How is Tuberculosis Treated?
Tuberculosis is a particularly nasty disease which is most often spread through inhalation of an airborne virus. Until the mid-20th century, the chances of survival were low, but an effective cure was created in the form of the antibiotic stretptomycin. However, while new cases of tuberculosis (commonly shortened to TB) has declined, it is still a killer worldwide. This is especially so in countries with high poverty and low access to medical aid such as those in Sub-Saharan Africa. Tuberculosis needs to be treated quickly and comprehensively, otherwise prognosis is poor. oneHOWTO details how tuberculosis is treated, but does so with the proviso that immediate medical attention is needed if you think you or someone you may know is infected.
What is tuberculosis?
Tuberculosis is an infectious disease which results in various symptoms, but not always at the onset of the infection. Many of us think of tuberculosis being a lung disease, but this is not strictly true. It is caused most commonly by the bacteria Mycobacterium tuberculosis. However, the disease is so commonly associated with the lungs that it is put into two main categories:
- Pulmonary tuberculosis: pulmonary means it is related to the lungs (just as ‘renal’ refers to the kidneys). Some people think that tuberculosis has to begin in the lungs. This is true in the overwhelming majority of cases as TB is an airborne bacteria which can be spread through coughing and sneezing (coughs and sneezes spread diseases).
- Extrapulmonary tuberculosis: there are a smaller amount of cases whereby TD does not start in the lungs. In these cases the bacteria can infect other tissue and organs in the body. However, many cases of extrapulmonary TB are those which begin in the lungs and then spread out to other organs. This may require additional treatment to affect these particular organs.
Symptoms of tuberculosis
As TB most often starts in the lungs, many of the symptoms relate to what we might expect from lung disease. However, as it is a bacterial infection, tuberculosis will also affect your overall immune system. This is one of the reasons it can be so dangerous in patients with HIV/AIDS. An already lowered immune system means the bacteria can seriously weaken the body, in turn allowing for greater possibility of further infection.
Some of the main symptoms of tuberculosis include:
- Persistent coughing
- Chest pain especially while breathing
- Loss of apetite
- Weight loss
- Coughing up blood or blood in sputum
- Night sweats
There may be some other symptoms depending on how far the infection has spread and which tissues it is affecting. For example, if it affected the liver then there would be some hepatic issues related to malfunction of this organ. If you detect different symptoms which suggest you may be suffering from a case of tuberculosis, it is important that you immediately visit the doctor so you can be properly examined and diagnosed. The weight loss associated with tuberculosis is why it is archaically referred to as ‘consumption’. This is because it was a disease which appeared to consume the very flesh of a human body.
It is not only HIV/AIDS which can increase your likelihood of contracting TB. There are other factors which can put you at risk. Many of these are other diseases which weaken your immune system. They include:
- Age (i.e. very young or old)
- Having cancer or undergoing cancer treatment
- Renal failure especially if on dialysis
- Certain medications which lower immune system
However, there are also many other risk factors. The belief that TB has been eradicated is in part due to the greater availability of medicine to treat it. However, if you live in a lower income country or are experiencing poverty in any country, your access to medicine is severely diminished. You may also have greater risk of other health issues, thus further weakening your immune system and increasing your chance of contracting TB.
There are also some lifestyle factors which may increase the risk of contracting tuberculosis:
- Substance abuse: continued drug and alcohol abuse is notorious for making you weaker and more prone to certain illnesses and conditions.
- Travel: if you are a regular overseas traveller, you are not only at a greater risk of fatigue and lowering your immunity, you may be travelling to countries areas such as parts of Africa and Latin American were TB is still unfortunately prevalent.
- Poor nutrition: whether you don't have access to food resources or you have an eating disorder, malnutrition is a contributing risk factor.
- Lack of medical care: whether you are unable to meet insurance payments or you live somewhere with poor healthcare resources, a lack of access to healthcare can result in greater risk of bacterial infection.
- Profession: if you work somewhere where bacterial infections like TB can be prevalent such as a healthcare facility, you are more likely to become infected. Also, if you work in resources where you meet people travelling from higher risk countries, then this can increase your probability of catching the disease.
- Smoking: whether smoking tobacco or other substances, anything which goes into the lungs via harmful smoke is much more likely to increase contracting TB.
