Tuberculosis, commonly known as TB, is a contagious infection that primarily affects the lungs. It is caused by the bacterium Mycobacterium tuberculosis. TB is spread through the air when an infected person coughs or sneezes, releasing bacteria into the air.
Symptoms of TB can include a persistent cough, chest pain, fatigue, weight loss, fever, and night sweats. It is important to seek medical attention if you suspect you have been exposed to TB or are experiencing these symptoms.
TB can be diagnosed through a skin test, blood test, or imaging studies, such as a chest X-ray. Treatment for TB usually involves a combination of antibiotics taken over a period of several months to ensure complete eradication of the bacteria.
Preventive measures for TB include good ventilation, wearing masks in crowded places, and avoiding close contact with individuals who have active TB. The Bacille Calmette-Guérin (BCG) vaccine is available to protect individuals at high risk of contracting TB.
Recognizing Symptoms of TB
Symptoms of TB develop gradually and may include:
- Continual cough with mucus or blood
- Persistent tiredness or fatigue
- Fever or night sweats
- Loss of appetite
- Unexplained weight loss
- Overall feeling of unwellness
In children, difficulty in gaining weight may be observed.
If TB spreads, additional symptoms can manifest such as:
- Enlarged lymph nodes
- Body aches
- Swollen joints or ankles
- Abdominal or pelvic discomfort
- Dark urine
- Headache, vomiting, confusion
- Stiff neck, rash
While latent TB does not show symptoms, active TB presents noticeable signs.
Recognizing Signs of Active TB
- Cough lasting more than 3 weeks
- Persistent tiredness or fatigue with no clear cause
- Frequent high temperature or night sweats
- Loss of appetite, unexplained weight loss
- Close contact with someone who has active TB
- Chest pain or discomfort
- Coughing up blood
- Shortness of breath
- Swelling of the neck
- Weakness or numbness in limbs
Recognizing Severe TB Symptoms
- Coughing up blood or mucus
Recognizing TB Meningitis Symptoms
- Stiff neck, severe headache
- Sensitivity to light, seizures, behavior changes, weakness
If you experience these symptoms, call for emergency medical assistance immediately. Remember to bring your medication with you.
Diagnostic Tests for TB
Various tests may be conducted to identify TB symptoms, including X-rays, ultrasounds, or biopsies. Individuals at risk for TB may undergo Mantoux or blood tests, with the former triggering a reaction if a TB infection is present.
In addition to these tests, sputum samples may also be collected and examined for the presence of the TB bacteria. This can help confirm a diagnosis of active TB infection. Additionally, a chest CT scan may be ordered to provide more detailed images of the lungs and surrounding tissues, which can aid in diagnosing TB.
Treatment for TB
TB is typically treated with antibiotics for a minimum of 6 months. In cases of brain, spinal, or heart infections, additional steroid therapy may be necessary. Latent TB requires antibiotic treatment for 3-6 months to ensure complete eradication of the infection.
Completing TB Treatment Course
It is crucial to complete the full course of antibiotics prescribed for TB to prevent the recurrence of the infection. It is important to take the medication exactly as prescribed by your healthcare provider and not to miss any doses. Failure to complete the full course of treatment can lead to the development of drug-resistant strains of TB, making it more difficult to treat in the future. Additionally, it is important to follow up with your healthcare provider regularly to monitor your progress and ensure that the infection has been fully eradicated.
Transmission and Risk Factors of TB
Bacteria that cause TB are spread through close contact with individuals displaying symptoms, especially through coughing. While active TB can be transmitted through inhaled droplets, latent TB does not spread but can progress to an active infection. Risk factors for TB include close contact, residence in affected areas, weakened immunity, age, living conditions, and personal habits.
It is important to note that TB is not easily spread through casual contact such as shaking hands or sharing utensils. Instead, prolonged exposure to an individual with active TB is necessary for transmission to occur.
