Treatment of pulmonary tuberculosis. Fact or fiction: when is home treatment for tuberculosis possible? You can be treated for tuberculosis on an outpatient basis

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Tuberculosis is an insidious and serious disease. A person can be a carrier of Koch’s bacillus for a long time, but the pathology does not manifest itself in any way, and no dangerous symptoms are observed. But any negative factors can transform the disease into an active form, and then long-term treatment cannot be avoided. Therapy is usually carried out in specialized medical institutions. But sometimes outpatient treatment of tuberculosis is possible, what is it and in what situations is it allowed.

What it is?

If tuberculosis therapy is carried out in a hospital, the patient is under the supervision of doctors around the clock throughout the course. Outpatient treatment includes the following:

1. The patient must come to the outpatient department every day and take medications under the supervision of medical staff.
2. Undergo routine examinations and tests at the department.

Home therapy has significant advantages over inpatient treatment. The risk of infection with chemo-resistant mycobacteria, which may be present in inpatient departments, is eliminated. In addition, being at home has a positive effect on a person’s psychological state.

Another important advantage, most likely for the state, is that this type of therapy significantly reduces the cost of anti-tuberculosis treatment and saves money for those patients who need hospitalization.

Indications and contraindications

Is it possible to treat tuberculosis on an outpatient basis? Yes, but only if he has his own testimony for this:

• The patient has tuberculosis in the early stages.
• The person is not dangerous to others.
• The health and life of the patient is not in danger.
• There is no high risk of developing serious complications.
• The patient is in a mentally adequate state.
• Age and health status allow you to come to the outpatient department every day.

If a decision is made to conduct therapy on an outpatient basis, the TB specialist must constantly monitor the progress of treatment.

Contraindications to this type of therapy are:

• The disease is in the active phase.
• A person can infect others.
• It is not possible to visit the outpatient department every day.
• The patient has mental illness.
• The life and health of the patient is at risk due to the severity of the stage of the disease.
• There are chronic pathologies that complicate the course of the disease.

Whether outpatient treatment is possible or not, only the doctor decides in each specific case.

Stages and treatment regimen

Almost all anti-tuberculosis institutions have outpatient departments. The essence of their therapy is as follows:

When treating tuberculosis, regardless of the location, be it inpatient or outpatient, it is important to adhere to the following principles:

1. Timely initiation of therapy.
2. Maintaining a hygienic regime in terms of nutrition and daily routine.
3. Carrying out etiotropic therapy aimed at taking antibiotics and chemotherapy drugs that can combat mycobacteria.
4. An integrated approach that involves combining several drugs and treatment methods at the same time.
5. Pathogenetic therapy. This principle involves the use of methods that will stimulate the immune response and increase the body's resistance to infection.
6. Treatment is symptomatic. For example, taking medications for fever or sleeping pills for sleep disorders.
7. Collapsotherapy methods. With their help, gas is injected into the pleural cavity in order to cause the collapse of the pathological area of ​​​​tissue in the lungs.

During therapy, it is also important to maintain continuity; you cannot take breaks in taking medications, otherwise mycobacteria will develop resistance to the active ingredients of the medications.

Any therapy also involves following certain steps:

1. Intensive therapy, which is most often recommended to take place in a hospital setting.
2. At the second stage, after the acute symptoms of the disease have resolved, treatment can be continued on an outpatient basis.

Treatment of tuberculosis on an outpatient basis involves taking antibacterial agents that have a detrimental effect on Koch bacilli. Among these are: “Isoniazid”, “Ethambutol”, “Rifampicin”, “Streptomycin”. If there is increased resistance of mycobacteria to such drugs, then fluoroquinolones and pyrazinamide are used.

Before prescribing a medicine, a bacteriological test is required to determine the sensitivity of mycobacteria to antibiotics.

The discovery of resistant strains forces doctors to prescribe several antibacterial agents to patients at the same time. In the treatment of tuberculosis, specialists resort to the use of three treatment regimens:

1. At the same time, Isoniazid, Streptomycin and Aminosalicylic acid are being taken.
2. When more resistant strains are discovered, a four-part scheme is used. To the first two components from the first regimen: “Rifampicin” and “Pyrazinamide”.
3. The five-component regimen, in addition to the previous one, involves taking Ciprofloxacin.

