Caused by Koch's bacillus, tuberculosis is an infectious disease that mainly affects the lungs. Discovered in 1882 by the German microbiologist Robert Koch, this particularly contagious pathology benefited from the discovery of the Calmette and Guérin bacillus vaccine - the famous BCG - in 1921. Since then, cases of tuberculosis have largely regressed in Europe but it still persists. parts of the world where the disease persists. Focus on tuberculosis.
The different types of tuberculosis:
There are several forms of tuberculosis:
- Pulmonary tuberculosis: formerly called phthisis, this type of tuberculosis is the most common. It is characterized by localized damage to lung tissue.
- Extra-pulmonary tuberculosis: bacteria can attack various organs and tissues such as lymph nodes, bones, meninges, the central nervous system, or even the kidneys. This form can be associated with pulmonary tuberculosis.
- Miliary tuberculosis: this form results in bacterial dissemination within the blood system, causing a generalized attack on the body.
What mode of transmission?
Koch's bacillus is transmitted mainly by air and, more precisely, by droplets of saliva spread in the atmosphere during a sneeze, for example. Contrary to popular belief, the disease is not contracted through direct contact with an infected person. It should also be known that people are only contagious when they present symptoms, that is to say during the active phase of the pathology. However, nearly a third of the population is currently a carrier of latent tuberculosis worldwide. This means that these individuals are carriers of Koch's bacillus but have not yet declared the disease. Only 10% of them will be likely to develop it one day. However, certain factors increase this risk: people infected with HIV, diabetics, smokers, and malnourished individuals.
What symptoms?
The most common clinical manifestations of pulmonary tuberculosis are:
- Moderate fever
- A persistent and expectorant cough,
- Bloody sputum
- Loss of appetite
- Weight loss,
- Chest pain
- Night sweats
- A generalized state of weakness,
- Joint pain
- Spinal pain.
How is tuberculosis diagnosed?
The diagnosis of tuberculosis is only established during its active phase. In the presence of symptoms of the disease, the doctor may carry out various medical examinations to confirm his diagnosis:
- a skin test: this involves injecting a low dose of tuberculin under the patient's skin. The infection is known if a skin reaction occurs within 48 to 72 hours. In the event of a negative result, the practitioner can repeat the test a few weeks later.
- an x-ray of the lungs: medical imaging may be helpful if the patient has an asymptomatic cough.
- samples of pulmonary secretions: the bacterial analysis makes it possible to confirm or not the diagnosis of tuberculosis. If necessary, the culturing of pulmonary secretions allows the identification of the incriminated bacteria and to adapt the treatment accordingly.
What treatment?
In the presence of mycobacteria, the doctor immediately places his patient on antibiotic therapy even if he does not yet have in his possession all the results allowing him to refine his management. This first-line treatment aims to stop bacterial proliferation while relieving the symptoms presented by the patient. This oral antibiotic therapy generally combines four different molecules: rifampicin, ethambutol, isoniazid, and pyrazinamide. It lasts between 6 to 12 months and requires daily intake to be fully effective. However, sometimes bacteria are resistant to certain antibiotics. In this case, the doctor sets up a so-called “second line” treatment which consists of combining 4 to 6 antibiotics which will be taken over a period of two years.
Tuberculosis requires regular monitoring until recovery, stopping work, and wearing a mask for the duration of the contagion. It is also a notifiable disease (a procedure that will be carried out by your doctor).
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