How to diagnose tuberculosis
In order to check if a person has been infected with tuberculosis, a health professional will perform a tuberculin skin test, which is also called a Mantoux test. This involves injecting tubercle bacillus antigens under the skin with a syringe. After 48-72 hours, the injection site is examined to see if there is a positive reaction. Essentially this is done by measuring the mark left at the injection site (induration). This measurement, however, is lesser for those with some of the risk factors mentioned above. For example, something without any immunodeficiency issues will need a large reading for a positive result than someone with HIV/AIDS.
It can be difficult to assess and see the signs of tuberculosis for many reasons. One is that if a patient has one or a combination of the risk factors associated with it, the symptoms could be those of other related illnesses. The best way is to have a physician make a thorough medical assessment. This will involve looking at the symptoms, considering the risk factors and then administering the Mantoux test if deemed necessary.
Another problem with diagnosing TB is that not all infections are active. If you have active pulmonary and/or extrapulmonary tuberculosis then the symptoms may be much clearer. However, you may be infected by the Mycobacterium tuberculosis bacteria and do not exhibit symptoms. This is known as having latent tuberculosis. While latent tuberculosis is not infectious, it does pose a risk to the person who has it. This is greater at the beginning of the initial infection, but decreases after time. While the symptoms do not persist with latent tuberculosis treatment is still needed. The above risk factors also apply and can increase the likelihood on it becoming activated.
Treatment of tuberculosis
Tuberculosis is difficult to treat especially as the way in which the bacteria affects the cells is relatively rare. The bacteria replicates at a slower rate, meaning the onset of tuberculosis can take a while to register. It also means it takes a long time to treat. Another factor in treatment is that there are different strains of TB. Some of these strains are more resistant than others, but many other factors also contribute to a build up of resistance.
If there is a positive result, medical treatment should be initiated with appropriate pharmaceutical products in order to stop the infection. This will always be prescribed by a medical professional and in accordance with the particular characteristics of each individual patient. Antibiotics are the only real treatment available, but the range of them can be quite large.
In general, TB is treated with long-term treatments lasting at least 6 months. The main antibiotic medications administered are:
Likewise, streptomycin and ethambutol may also be used. Some people with tuberculosis may require hospitalization during part or all of their treatment, depending on the severity of the infection. Although the cure rate is high, if left untreated or treated incorrectly, tuberculosis can result in the patient's death. It is imperative that tuberculosis patients take their full course of treatment. If the patient has extrapulmonary tuberculosis then treatment of the damaged organs may also be required.
If you start to take antibiotics for TB, but don't take the whole course this can be deadly. The reason is that the antibiotics have worked to a point, but not eradicated the infection in the lungs or elsewhere. The unfortunate nature of infection means that it spreads. So, even if the bacteria is weakened, it will return and symptoms will reoccur. However, this is not the only concern. The bacteria will also have built up a resistance to the antibiotic and it may no longer work as an effective cure. New antibiotics will have to be tested and taken.
Multiple drug-resistant tuberculosis (MDR-TB) are the different strains of TB which are resistant to drugs. This form of TB can recur and, if it does, can be very difficult to treat. It will often lead to a very long stay in hospital, maybe even years long. This is one of the reasons writers like John Keats and D.H. Lawrence went to warmer climates to recover as it helped bolster their immune system.
Prevention of tuberculosis
With very few exceptions, prevention is better than cure when it comes to disease. Prevention of TB through vaccination is one of the reasons its fatality rates have decreased since the 20th century. This is in combination with better treatment options. However it is also very difficult to prevent with vaccinations alone. The vaccine Bacillus Calmette-Guérin is the only known vaccine and is administered in greater risk countries. It generally only lessens the risk by about 20%. It is administered to children, but not to those who have HIV/AIDS.
Better prevention is found in staying away from at risk areas and by reducing the risk factors, especially through lifestyle choices such as abstaining from or quitting smoking. Read our article to find our more about which measures are taken to avoid being infected with tuberculosis.
This article is merely informative, oneHOWTO does not have the authority to prescribe any medical treatments or create a diagnosis. We invite you to visit your doctor if you have any type of condition or pain.
If you want to read similar articles to How is Tuberculosis Treated?, we recommend you visit our Diseases & secondary effects category.
- Visit your doctor immediately if you think you have been infected with tuberculosis.