The duration of therapy depends on the severity of the disease. Early-stage tuberculosis will require taking medications for 3-4 months, and if a five-component regimen is prescribed, then therapy will most likely last at least a year.

In addition to the listed drugs, immunomodulators, for example, interferon-based drugs, are added to the treatment regimen. Physiotherapeutic procedures provide significant assistance in therapy. Breathing exercises are recommended for all patients. The outpatient department has a physical therapy room, where a set of exercises is performed under the guidance of a specialist.

You should also not forget about proper nutrition during tuberculosis therapy. The diet should be rich in vitamins, minerals and all beneficial substances for the body.

Where is outpatient treatment in the Russian Federation?

Almost every TB dispensary has an outpatient department. If we talk about Moscow, then such medical care can be obtained in the following institutions:

• Anti-tuberculosis dispensary on the street. Dokunina, 18.
• Branch of the International Scientific and Practical Center for the fight against tuberculosis of the Department of Health in the South-Western Administrative District No. 4.
• Anti-tuberculosis clinical dispensary No. 21 on Metallurgov Street.
• Moscow regional dispensary on the square. Struggles, 11 and others.

In our northern capital, St. Petersburg, there are no problems with this either; you can get effective treatment for tuberculosis at the following addresses:

• Anti-tuberculosis dispensary No. 2 on the street. Children's, 14.
• Anti-tuberculosis dispensary on the street. Serdobolskaya.
• Leningrad regional anti-tuberculosis dispensary at the address: lane. Nogina, 5.

When engaging in outpatient treatment, it is important to remember that even after undergoing procedures and taking medications in the department, you should follow all medical recommendations at home. Pay attention to your work and rest schedule, take recommended multivitamins, and do breathing exercises. If the disease is in the initial stages of development, then this type of treatment will help to recover and cope with the pathology.

Discussion Club of the Russian Medical Server > Medical consultation forums > Infectious diseases > Tuberculosis > Diagnosis and treatment of tuberculosis >

Hello Anna Sergeevna!


1 day - isoniazid (1 tablet)



Now the questions:

I'm looking forward to the answers!

12.08.2011, 21:33

Hello.

Thank you.

Advantages and disadvantages of outpatient treatment for tuberculosis

Do you need to add streptomycin to isoniazid and rifampicin during these 4 months of support, in what dose?

13.08.2011, 14:45

Got it, thanks!

17.08.2011, 23:21

18.10.2011, 17:43

Thank you!

Anna Sergeevna, greetings.

Good afternoon

I would like to get some advice on whether it is possible to fast after an illness?

23.02.2012, 11:16

Got it, thanks!

Ambulatory treatment

Outpatient treatment is one of the important stages of long-term chemotherapy for tuberculosis patients. For a significant proportion of patients, outpatient treatment is a continuation of treatment begun in the hospital; for another, less significant proportion, treatment is carried out entirely on an outpatient basis.

Outpatient treatment of patients should be carried out according to a strictly individual plan, taking into account pathological changes in organs and clinical manifestations of tuberculosis in each patient.

How to behave during the outpatient stage of tuberculosis treatment?

The basic principles of antibacterial treatment remain valid for outpatient treatment. During outpatient treatment, correct and systematic monitoring of drug intake is necessary. The forms and methods of control are different: taking the drug in the presence of a nurse, for which the patient comes to the dispensary, or laboratory control of taking drugs from the GINK and PAS group.

For laboratory monitoring of patients taking GINK drugs, the following method is used: to 5 ml of urine, 5 ml of a reagent is added, which includes ammonium vanadium - 0.1 g, glacial acetic acid - 5 ml, concentrated sulfuric acid - 2.2 ml, distilled water - 100 ml. If GINK drugs are present in the urine, a brown color appears.

To determine PAS in urine, the following method is used: add 5-10 drops of urine and 3-5 drops of a 3% ferric chloride solution to 5 ml of distilled water.

If the patient's urine contains PAS, the solution turns red-violet.

The introduction into practice of a single dose of tuberculostatic drugs, as well as various intermittent chemotherapy regimens, greatly facilitates the organization of controlled outpatient treatment of tuberculosis patients.