People with weakened immunity, such as those with HIV/AIDS or diabetes, are at a higher risk of developing active TB. Age also plays a role, with individuals over the age of 65 being more susceptible to the disease. Living in crowded or poorly ventilated areas, such as prisons or homeless shelters, can increase the risk of TB transmission.
Personal habits such as smoking or excessive alcohol consumption can also weaken the immune system, making individuals more vulnerable to TB infection. It is important for individuals at higher risk for TB to undergo regular screening and seek treatment if necessary to prevent the spread of the disease.
Preventive Measures for TB
The BCG vaccine is recommended for individuals at risk of contracting TB to protect against the infection.
Characteristics of Mycobacterium Tuberculosis
Mycobacterium tuberculosis is a type of bacteria that thrives in oxygen-rich environments with slow growth. These bacteria exhibit resistance to certain conditions and chemicals.
Survival of Mycobacterium Tuberculosis
The survival of Mycobacterium tuberculosis depends on factors such as temperature, humidity, and light. Under ideal conditions, these bacteria can survive in the air for 3-4 months.
Factors Affecting Mycobacterium Tuberculosis Survival
The survivability of Mycobacterium tuberculosis is influenced by temperature variations and exposure to different substances.
Addressing Prolonged Fever in TB Patients
When TB patients experience prolonged fever, a detailed examination, treatment, and monitoring plan are essential to determine the cause and provide appropriate care.
Investigating Prolonged Fever in TB Patients
A systematic procedure is followed to investigate and address prolonged fever in patients with TB.
MTB – mycobacterium tuberculosis
The categorization of all individuals was determined based on the results of their chest X-ray examinations:
- For those with moderate disease: multiple zones affected, non-cavitary
- For individuals with extensive disease: presence of cavitation or multiple zones affected
- For those with disseminated disease: involvement of extra-pulmonary regions
Results
The research study involved 40 male patients who tested positive for TB through sputum analysis and negative for HIV. Their ages ranged from 22 to 55 years. Various comorbidities were present among these individuals, including diabetes, liver cirrhosis, and heart conditions. Additionally, a history of smoking and alcohol consumption was identified.
Among the participants, 22 individuals exhibited extensive radiological disease, with dissemination and toxaemia observed in 20 cases. On the other hand, 9 patients showed signs of moderate disease, with dissemination noted in 4 instances. No cases of toxaemia were recorded.
TABLE 2.
The classification was carried out for the 40 TB patients who experienced prolonged fever:
| Scope | Localized | Spread | Toxemia & Spread | Overall |
|---|---|---|---|---|
| Comprehensive | Two | Eight | Twelve | Twenty-two |
| Primary Focus | 3 | 2 | 0 | 5 |
| Summary | 12 | 16 | 12 | 40 |
There are a variety of reasons why fever may occur, such as complications from TB, reactions to medication, or other underlying health conditions. However, with proper management, all individuals were able to recover from their fever.
TABLE 3.
Factors contributing to extended periods of fever in patients with TB:
| Cause of the Disease | Number of Affected Individuals | ||
|---|---|---|---|
| Direct Consequences of Tuberculosis | 9 Cases | ||
| Disagreement of TB accompanied by toxemia |
| 4 cases |
| Arthritis of the hip | Case Study 1 |
| Resistance to Medications | 4 |
|---|---|
| Drug resistance is a phenomenon where organisms are able to survive exposure to a drug that would normally kill or inhibit them. | 4 |
Numerous factors can cause a fever, such as drug reactions and related illnesses. Prompt and efficient management can lead to full recovery.
The body’s febrile response serves as a defense mechanism against invading microbes by activating cytokines. Prolonged fevers, however, can have negative effects on metabolism, potentially leading to malnutrition and weakening of the immune system. Therefore, accurately identifying the underlying cause of a fever is crucial for successful treatment. In a recent study, only patients with positive sputum tests were examined to avoid misdiagnoses. It was found that patients with persistent fevers despite treatment for pulmonary TB had various reasons for their continued symptoms, including drug resistance and hypersensitivity reactions. Fevers linked to other ailments, especially lung infections, were also common. Drug-induced fevers, notably from streptomycin, were observed but disappeared after discontinuing the medication.
