Miliary tuberculosis of the lung: forms, diagnosis, symptoms, treatment

Miliary tuberculosis is a serious enough disease, which is often confused with typhoid fever. The disease affects various systems of internal organs, starting with the liver and ending with the lungs. This form of tuberculosis is diagnosed in a small number of people.

Description of the disease

Miliary tuberculosis of the lungs is an acute form of the disease, characterized by the emergence of lesions at the same time in several organs. Isolate the acute and chronic stage of the pathology. The latter is considered the most dangerous. The acute form usually develops against the background of infection of the bloodstream with pathogenic microorganisms. As the disease progresses, they penetrate more and more organisms, infecting them. Against the background of extensive infection, the shells of the brain are seriously affected.

The main causative agent of the disease are the mycobacterium tuberculosis, which, as a result of the weakening of the body's defenses, penetrate the body in large quantities. Subsequently they spread together with the blood flow.

According to experts, three men suffering from tuberculosis have only one woman with a similar diagnosis. Most pathology is diagnosed among the stronger sex, whose age varies from 20 to 40 years.

Miliary tuberculosis is considered a socially conditioned disease, as its prevalence among the population is determined by living conditions. Epidemic trouble is due to active migration flows, a drop in the level of material opportunities, an increase in the number of socially unadapted people.

Causes of the disease

The causative agents of tuberculosis are the bacteria of the genus Mycobacterium. In total there are more than 70 species. They are common in water, soil, air, the body of animals. For humans, only a few species present a particular danger, which scientists conditionally combine into a complex of M. tuberculosis. The spread of pathogenic bacteria occurs in one of three ways: from a primary source of infection, from old tuberculosis foci or as a result of surgical operations on an organ already affected by the disease.

The group at increased risk of developing this disease includes children who have not been vaccinated in a timely manner, people with immunodeficiency or who have taken long-term medications to suppress excessive activity of the body's defenses.

What signs help to recognize miliary tuberculosis?

Symptoms of this disease are not specific, they depend on the area of localization of the lesion. The following are common symptoms common to patients:

• Weakness in the body.
• Fever.
• Temperature increase.
• Pronounced intoxication.
• Decreased body weight.
• Problems with breathing.
• Cyanosis of the skin.
• Excessive sweating at night.
• Dry cough.

The disease can occur in acute, chronic or acute form. Each of them has its own characteristics.

The chronic form proceeds wavy. This means that the phase of exacerbation is replaced by remission. Patients turn to a doctor for help with complaints of disability, a sharp decrease in body weight, rapid fatigue. In some cases, hemoptysis is present.

Acute miliary tuberculosis usually takes place in severe form, and its symptoms vary depending on the localization of inflammation. In some patients, doctors report severe pulmonary insufficiency amid a rise in temperature and intoxication syndrome. The lungs are usually affected over the entire surface. If the rash is observed only in the subclavian areas, it is a question of the so-called limited miliary tuberculosis. This type of pathology is asymptomatic, sometimes subfebrile temperature and dry cough are fixed.

The acute form of the disease is otherwise called tuberculous sepsis. It is characterized by a rapid current. Literally 2-3 weeks after the appearance of primary symptoms, a lethal outcome is possible . This disease is characterized by high fever and dyspeptic disorders. Many patients complain of severe headaches. This symptom is due to a serious vascular lesion and the involvement of the cerebral membranes in the pathological process.

Forms of miliary tuberculosis

Depending on the prevalence of symptoms, the disease is divided into the following forms:

• Pulmonary. On the background of general intoxication there are signs of respiratory failure.
• Typhoid. Rashes occur in all systems of internal organs. This form of the disease is characterized by the appearance of fever and signs of general intoxication, so it is often confused with typhoid fever.
• The meningitis. It differs by the presence of infectious foci in the meninges.

Establishing diagnosis

In the case of causeless weight loss, sweating at night, a feeling of weakness and decreased appetite, it is recommended to seek advice from a specialized specialist, namely, a phthisiatrician or infectious disease specialist.

Diagnosis of miliary tuberculosis includes the following procedures:

• Complete blood count.
• Lumbar puncture.
• CT of the brain and thorax.
• Ultrasound of internal organs.
• Radiography of the chest.
• Echocardiography.

Based on the results of the tests, the doctor can confirm or refute the diagnosis of "miliary tuberculosis". Symptoms that characterize a person's condition, do not allow to assert 100% of the presence of ailment. Only instrumental diagnostics can help to establish a definitive diagnosis.

What treatment is required?

Therapy of this disease requires a lot of effort and time. For almost a year the patient has to take several medications. Usually they are prescribed "Streptomycin", "Isoniazid", "Rifampicin", "Moxifloxacin". Such a variety of medicines doctors explain by the fact that each means individually has a certain effect on the course of treatment, and together they can all overcome the ailment.

Miliary lung tuberculosis also provides for other types of compulsory therapeutic procedures (breathing exercises, physiotherapy, taking immunostimulating drugs). The patient should adhere to the correct mode of work and rest, clearly follow all the recommendations of the doctor. Particular attention should be given to the diet. It should be diversified with dairy products.

If the patient lives with young children, they usually recommend a temporary hospitalization for 3-4 weeks.

Surgery

Many patients with this disease are prescribed surgery, which involves excision of a part of the lung. Resection is recommended for cicatricial structures of bronchi, patients with hemoptysis.

It is possible to use other methods of treatment, including a combined nature. In particularly serious cases, it is usually recommended to remove part of the lung or the entire organ, the imposition of an artificial pneumothorax, and also the drainage of the cavity.

Forecast

Undoubtedly, treatment of miliary tuberculosis with the use of chemotherapy is an important stage in the fight against the disease. Before the active use of anti-tuberculosis drugs, the mortality rate of patients with this diagnosis was almost 100%. Timely and competent therapy today allows to reduce these indicators to 10%. The earlier the diagnosis is made and the appropriate treatment is started, the higher the chances of a favorable prognosis. Most of the fatal cases with this disease are recorded in the first few weeks of patients being in a medical facility. Specialists explain such sad statistics by the late onset of therapy.

The probability of relapse is only 4%. If the patient follows all the prescriptions of the doctor and strictly accepts prescribed medications, the chances of re-infection are markedly reduced.

Complications of the disease

In the absence of timely treatment, the following complications may develop: the formation of multiple caverns in the lungs, bronchogenic dissemination, caseous pneumonia.

Preventive measures

Miliary tuberculosis is usually diagnosed in certain social strata (people with low income, migrants, etc.). Men are sick several times more often and more intensely than women. People at the age of 20 and up to 39 years are at risk.

Prevention of this pathology primarily implies the complete exclusion of close contact with people who have signs of pulmonary diseases. It is equally important to ensure proper and rational nutrition in order to strengthen immunity. Doctors recommend moderate hardening.

Miliary tuberculosis can be prevented if the influence of factors negatively affecting immunity is reduced. These include frequent hypothermia, lack of physical activity, starvation, work in adverse conditions.

On the part of the state, anti-epidemic measures should be carried out in disadvantaged regions. In addition, funds must be allocated from the budgets to treat patients with this diagnosis. If there is a high risk of tuberculosis in the region, people must undergo a physical examination when applying for a job.

Conclusion

In this article, we described what constitutes a disease, like miliary tuberculosis. Photos of patients with this diagnosis can be seen in specialized medical reference books. This disease is diagnosed today more and more rarely, and the cases of lethal outcome are fixed ever less. Doctors warn that timely detection of the disease can minimize the likelihood of complications, including death.