Both of these methods (one-time and intermittent) were introduced into practice after experimental and clinical observations and are used in both outpatient and inpatient settings. It has been proven that with a single daily dose of tuberculostatic drugs, a sufficiently high concentration of drugs is created in the blood of the patient being treated to obtain a therapeutic effect.

A justified and correct method of treatment is a one-time dose for patients after several months of divided doses of drugs, necessary to relieve severe intoxication and radiologically detectable favorable evolution of the tuberculosis process. Thus, after 2-4 months of intensive chemotherapy in a hospital (or sanatorium), you can switch to the method of taking a single daily dose of drugs.

Discussion Club of the Russian Medical Server > Medical consultation forums > Infectious diseases > Tuberculosis > Diagnosis and treatment of tuberculosis > I am being treated for tuberculosis on an outpatient basis.

Hello Anna Sergeevna!
I came across this forum by accident and I really liked the content and professionalism of your answers.
I also suffer from tuberculosis and I always try to find out the effectiveness of the actions and prescriptions that TB doctors give me, but I always come across irritation and such a reaction - mind your own business, don’t pretend to be smart, drink what they give you, but all side effects will go away someday... But we all want to be cured completely and do it with the least harm to the body!!!
My diagnosis: infiltrative tuberculosis of the upper lobe of the right lung, VK-, was discovered for the first time, like in most cases, by accident. Weight 55 kg. height 162 cm.
I am undergoing outpatient treatment. I have already completed an intensive course, but not very cleanly, because after 1.5 months of taking chemotherapy drugs (isoniazid-1 tablet, rifampicin-4 tablets, pyrazinomide-4 tablets, ethambutol-3 tablets) I developed a severe allergy with hives and itching on the arms and legs, but the phthisiatrician forbade reducing or canceling doses, because Resistance may develop, but he prescribed Suprastin 2 tablets. in a day. After 3-4 days I could no longer sleep due to itching and hives all over my body.

Is it possible to treat tuberculosis on an outpatient basis?

After that, I was taken off the drugs for 3 days and detoxified with prednisone during this time. How this affected drug resistance is not clear, no one has explained...
Then they prescribed me to take medications according to the following scheme:
1 day - isoniazid (1 tablet)
Day 2 – isoniazid + rifampicin (1+4)
Day 3 – isoniazid + rifampicin (1+4)
Day 4 - isoniazid + rifampicin + pyrazinamide (1+4+4)
Day 5 - isoniazid + rifampicin + pyrazinamide + ethambutol (1 + 4 + 4 + 3)
After the 4th dose, my allergy appeared again and I was left to drink only isoniazid + rifampicin (1+4) until the end of the intensive course.
I passed the interim tests and took an overview picture, they said the tests were normal, the picture shows positive dynamics.
Now the questions:
1. tests showed high hemoglobin - 158, sugar -5.7 and ketones++ in the urine (liver tests are all at the upper limit of normal, other indicators of the blood flow and blood volume are normal), but the phthisiatrician said that this is normal, nothing needs to be done . Is it so?
2. I am transferred to a maintenance course: 3 times a week isoniazid + rifampicin (2+4), please advise, should I insist on taking isoniazid + rifampicin (1+4) daily, so the treatment will be more effective?
3. Is it possible to do gymnastics according to Strelnikova during the treatment period?
I'm looking forward to the answers!

12.08.2011, 21:33

Hello.
This is a typical pyrazinamide allergy. It can be replaced with streptomycin for 60 doses.
Hemoglobin is normal, as is sugar. But all together can indicate dehydration. Drink more.
WHO currently does not recommend intermittent dosing
You can do any gymnastics that does not lead to loss of consciousness.

And regarding resistance, can 3 days of interruption of dosage and then taking the drugs separately provoke resistance?

13.08.2011, 14:45

No, this should have been done in the intensive phase.
Stability could not provoke all this. Moreover, it was initially unknown about it.

Got it, thanks!
I have another question: is it possible to carry out cosmetic procedures such as injections of Dysport (Botox) and hyaluronic acid during anti-tuberculosis treatment?

17.08.2011, 23:21

It’s not worth it, the issue has not been studied, the consequences may be unpredictable.

