Extrapulmonary tuberculosis - a common name for all forms of tuberculosis, which occur outside the lungs. Among all TB patients extrapulmonary tuberculosis diagnosed in 10-25% of patients. Most often it is a secondary infection that develops in patients with pulmonary tuberculosis, but in some cases it may be a primary disease. Especially likely to develop extrapulmonary tuberculosis in people with a weakened immune system, for example, in patients with tuberculosis and AIDS more than 50% of cases detected extrapulmonary tuberculosis. Symptoms of extrapulmonary tuberculosis can be very different, depending on which organs the disease struck.

Extrapulmonary tuberculosis

• Tuberculosis of the lymph nodes, or tuberculous lymphadenitis - the most common type of extra-pulmonary tuberculosis. The majority of patients with this disease tubercular lesions usually appear in the lymph nodes of the neck, at least - in the hilar, inguinal, axillary lymph nodes. In patients who are not infected with HIV, tuberculosis, lymphatic system often does not cause symptoms persist, and HIV-infected disease symptoms are usually fever, profuse sweating at night and rapid weight reduction.

In the early stages of the disease lymph nodes increase, but remain mobile and painless. Later, between several lymph nodes, or between lymph nodes and surrounding tissue adhesions are formed, and the nodes become less mobile, and some patients at a pressure on them to experience pain.

As a rule, tuberculin tests in patients are positive and rentegodiagnostika does not show any irregularities (if not tuberculosis lymph nodes is associated with pulmonary tuberculosis).

After the start of TB treatment affected lymph nodes may increase even more, and sometimes increases previously healthy lymph nodes Lymph nodes - what keeps our immune system ; this side effect usually takes place a few weeks later.

• Tuberculosis of pleura. Pleura - a serosa lung, but the pleural tuberculosis belongs to the species of extrapulmonary tuberculosis. Symptoms of pleural tuberculosis are usually shortness of breath, fever, cough and chest pain. Approximately 20% of patients radiography shows the presence of tuberculous lesions in the lungs. With the help of computer tomography in most cases, you can detect pleural thickening.
• Skeletal tuberculosis most often affects the spine, in rarer cases - bearing joints and bones. Patients complain of pain in the back or joints, and the classic symptoms of TB Symptoms of TB - how to recognize the disease   - Fever, cough, weight reduction - usually absent. For the treatment of skeletal tuberculosis is sometimes required, not only medical, but surgical treatment.
• Tuberculosis of the central nervous system (CNS). This type of extrapulmonary tuberculosis include TB meningitis Meningitis - an inflammation of the meninges , Tuberculous arachnoiditis, and some other diseases. TB meningitis is the most common type of CNS tuberculosis.

The first signs of CNS TB are usually extreme fatigue, fever, and headache. After two or three weeks of symptoms such as vomiting and changes in mental status. If the disease is left untreated, the patient may fall into a coma. Not all stages of the disease patients may experience muscle spasms.

The lack of timely treatment of tuberculosis central nervous system usually leads to serious complications or death. The treatment of patients with this form of extrapulmonary tuberculosis, lasts from nine to twelve months. In addition to anti-TB drugs in the first six to eight weeks of therapy often used corticosteroids (dexamethasone) - it can significantly reduce the likelihood of death and serious health consequences.

Mortality was highest among patients with tuberculosis of the CNS under the age of 5 and older than 50 years and among those who have symptoms of the disease appeared in two months or more before the start of treatment.

• Tuberculosis of the intestine may develop as a result of ingestion of contaminated substances (primary infection), or the spread of mycobacteria from the lungs to other organs through the bloodstream (secondary infection). Typical symptoms of intestinal tuberculosis are abdominal pain, diarrhea, fever, and weight reduction. In some cases rectal bleeding. To diagnose extrapulmonary tuberculosis of this type may require CT or colonoscopy. In the differential diagnosis is necessary to exclude Crohn's disease, amoebiasis, neoplasms, actinomycosis.
• Tuberculosis of the urinary system is typically first hits the kidney, then - the bladder, and other surrounding structures. The symptoms of this disorder may be dysuria and hematuria, but 90% of tuberculosis patients Tuberculosis - a full recovery is not guaranteed   this type in early stages asymptomatic. Thus computed tomography is possible to see the defeat of the kidneys, bladder, and sometimes - the prostate gland. In the later stages of tuberculosis of the urinary system can cause pain in the lower abdomen, infertility, vaginal bleeding. The disease responds well to medical treatment, but if you start treatment too late, it can lead to serious kidney damage.
• Tuberculosis pericardium is almost always a secondary disease in patients suffering from pulmonary tuberculosis, lymph nodes or backbone. The disease develops rapidly and leads to symptoms such as chest pain, shortness of breath, fever, rapid or irregular heartbeat, and swelling of the feet. For the diagnosis often requires a biopsy of the pericardium. Corticosteroids, in addition to anti-TB drugs makes it easier to get rid of the symptoms of pericardial tuberculosis, but does not reduce the likelihood of serious complications or death.

