Tuberculosis🫁🦠 : Microbiology , Clinical features , Diagnosis , Treatment

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Tuberculosis (TB) 🫁🦠-
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Tuberculosis (TB) is a highly contagious infectious disease caused by the bacterium Mycobacterium tuberculosis. It primarily affects the lungs (pulmonary TB) but can also involve other organs (extrapulmonary TB) such as the lymph nodes, bones, kidneys, and central nervous system. TB spreads through airborne droplets when an infected person coughs, sneezes, or talks, making it a major public health concern worldwide, especially in low- and middle-income countries. 🌍💨
Pathogenesis: Upon inhalation, the bacteria reach the alveoli in the lungs, where they are phagocytosed by alveolar macrophages. M. tuberculosis can survive and multiply within these macrophages by inhibiting lysosome fusion, leading to granuloma formation, which is the body’s attempt to contain the infection. The granulomas can remain stable (latent TB infection) or break down, leading to active TB disease when the immune system is compromised.
Clinical Presentation: Symptoms of active pulmonary TB include a persistent cough lasting more than three weeks, hemoptysis (coughing up blood), night sweats, fever, unintentional weight loss, and fatigue. Extrapulmonary TB symptoms vary depending on the affected organ but commonly include swollen lymph nodes, bone pain, or neurological deficits in the case of TB meningitis.
Diagnosis: Diagnosis is made through a combination of clinical evaluation, chest X-rays, sputum smear microscopy, culture, and nucleic acid amplification tests (NAATs) like the GeneXpert. The Mantoux tuberculin skin test (TST) and Interferon-Gamma Release Assays (IGRAs) are used to detect latent TB infections.
Management: TB treatment involves a prolonged course of multiple antibiotics to ensure complete eradication of the bacteria and prevent resistance. The standard regimen includes isoniazid, rifampicin, pyrazinamide, and ethambutol for the first two months (intensive phase), followed by isoniazid and rifampicin for the next four months (continuation phase). Drug-resistant TB, including multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), poses significant treatment challenges and requires second-line drugs.
Prevention: Prevention strategies include Bacillus Calmette-Guérin (BCG) vaccination, early detection and treatment of active cases, and the use of personal protective equipment in healthcare settings. Close contacts of active TB patients are also screened and treated for latent TB if necessary.
Tuberculosis remains a leading cause of morbidity and mortality worldwide, but with effective public health interventions, treatment adherence, and global cooperation, significant progress can be made towards TB elimination. 🏥🔬

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