Dear Anna Sergeevna! I need your advice again.
After two months of a maintenance course (daily intake), I took liver tests and they showed - ALT-86.4, AST-14.5, bilirubin-1.1. The phthisiatrician said that the tests were elevated and recommended taking Hepadif. And I already constantly take hepatoprotectors (Essentiale, Karsil, Hepabene) in 20-day courses, brew oats with immortelle, corn silk and parmelia. I still have two more months of treatment, is it possible to switch to a 3-times-a-week medication regimen?

18.10.2011, 17:43

An increase in transaminases by less than 5 times does not require discontinuation of medications. Drink the so-called Hepatoprotector courses do not make sense.

Thank you!
That is, during treatment the liver and kidneys cannot be supported by anything?

Anna Sergeevna, greetings.

I would like to get some advice on whether it is possible to fast after an illness?
The treatment ended at the end of December 2011, I feel fine.

Good afternoon

I would like to get some advice on whether it is possible to fast after an illness?
Anti-tuberculosis treatment ended at the end of December 2011, I feel fine, general tests are normal.

23.02.2012, 11:16

Hello. If you tolerate it well, it’s possible, but without violence to the body.

Got it, thanks!

Discussion Club of the Russian Medical Server > Medical consultation forums > Infectious diseases > Tuberculosis > Diagnosis and treatment of tuberculosis > I am being treated for tuberculosis on an outpatient basis.

View full version: I am being treated for tuberculosis on an outpatient basis.

Hello Anna Sergeevna!
I came across this forum by accident and I really liked the content and professionalism of your answers.
I also suffer from tuberculosis and I always try to find out the effectiveness of the actions and prescriptions that TB doctors give me, but I always come across irritation and such a reaction - mind your own business, don’t pretend to be smart, drink what they give you, but all side effects will go away someday... But we all want to be cured completely and do it with the least harm to the body!!!
My diagnosis: infiltrative tuberculosis of the upper lobe of the right lung, VK-, was discovered for the first time, like in most cases, by accident. Weight 55 kg. height 162 cm.
I am undergoing outpatient treatment. I have already completed an intensive course, but not very cleanly, because after 1.5 months of taking chemotherapy drugs (isoniazid-1 tablet, rifampicin-4 tablets, pyrazinomide-4 tablets, ethambutol-3 tablets) I developed a severe allergy with hives and itching on the arms and legs, but the phthisiatrician forbade reducing or canceling doses, because Resistance may develop, but he prescribed Suprastin 2 tablets. in a day. After 3-4 days I could no longer sleep due to itching and hives all over my body. After that, I was taken off the drugs for 3 days and detoxified with prednisone during this time. How this affected drug resistance is not clear, no one has explained...
Then they prescribed me to take medications according to the following scheme:
1 day - isoniazid (1 tablet)
Day 2 – isoniazid + rifampicin (1+4)
Day 3 – isoniazid + rifampicin (1+4)
Day 4 - isoniazid + rifampicin + pyrazinamide (1+4+4)
Day 5 - isoniazid + rifampicin + pyrazinamide + ethambutol (1 + 4 + 4 + 3)
After the 4th dose, my allergy appeared again and I was left to drink only isoniazid + rifampicin (1+4) until the end of the intensive course.
I passed the interim tests and took an overview picture, they said the tests were normal, the picture shows positive dynamics.
Now the questions:
1. tests showed high hemoglobin - 158, sugar -5.7 and ketones++ in the urine (liver tests are all at the upper limit of normal, other indicators of the blood flow and blood volume are normal), but the phthisiatrician said that this is normal, nothing needs to be done . Is it so?
2. I am transferred to a maintenance course: 3 times a week isoniazid + rifampicin (2+4), please advise, should I insist on taking isoniazid + rifampicin (1+4) daily, so the treatment will be more effective?
3. Is it possible to do gymnastics according to Strelnikova during the treatment period?
I'm looking forward to the answers!

12.08.2011, 21:33

Hello.
This is a typical pyrazinamide allergy. It can be replaced with streptomycin for 60 doses.

Treatment of tuberculosis at home - with great care

Hemoglobin is normal, as is sugar. But all together can indicate dehydration. Drink more.
WHO currently does not recommend intermittent dosing
You can do any gymnastics that does not lead to loss of consciousness.