Treatment

Extrapulmonary TB are treated with the same drugs as pulmonary tuberculosis. For the treatment of most types of extrapulmonary tuberculosis is assigned to a course of therapy lasting six to nine months; the first two months, patients taking isoniazid, rifampicin, pyrazinamide and ethambutol (sometimes - only three drugs), in the following months - isoniazid and rifampicin. Other drugs may be used in cases where tuberculosis caused by drug-resistant bacteria.

The course of treatment of patients with CNS tuberculosis may last up to one year, and sometimes even longer. In some cases, longer therapy is required and patients with skeletal tuberculosis. It is highly recommended to use a strategy of directly observed treatment - it significantly increases the likelihood that treatment will be effective. In addition, patients should pay attention to their way of life - to begin to eat properly, give up bad habits, sleep and how it allows health, sports.

The fungi of the genus Candida can affect all organs and tissues. Most often the disease begins with the destruction of the mucous membranes, and then moves to the internal organs through the bloodstream. The cause of these diseases is usually decline in the body's defenses (immune system).

What causes candidiasis internal organs

Candidiasis of internal organs (visceral candidiasis) often develops on the background of long-term use of antibiotics or glucocorticoids. Antibiotics suppress the immune system, cause goiter, which is the cause of development of pathogenic microflora. Inhibits the development of normal microflora, which is involved in the formation of certain vitamins. All this promotes candidiasis in the intestine. Antibiotics may also directly stimulate the growth of fungi of the genus Candida in the intestines, which are then released into the bloodstream and spread to various organs.

There candidiasis internal organs and in different types of immunodeficiency. For example, in the treatment of cancer patients using drugs that suppress the immune system, as well as radiation therapy. Both methods contribute to the formation of secondary immunodeficiency, against which is often candidiasis internal organs. Also susceptible candidiasis internal organs AIDS.

Signs

Most often, when candidiasis internal organs are affected bronchopulmonary system, gastrointestinal tract, kidneys and urinary tract, reproductive organs. However, it may result in any organ, including the heart and brain. Candidiasis of internal organs can occur, and quickly, and very hard, with a sharp violation of the patient's condition.

Candidiasis is often attached to a chronic infectious and inflammatory diseases, such as chronic bronchitis and pneumonia. The disease then takes a long protracted course. The patient's condition is worsening in patients receiving antibiotics. There are signs of bronchitis Bronchitis - protection if the body has malfunctioned , Pneumonia, sometimes reminiscent of tuberculosis disease Tuberculosis - a full recovery is not guaranteed . Almost always amazed pharynx and larynx, appears dry compulsive nonproductive cough, hoarseness, voice sometimes disappears altogether. The temperature often kept small (low-grade), but sometimes it can rise up to high numbers.

Candidiasis of the gastrointestinal tract is characterized by loss of appetite, nausea, vomiting (in the vomit found white films), diarrhea, abdominal distension (flatulence), pain in the stomach and along the intestine. All this causes a decrease in performance, fatigue, lethargy, malaise.

Candidiasis of the urinary tract are often attached to chronic pyelonephritis, weighing it for. Characteristic symptoms of inflammation worn as a low grade fever, weakness, general malaise, and changes in the urine: the emergence of a large number of fungi, red blood cells, protein, and renal epithelium.

Candidiasis of the brain in its manifestations reminiscent of a tumor or abscess Abscess - why it is so dangerous ulcers?   brain injury can occur and meninges fungi genus Candida, ie Candida meningitis Meningitis - an inflammation of the meninges . Meningitis is characterized by the appearance of severe headaches, nausea and vomiting, not bringing relief.

Diagnostics

Diagnosis of visceral candidiasis is difficult because the fungi of the genus Candida are representatives of conditionally pathogenic microflora, constantly lives on the skin and mucous membranes of humans. Therefore, it is important not detect the fungus, and its large number. To confirm the diagnosis of visceral candidiasis serological tests carried out in the course of which revealed the presence of antibodies to the fungus genus Candida. In addition, allergic skin tests are conducted with kandidaallergenami.

Seeding is also carried out of the biological material (sputum, urine, stool) to a culture medium to detect fungus, and their sensitivity to certain antifungal drugs.

Treatment and prevention

Treatment of candidiasis internal organs - is not an easy task. Assign antifungals, both internally and in the form of injections. One course of treatment is not always enough, then it is repeated after a short break. Be sure to prescribe medicines strengthen the immune system, vitamin-mineral complexes.

Prevention of candidiasis internal organs is the early detection of lesions of the skin and mucous membranes, and their timely treatment. If the phenomenon of yeast detected in a pregnant woman, it necessarily being treated, the infection did not get during childbirth on the skin and mucous membranes of the newborn.

When the disease grudnichka thrush treat it immediately, and all of his belongings and utensils thoroughly disinfected or boiled.

Galina Romanenko