Phthisiology: diseases — симптомы, диагностика и лечение

Pulmonary tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, also known as Koch's bacillus. It is transmitted through the air, which means that anyone can encounter it - in transport, in line, in the office, at a party. This is fundamentally important to understand, because there is still an unfair stereotype around tuberculosis: that only people without home and work suffer from it. In fact, teachers, students, drivers, doctors, entrepreneurs—those who have coincided with contact with the infection and temporarily weakened body defense—get sick. For Central Asia, the topic remains relevant, and the main practical rule is simple: a cough that lasts longer than two to three weeks is not a “lingering cold,” but a reason to take a photo of the lungs and give sputum. Tuberculosis is curable, and if detected in time, it is almost always curable.

Osteoarticular tuberculosis is a form of extrapulmonary tuberculosis in which mycobacteria enter the bones and joints through the bloodstream. Most often, the spine is affected, primarily the thoracic and lumbar regions: the vertebral bodies and intervertebral disc are destroyed, a leaky abscess is formed, and with significant destruction, the spine is deformed with the formation of a hump. Less commonly affected are the hip and knee joints. The disease develops slowly, over months, so it has long been mistaken for osteochondrosis or arthrosis. The key to preserving function is early detection with MRI and comprehensive anti-TB treatment.

Hemoptysis is the appearance of blood in the sputum when coughing. This is not a separate disease, but a symptom, which can be either a harmless cause or a serious respiratory disease. Blood occurs in the form of single veins, pink foam or clots; sometimes its source is not in the lungs at all, but in the nasopharynx or stomach. Even a small amount of blood is a reason to consult a doctor and take a chest X-ray, because this symptom helps to identify tuberculosis, bronchiectasis or a tumor in time. Excessive discharge of scarlet blood is an emergency situation that requires calling an ambulance.

Tuberculosis of the lymph nodes is the most common form of extrapulmonary tuberculosis. Mycobacteria enter the nodes with the flow of lymph or blood, most often from the lungs, and cause special inflammation in them with the formation of granulomas. Mostly the cervical and supraclavicular nodes are affected: they slowly enlarge, at first they remain dense and painless, then they are soldered together into a package, soften and can break out with the formation of a long-term non-healing fistula. Unlike ordinary lymphadenitis, the process takes weeks and months to develop and does not respond to conventional antibiotics. Long-term treatment with special anti-tuberculosis drugs.

Tuberculosis of the genitourinary system is the second most common form of extrapulmonary tuberculosis, and at the same time one of the most lately recognized. It disguises itself as ordinary chronic cystitis or pyelonephritis: the patient receives antibiotics for years, but the symptoms return. The key to a timely diagnosis is the characteristic combination of leukocytes in the urine with sterile cultures and an acidic urine reaction, which should alert the doctor.