Thank you. Do you need to add streptomycin to isoniazid and rifampicin during these 4 months of support, in what dose?
And regarding resistance, can 3 days of interruption of dosage and then taking the drugs separately provoke resistance?

13.08.2011, 14:45

No, this should have been done in the intensive phase.
Stability could not provoke all this. Moreover, it was initially unknown about it.

Got it, thanks!
I have another question: is it possible to carry out cosmetic procedures such as injections of Dysport (Botox) and hyaluronic acid during anti-tuberculosis treatment?

17.08.2011, 23:21

It’s not worth it, the issue has not been studied, the consequences may be unpredictable.

Dear Anna Sergeevna! I need your advice again.
After two months of a maintenance course (daily intake), I took liver tests and they showed - ALT-86.4, AST-14.5, bilirubin-1.1. The phthisiatrician said that the tests were elevated and recommended taking Hepadif. And I already constantly take hepatoprotectors (Essentiale, Karsil, Hepabene) in 20-day courses, brew oats with immortelle, corn silk and parmelia. I still have two more months of treatment, is it possible to switch to a 3-times-a-week medication regimen?

18.10.2011, 17:43

An increase in transaminases by less than 5 times does not require discontinuation of medications. Drink the so-called Hepatoprotector courses do not make sense.

Thank you!
That is, during treatment the liver and kidneys cannot be supported by anything?

Anna Sergeevna, greetings.

I would like to get some advice on whether it is possible to fast after an illness?
The treatment ended at the end of December 2011, I feel fine.

Good afternoon

I would like to get some advice on whether it is possible to fast after an illness?
Anti-tuberculosis treatment ended at the end of December 2011, I feel fine, general tests are normal.

How is pulmonary tuberculosis treated in adults on an outpatient and inpatient basis? Treatment of consumption (tuberculosis, chest disease) is a long-term, complex process. It involves taking strong medications, using physiotherapeutic procedures or other therapeutic methods, depending on the severity, form of the disease, and the general condition of the sick person. The TB doctor is authorized to decide how treatment can be carried out - outpatient or inpatient (in a special department of the hospital).

What is consumption?

Tuberculosis, which used to be called consumption, is considered one of the most insidious infections affecting humans. The pathogen (an acid-fast, very aggressive microorganism - Koch's bacillus) is transmitted in several ways. The leading methods of transmission are airborne, contact, and nutritional (food). Tuberculosis is accompanied by the formation of specific inflammatory foci and intoxication in the affected tissues.

The course of tuberculosis in its initial stages is sometimes practically asymptomatic or may be accompanied by subtle signs.

In such cases, the disease is determined by an X-ray photograph taken during a preventive medical examination of adults.

The picture of tuberculosis is characterized by the following clinical manifestations that allow one to suspect an infection:

• heavy night sweats;

• severe weakness, fatigue, apathy;
• low-grade fever (37–38 degrees) for a long period of time;
• steady loss of body weight, pale skin;
• swollen lymph nodes;
• with pulmonary tuberculosis - cough, shortness of breath, hemoptysis.

It should be noted that it is pulmonary tuberculosis (primary lesion) that most often begins other forms of the disease. By hematogenous route (through the bloodstream), mycobacteria from the lungs penetrate into other organs, provoking secondary inflammatory foci. In some situations, tuberculosis of internal organs or cases of tuberculous inflammation of the brain occur without the pathological process affecting the lungs.

There are two stages in the tuberculosis process: penetration of the pathogen into the body (infection) and development of the disease.

At the first stage, the identified disease is easier to treat. Late-diagnosed tuberculosis is fraught with dangerous consequences (even death), and its treatment is often ineffective.

The diagnosis is based on examination of the patient, collection of anamnesis, data from laboratory and instrumental studies. Mandatory are radiography of the lungs, bacteriological culture of sputum coming from the bronchi and lungs during coughing, PCR analysis, biochemical and serological tests, histological examination of the affected tissues. A specific method - the Mantoux test - can also be used to diagnose children and adults.

Basics of anti-tuberculosis therapy

Treatment of consumption is a difficult, lengthy process (sometimes it takes up to 1.5-2 years to treat), a step-by-step process, during which the patient is forced to regularly take special medications, undergo the necessary tests, and adhere to an appropriate regimen and diet.