The study highlighted the challenges in diagnosing and managing fevers in TB patients, stressing the importance of thorough clinical assessments and investigations. Fevers should not be automatically attributed to TB or drug resistance without first ruling out other potential causes. Ultrasonograms were recommended for identifying pus collections in specific areas.
Tuberculosis (TB), caused by Mycobacterium tuberculosis, is an airborne disease that can affect various parts of the body aside from the lungs. Although TB is treatable, it remains a significant public health issue globally and is endemic in Singapore.
Active TB patients are infectious and may exhibit symptoms that require immediate medical attention. On the other hand, individuals with latent TB infections (LTBI) may be asymptomatic and non-infectious, as the bacteria are dormant in their bodies. While dormant, LTBI individuals do not spread TB but are at risk of reactivating the disease if their immune system weakens.
TB is transmitted through the air via coughing or sneezing, necessitating close contact for infection. Symptoms of TB disease include a persistent cough, coughing up blood, and loss of appetite. Early detection and treatment are crucial to prevent severe lung damage or death.
Individuals at higher risk of developing active TB include those with compromised immune systems, prolonged exposure to TB-infected individuals, substance abuse, specific medical conditions, and children or the elderly. Preventative treatments are available for high-risk groups to lower the chances of developing active TB.
Taking precautions against TB involves completing prescribed treatments, staying home during the initial medication course, wearing masks, and practicing good respiratory hygiene. Close contacts of active TB patients may undergo screening through the National Tuberculosis Programme for early detection and prevention.
Screening for TB may involve a QuantiFERON blood test and a chest X-ray, with results typically available within two to three weeks. Additional tests may be necessary to differentiate between latent TB infection and active TB disease based on blood test outcomes. Registered close contacts of identified TB cases under the National Tuberculosis Programme receive free TB screening to prevent the development of active TB.
After communicating with the workplace supervisor or HR, the public health officer-in-charge (PHO) will conduct a risk assessment. Information needed includes details of prolonged exposure to the TB patient, floorplans, photographs, and possibly an on-site visit. The PHO will create a list of employees for TB screening, with information forwarded to the NTBSC for scheduling. Employees will receive appointment notifications via SMS, while supervisors or HR will receive email alerts for monitoring and manpower allocation.
To lower the risk of contracting active TB, maintaining good ventilation, practicing proper cough etiquette, and regular handwashing are essential preventive measures.
Active TB is treated with a combination of medications for a minimum of six to nine months. Completing the treatment is crucial to prevent disease recurrence or drug resistance. Directly Observed Therapy (DOT) is used to ensure proper medication intake and monitoring. Hospitalization or isolation may be required if the condition worsens. Individuals with latent TB infection may undergo preventive treatment to reduce the risk of developing active TB in the future. Completion of the treatment regimen is essential to lower the risk of active TB development. The BCG Vaccine provides limited protection against specific forms of TB.
The National Tuberculosis Care Centre (NTBCC) at 144 Moulmein Road in Singapore offers TB evaluation and treatment. General inquiries can be addressed to the NTBCC during office hours from Monday to Saturday.
The National Tuberculosis Screening Centre (NTBSC) screens close contacts of TB patients at 142 Moulmein Road in Singapore. Appointments at the NTBSC can be made during specific hours from Monday to Friday.
For more information on past TB screenings and clusters identified in various locations in Singapore, further details can be obtained.
The National Tuberculosis Programme (NTBP), established by the Ministry of Health in 1997, aims to prevent and manage TB in Singapore. Operating under the Communicable Diseases Agency (CDA), the NTBP focuses on diagnosis, contact tracing, community engagement, partnerships, and sustainable strategies for TB control.
Close contacts of TB cases advised to seek medical attention if identified do not require isolation unless they test positive for TB. They can continue their daily activities. After two weeks of treatment, contacts are no longer infectious and must follow up as instructed by their healthcare provider. TB screening at the NTBSC is free for identified contacts only.