Pulmonary T.B. (short form for tuberculosis), is a disease which causes not only much sickness but also deaths and sequel which can make a person chronically sick.

It has a high prevalence in developing Asian and African countries. Since the past 2 decades, there has been a resurgence of T.B in affluent developed countries, due to   immune suppressive therapy, HIV/AIDS and other immune depressed conditions.

The lungs get infected via inhalation of drops containing T.B. germs. These drops come in the atmosphere when an infected person coughs or sneezes or talks. Germs of T.B. called mycobacterium tuberculoses get destroyed easily by sun light.

One third of the world’s population is said to be infected by T.B., but all do not develop the disease. Development of the disease depends on the amount of bacilli inhaled and resistance of the affected person. 

Once the germs   enter the body, body’s immune system tends to contain the infection by forming what is known as, ”Ghon’s complex”.  But if the person is exposed another   time, or his immunity goes down for any reason, he can develop full fledged infection as the mycobacteriums lying dormant are activated. 

Pulmonary T.B. like any other infectious disease does not discriminate and can affect a person of any gender, age or socio economic status.

But mostly it is the world’s poor who are more affected for multiple reasons. Overcrowding , malnutrition, immune deficiency states are some of the risk factors which make a person more vulnerable to T.B. Occupations which involve constant exposure to silica,  asbestos or coal dust also increase susceptibility to develop T.B. of the lungs.

Smokers are yet another group of people at risk to have pulmonary T.B. as chronic   smoking damages the protective layer of respiratory passages.

Chronic cough with or without bloody sputum, not responding to conventional antibiotics is one of the hallmark features of pulmonary T.B. The person also suffers from low grade evening or night fever, loss of appetite and resultant loss of weight and asthenia.

If untreated, the infection can spread and damage the whole lung parenchyma. It can spread to covering of the lung and to another lung. The infection can also possibly extend via blood stream to various other parts of the body, affecting them, what is called as extra pulmonary T.B.

A person suffers not only at time of infection but also from the sequel. If the lung parenchyma gets damaged due to T.B. even after clearing of the infection, he shall suffer from chronic dyspnoea and the physical stamina is reduced. Healing of a focus of T.B. can occur by fibrosis, where elasticity of the lung is damaged. This also leads to breathlessness and reduced work efficiency.

Diagnosis of pulmonary T.B. is suspected when a person has the typical symptoms. It is confirmed by demonstration of the mycobacterium in sputum.  X-ray of the chest and Mantoux test(testing sensitivity to tubercular antigen) also aid in diagnosis

Problem arises during treatment of tuberculosis. Good treatment to ensure complete eradication of the mycobacterium is for 6 months. Many persons start feeling good after one to 2 months and abandon the drugs on their own.

These people still harbor the germs and can infect other people with whom they come in contact. When treatment is restarted, the mycobacterium     develop resistance to the drugs used. Multidrug resistance T.B.  has become a cause for concern, globally.

Adverse drug reactions are yet another reason for people to abandon the treatment.

Prevention of T.B. is of utmost importance. Spitting in public should be strictly prohibited. While coughing or sneezing, a person should   cover his mouth to prevent the droplets from being dispersed in the environment.

Houses and work places should have adequate sun light and cross ventilation to prevent   accumulation of germs of any kind. Screening for T.B. is must for people in contact with T.B. cases or in high risk groups like prisoners or HIV patients,

Once somebody has pulmonary T.B. it is essential to take treatment for the entire duration. Good nutritious diet,  helps to prevent or minimize the adverse effects of anti T.B. drugs.

Having pulmonary T.B. is not a death sentence like older times before advent of anti T.B. drugs. But to prevent much damage to lungs, it is essential to take the treatment for entire duration.

E-mail –rachna212002@yahoo.co.uk