Treatment of consumption in adults is:

• conservative - adequate drug therapy;
• radical - you can perform surgical intervention on the lungs according to indications (partial or complete removal of the affected organ, removal of tuberculomas from the lungs).

Optimal conditions for undergoing treatment procedures are provided to patients in specialized anti-tuberculosis hospitals. When a person is admitted to a hospital to treat an illness, doctors have the opportunity to constantly monitor the state of his health and the quality of treatment measures. You can monitor the correctness and frequency of medications taken by the patient, and immediately adjust the prescription if the need arises.

The advantage of inpatient treatment is also the ability to isolate the sick person from the healthy population.

All patients with open forms of tuberculosis, with a complicated, severe course of the pathological process require hospitalization and treatment in a specialized dispensary.

When is outpatient treatment allowed?

The possibility and advisability of treating tuberculosis outside the hospital - on an outpatient basis - is decided in each individual case by the attending physician. Many factors are taken into account.

The option of outpatient treatment is considered in cases where the disease is diagnosed at an early (initial) stage, if the patient does not pose a threat to others (non-contagious) and there is no danger to the life of the patient himself in terms of the development of complications of tuberculosis. Concomitant pathologies (they also need to be treated), age, mental adequacy of the patient, etc. are taken into account.

Outpatient treatment of the disease involves continuous monitoring of the therapeutic process by a phthisiatrician, the patient visiting a special room at a hospital inpatient unit at the appointed time, and undergoing tests.

Anti-tuberculosis dispensaries have outpatient departments, where the patient is provided with rational treatment and the necessary services are provided:

1. Development of an individual scheme for comprehensive anti-tuberculosis treatment, dispensing prescribed medications, taking them under the supervision of an authorized medical professional.
2. Carrying out the necessary diagnostic tests - as planned, you need to donate sputum, blood, urine for research, undergo chest x-rays, etc.
3. You can take physical procedures prescribed by your doctor.

Outpatient treatment of the disease involves daily visits by the patient to a special department.

In an outpatient manner, you can continue (only with the doctor’s permission) inpatient treatment when, after a therapeutic course at a tuberculosis clinic, encouraging positive dynamics are observed, only if the patient has ceased to be infectious. The patient’s safety for others is checked in a laboratory. Treatment continues until complete remission.

It is prohibited to use any alternative medicine without the knowledge of a doctor. It must be remembered that in this way you can aggravate the course of lung disease and cause irreparable harm to health.

Most often it leads to disorders in the pulmonary system. Timely detection of pathology and the prescription of a therapeutic course can stop the further development of the disease and increase the body's resistance to infection. Treatment of pulmonary tuberculosis in adults is often long-term and may require up to several months of persistent therapy.

Causes

The main reason for the development of tuberculosis is the penetration into the body and subsequent activation of acid-fast mycobacteria (Koch bacilli). These microbes have been known to mankind for centuries and are extremely resilient and resistant to drug therapy.

Tuberculosis can also be caused by other microorganisms, including Mycobacterium tuberculosis, Mycobacterium africanum, Mycobacterium bovis, Mycobacterium pinnipedii, Mycobacterium bovis BCG and others.

It is widely known that tuberculosis infection most often occurs through airborne droplets. Pathogens can also enter the human body through nutrition (by consuming products that have had contact with a patient with open form of tuberculosis), intrauterine (the fetus is affected by an infected mother), contact (in this case, the infectious agent enters the body of a healthy person through mucous membranes or microdamages on the skin).

Certain segments of the population are especially susceptible to infection with tuberculosis. These categories include the poor, the homeless, people in prison, people suffering from immune disorders, diabetes, and chronic diseases of the respiratory system. Mycobacterium infection also occurs in health care workers who do not take increased precautions when working with tuberculosis patients.

Symptoms of pulmonary tuberculosis in adults

The first signs of mycobacteria infection are in many ways similar to a common cold. The patient has symptoms such as:

1. Increased body temperature to subfebrile levels (from 37 to 37.5 °C).
2. Dry cough.
3. Body aches.
4. Runny nose, nasal congestion.
5. Chills.
6. Sleep disorders.
7. Increased sweating.
8. Increase in the size of lymph nodes.

