TUBERCULO
SIS
INTRODUCTION
Tuberculosis is a serious disease that most often affects the lungs
but can also affect other organs (extrapulmonary tuberculosis).
It was on March 24, 1882 that the German doctor Robert Koch
isolated the bacterium responsible for tuberculosis and which has
bacill
es cohabited with humans for millions of years. This discovery
acido earned him the Nobel Prize in Medicine in 1905.
-
alcoo
lo- March 24 has been declared World Tuberculosis Day by the World
résist Health Organization (WHO).
ants.
DEFINITION
Tuberculosis is a bacterial infection that can affect many organs.
Human is the only reservoir of the germ and represents the main
agent of transmission of the bacterium.
bacill
The disease can progress in several phases:
es
acido • Primary tuberculosis infection: this corresponds to the body's
- first contact with the bacterium. Resulting damage in lung
alcoo
lo-
(known as lung canker). The multiplication of the bacteria leads
résist to the immune response and make caseous necrosis (the body's
ants. defense to prevent the development of bacteria). In the
majority of cases, the bacillus can remain in the body in a
"dormant" state for years until the immune system becomes
weak (latent tuberculosis).
• Active tuberculosis : certain diseases promote its
occurrence (AIDS, diabetes, alcoholism, malnutrition, etc.)
after a primary tuberculosis infection. The bacterium can
then reach many organs (lung, kidney, bone, brain).
CAUSES
The bacterium responsible for human tuberculosis is the bacillus of
Koch: Mycobacterium tuberculosis (in the form of rods) belonging
to the family of mycobacteria which are also called AFB = acid-fast
bacillus.
This bacterium was discovered by Robert Koch in 1882. It is still
common to call the pathogen "Koch's bacillus".
TYPE
There are 3 types of tuberculosis:
• Pulmonary tuberculosis or phthisis:
It is the most common form of tuberculosis (about 70% of cases).
The bacteria destroy lung tissue, creating cavities. The disease
remains localized in the lungs.
• Extra pulmonary tuberculosis:
In this case, the bacteria attack other parts of the body, such as
the bones, kidneys, lymph nodes, meninges or central nervous
system. Extra pulmonary tuberculosis may or may not be
accompanied by pulmonary tuberculosis.
• Disseminated or miliary tuberculosis:
The bacteria spread through the bloodstream and attack
the whole body. It is therefore a pulmonary and extra-
pulmonary tuberculosis.
SYMTOMS
• A chronic cough (lasts more than 15 days) with thick sputum,
sometimes including hemoptysis (streams of blood)
• A lingering fever
• night sweats
• Alteration in general state = Asthenia (weakness) + Anorexia
(loss of appetite) + Weight loss
PARACLINICAL EXAMINATIONS
• TST (tuberculin skin test): a small test for the diagnosis of
tuberculosis. This test is also widely used to check the proper
functioning of the BCG vaccine (bacille Calmette-Guerin) which
protects against tuberculosis.
NEGATIVE POSITIVE
• Rx Thorax: is a medical imaging technique based on X-rays
for diagnosing pathologies reaching or affecting the thorax
and lungs.
NORMAL INFECTED
• BK sputum: The cytobacteriological examination of sputum
consists of examining the sputum of a person in the event of a
respiratory infection, in order to determine which germs are
involved.
• IGRA (Interferon Gamma Release Assay test) is a new blood
draw test to detect BK infection by assessing the strength of the
body's immune response against TB by measuring the
production of a molecule in the blood defense (gamma
interferon) by leukocytes exposed to tuberculosis antigens.
TRANSMISSION MODE
The disease spreads from person to person through the air. When
people with pulmonary TB cough, sneeze or spit, they throw TB
germs into the air. You only need to inhale a few of them to
become infected.
Precisely pulmonary tuberculosis which is contagious.
EPIDEMIOLOGY
According to the World Health Organization (WHO), tuberculosis
kills nearly 1.8 million people every year worldwide. On average,
10 million people contract it each year. It is one of the top 10 causes
of death worldwide. More than 95% of TB deaths occur in low- and
middle-income countries, including some countries neighboring
Europe.
The number of people newly diagnosed and cases reported to
national governments fell from 7.1 million in 2019 to 5.8 million in
2020.
According to WHO estimates, in 2020 around 4.1 million people have
tuberculosis but have not been diagnosed or have not been
officially notified to national authorities. This figure is up from the
2.9 million cases reported in 2019.
TREATMENT
Isolation must be for 5 weeks in the event of discovery of Koch's
bacillus in respiratory secretions.
The curative treatment aims to destroy the bacteria present in the
infected organs and is based on a combination of four antibiotics:
Isoniazid, Rifampicin, Ethambutol and Pyrazinamide. It should be
started as soon as possible.
The treatment includes a combination of the 4 previous anti-
tuberculosis antibiotics according to two schemes: 4RHEZ/2RH
These drugs will be taken in the morning on an empty stomach at
the same time.
PREVENTION
Improving living conditions : lack of hygiene, malnutrition,... and
washing hands regularly, etc.
Vaccination with BCG (Bacille Calmette and Guérin) aims to
protect young children and infants from serious forms of
tuberculosis, in particular meningitis (an infection of the envelopes
of the brain).
We have to notify about Tuberculosis.
CONCLUSION
Tuberculosis is an infectious disease that particularly affects
vulnerable people. Vaccination is also recommended for these
people at risk. Treatment is based on taking antibiotics, which
aims to destroy the bacteria present in the infected organs.
