Pulmonary Tuberculosis

Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis, which can affect many organs; pulmonary involvement (pulmonary tuberculosis) is most common. Sputum-positive patients are the main source of infection. Humans are mainly infected by inhaling droplet nuclei spread by coughing or sneezing TB patients. Inhaled tubercle bacilli are phagocytosed by alveolar macrophages.

Common Symptoms

Middle lobe fibrosis; moist rales; nasal tuberculosis; hemoptysis with paroxysmal cough; extrapulmonary tuberculosis; cough; sepsis; low fever; massive hemoptysis; weight loss

Causes and Pathogenesis

Tubercle bacilli belong to the order Actinomycetales, family Mycobacteriaceae, genus Mycobacterium, and are pathogenic acid-fast bacilli. They are mainly classified into human, bovine, avian, and murine types; the human type is mainly pathogenic to humans, with rare bovine infection. Drug resistance can develop from naturally resistant strains or from rapid emergence of resistance when a single anti-TB drug is used alone (acquired resistance). Resistant strains complicate treatment and affect efficacy.

Treatment

Drug therapy, supportive therapy

Preventive Measures

Daily prevention of pulmonary tuberculosis: 1. BCG vaccination: Uninfected individuals such as neonates, Mantoux-negative recruits and students, young staff newly assigned to TB units, and adolescents receiving renal transplants should receive BCG. 2. Chemoprophylaxis: Selective chemoprophylaxis for infected individuals: (1) Close contacts of sputum-positive patients, such as Mantoux-positive (unvaccinated) children and strongly positive adolescents. (2) Children and adolescents with Mantoux conversion, and adults with strongly positive reactions. (3) Non-active pulmonary tuberculosis with any of: long-term high-dose corticosteroids, immunosuppressants, or cytotoxic drugs; radiotherapy; peri-gastrectomy; strongly positive Mantoux in recruits/new students; dual TB-HIV infection with positive Mantoux in AIDS patients; renal transplant recipients with prior TB or non-active TB; diabetes with non-active TB; Mantoux-positive silicosis patients. Isoniazid chemoprophylaxis: adults 0.3 g/day, children 6-8 mg/(kg·day), single dose, for 6 months. 3. Eliminate the source of infection: Smear-positive pulmonary TB is the main source; eliminating it is the fundamental control measure. New and retreatment smear-positive cases are the main targets of chemotherapy. Health education: (1) Transmission: The main source is sputum-positive pulmonary TB patients. Active patients unknowingly spread bacilli to those around them. Coughing is the main route; when coughing, sneezing, or spitting on the ground, droplet nuclei are inhaled by susceptible individuals. Do not spit indiscriminately; cover mouth and nose when coughing. (2) Diet and lifestyle: TB is a chronic wasting disease; nutrition is essential. Apart from dietary restrictions for comorbidities (hypertension, hyperlipidemia, diabetes), there are no other restrictions. Protein, carbohydrates, fat, vitamins, and minerals are all needed; especially protein enhances resistance and aids cell repair. Eat more fish, lean meat, eggs, milk, and soy products.

Department to Visit

It is recommended to visit the Infectious Diseases department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.