has shown that patients with tuberculosis can live no more than six months without treatment. However, life expectancy will be affected by factors such as:

• Bad habits.
• Reduced immunity.
• HIV or AIDS in a patient.
• Tuberculosis in the elderly and children.

Constant stress can complicate the patient’s condition, poor nutrition and much more.

It is these people who are more susceptible to the active development of the disease and rapid death than others. People leading an antisocial lifestyle, as well as low-income people, suffer the most from the disease.

Only with the help of competent and timely treatment can a person live for many more years. Modern medicine can cure or stop the progression of even tuberculosis.

Diagnostics

This process consists of several stages:

If necessary, additional examination methods are possible:

1. Bronchoscopy, which makes it possible to view the lungs from the inside. If necessary, a swab is taken from the affected area.
2. Pleural puncture, which indicates the presence or absence of microbacteria.
3. Biopsy. If it indicates the presence of a granuloma, then there is no longer any doubt about the diagnosis; it is tuberculosis.

Treatment options

If medications were chosen correctly, then the open form of tuberculosis can be cured. For this, a group of 4 drugs is used (listed below). But for a complete recovery, additional medications will be required, since the virus has the ability to quickly develop immunity to antibiotics.

Complex treatment includes:

1. Taking antibiotics.
2. Healthy lifestyle.
3. Proper nutrition.
4. Do breathing exercises daily.

IN advanced cases The disease is treated through surgery.

Drug treatment regimens may be as follows:

• Consisting of 4 components such as Isoniazid, Rifampicin, Streptomycin and Rifabutin).
• Consisting of 5 components, when a fluoroquinolone antibiotic is added to the previous medications.

The doctor also prescribes anti-inflammatory and immunostimulating drugs.

Complications

The worst thing is death from tuberculosis. With absence adequate treatment, it comes very quickly, because bacteria destroy internal organs person, and they cease to perform their functions.

There are complications such as:

• Joint damage, development of bone tuberculosis, severe pain, swelling.
• Bleeding in the lungs.
• Weakening of the immune system, development concomitant diseases, which only worsen the condition of the body.
• Broncholitis, i.e. calcified formations in the lungs.
• Fungal infection of the lungs, damage to the walls of blood vessels, which can cause bleeding.
• Inflammation in the lungs.

If tuberculosis was nevertheless cured, this does not mean that it will not appear again. This is a recurrent disease that can reappear when the immune system is weakened.

This is especially true for pregnant women who have previously suffered from tuberculosis. This may affect mental or physical development unborn child, as well as cause consequences such as frozen pregnancy or death of the child during childbirth.

To prevent development of this disease, you can get vaccinated. For children it is done in the maternity hospital. And in adults this is done according to indications. The most important thing is to comply sanitary standards and undergo annual examinations. Any signs should prompt you to see a doctor.