Such symptoms can be present individually or combined in various variations.

The main clinical signs of tuberculosis appear as the disease progresses. The initial symptoms are supplemented by:

• a change in the patient’s appearance – the face becomes unhealthy thin and pale, the features become sharper, the cheeks become hollow, and a painful shine appears in the eyes;
• rapid weight loss while maintaining the usual appetite;
• an increase in hyperthermia in the evenings (t reaches 38 degrees or more, and subsides in the morning);
• constant cough, changing from dry to wet;
• pain in the chest, between the shoulder blades, intensifying with inspiration.

Coughing with sputum and bloody spots is observed when the disease passes into the infiltrative form. If blood is released in the form of a fountain, such a sign indicates a rupture of the cavity.

Diagnosis of the disease

The main methods for diagnosing a dangerous disease are:

• clinical examination, consisting of studying the condition of the lymph nodes, range of motion of the sternum, listening to the lungs and bronchi;
• chest x-ray;
• bacterioscopic examination of sputum for the presence of tuberculosis pathogens;
• blood analysis.

In some cases, the patient undergoing examination is prescribed a computed tomography (CT) scan and bronchoscopy.

The development of tuberculosis infection in children is indicated by a positive reaction to the Mantoux or Diaskintest test.

Treatment of pulmonary tuberculosis

Treatment of tuberculosis traditionally requires a considerable period of time - from 3 months to 2 years. The open form of the disease requires mandatory placement of the patient in a hospital. With a closed type of pathology, therapy is carried out on an outpatient basis.

The main method of treatment is taking special medications. If there are appropriate indications, surgery is prescribed.

The patient’s stay in the sanatorium allows the patient to stay in a sanatorium to consolidate the results of the treatment course. Treatment abroad based on the use of new medical technologies is considered highly effective.

Treatment in the early stages

The fight against the disease at an early stage consists of prescribing to the patient:

1. Antibiotics.
2. General strengthening drugs.
3. Immunomodulators.
4. Physiotherapy.

At the initial stage of pathology, aerosol antimicrobial therapy, which has a preventive effect and prevents further activation of pathogenic bacteria, becomes relevant. Taking vitamin complexes contributes to the overall strengthening of the body and increasing its resistance to infection. The administration of immunomodulators helps reduce the period of intoxication, increase the protective function, regression of the tuberculosis process, and reduce the frequency and severity of side effects of chemotherapy.

A significant improvement in the condition of lung damage can be achieved through electrophoresis and collapse therapy. It is allowed to begin such physical treatment only during the period of remission and while undergoing a rehabilitation course.

Traditional medicine methods help to enhance the effectiveness of basic therapy for tuberculosis at an early stage. A good addition to antimicrobial and supportive medications is the use of milk with rendered bear lard, a decoction of marshmallow roots, and badger fat with honey.

Medications

The selection of medications and determination of dosages is carried out on an individual basis. At the beginning of anti-tuberculosis therapy, drugs of first choice are used. The patient is prescribed a course:

• Ethambutol;
• Rifampicin;
• Streptomycin;
• Isoniazid;
• Pyrazinamide.

In case of an increased likelihood of the disease progressing to the next stage, it is planned to include Ofloxacin, Levofloxacin, Ethionamide, Lomefloxacin in the main regimen.

Among vitamin complexes, the choice is made in favor of drugs saturated with vitamins A, C, group B, E and D. Among the immunomodulators for tuberculosis, Leukinferon, Imunofan, Polyoxidonium, Glutoxim, Lykopid are effective.

The elevated temperature characteristic of the disease only goes down if it reaches 38.5-39 degrees. In such situations, ibuprofen drugs or Paracetamol are used.

Treatment in hospital

The length of stay of a patient with open form of tuberculosis in hospital is determined:

• severity and stage of the infectious process;
• the level of resistance of the body to the disease;
• existing complications such as emphysema, pulmonary hemorrhage, heart or pulmonary failure;
• the presence of contraindications to the medication course.

The degree of damage to the lungs or other organs is also taken into account (in the second case we are talking about secondary tuberculosis).

Placing a patient in a hospital is necessary to carry out the most accurate diagnosis, monitor all stages of the treatment course, and provide immediate medical care in case of complications. Keeping the patient under constant medical supervision makes it possible to take timely necessary measures in the event of the disease spreading beyond the lungs and to carry out urgent operations.

The course of treatment in a hospital setting takes at least 2 months. After the patient ceases to pose a danger to others, measures are taken to restore the body. To do this, the patient is sent to a tuberculosis dispensary or a specially equipped sanatorium. Also, consolidation of the course in an adult or child can be carried out at the place of residence (outpatient treatment).

A course of chemotherapy using anti-tuberculosis drugs becomes the basis for the treatment of a dangerous disease. The drugs used are often combined with each other - thanks to this, it is possible to avoid addiction to the active substances from the causative agent of the disease.

In the case of a correctly selected treatment regimen, on days 20-25 the process of abacillation of the patient is observed - the cessation of the release of pathogens into the sputum. At this stage, the decay of lung tissue stops, and the patient is no longer infectious.

The first course of therapy is completed after 2-3 months. During this period, the patient may be discontinued some medications. Basic antimicrobial agents, such as Rifampicin and Isoniazid, are taken for another 4-6 months. While in the hospital, the patient periodically takes blood and sputum tests, which are necessary to monitor his condition and the dynamics of the treatment.

Many anti-TB drugs are highly toxic and can cause severe side effects. To avoid deterioration of the patient's general condition, constant medical supervision is required. If medications are poorly tolerated, the doctor makes adjustments to the implemented therapeutic regimen.

Operation

Indications for surgery in a patient with tuberculosis are:

1. Low effectiveness of chemotherapy.
2. The presence of complications and critical consequences of the disease (bleeding in the lungs, spontaneous pneumothorax).
3. The presence of morphological changes, which cannot be avoided.

Surgical treatment helps restore the activity of the pulmonary parenchyma, remove accumulations of fluid and sputum, and eliminate congenital or acquired anatomical anomalies. More often, planned operations are performed for tuberculosis. Sometimes there is a need for emergency intervention (in cases of rapid development of pathology, a sharp deterioration in health, or risk of death of the patient).

The main types of surgical intervention are:

• lobectomy (resection of the pulmonary lobe);
• pneumectomy (complete removal of the lung);
• thoracoplasty (minimally invasive type of surgery).

Before and after surgical treatment, an intensive course of chemotherapy is required to ensure stabilization of the patient's condition.

Spa treatment

Sanatoriums for the recovery of patients who have suffered severe lung pathology are traditionally located in coastal, mountain, steppe, and forest-steppe zones. It provides for comprehensive treatment of tuberculosis in combination with climatic and physical factors.

Patients are prescribed:

1. Chemotherapy.
2. Inhalations.
3. Air baths.
4. Breathing exercises.
5. Heliotherapy.
6. Climatotherapy.
7. Treatment of concomitant diseases.

Treatment in sanatorium-resort conditions is especially indicated in the presence of focal, disseminated, infiltrative tuberculosis, which has passed into the resorption phase, scarring of the lung tissue. Also, postoperative patients, people who have completed the main course of treatment for tuberculoma, cavernous and fibrous-cavernous forms of the disease, and tuberculous pleurisy are sent to such institutions.

Treatment of tuberculosis abroad

Tuberculosis treatment abroad is carried out in accordance with all modern standards. Most often, the patient manages to completely get rid of the infection and undergo an effective recovery course.

Tuberculosis treatment is provided with high quality in Germany, Belgium, and Switzerland. The fight against the disease in these countries is based on the principle of an individual approach to each patient, the use of traditional and new drugs, and performing the safest surgical operations. A significant role is given to rehabilitation, including cryotherapy, massages, electrotherapy, iontophoresis, and the appointment of a special diet.

Judging by your diet, you don’t care about your immune system or your body at all. You are very susceptible to diseases of the lungs and other organs! It's time to love yourself and start improving. It is urgent to adjust your diet, to minimize fatty, starchy, sweet and alcoholic foods. Eat more vegetables and fruits, dairy products. Feed the body by taking vitamins, drink more water (precisely purified, mineral). Strengthen your body and reduce the amount of stress in your life.