Tuberculosis bronchus, according to various sources, is diagnosed in 10-40% of patients with active TB of the lungs. This disease was first described in 1698, but it still is a rather difficult diagnostic challenge. However, since the advent of anti-TB drugs TB incidence has steadily declined bronchi, and treatment usually gets rid of the disease, and to prevent the development of any complications. Tuberculosis bronchus are sick, mostly young people; more than half of patients with the disease under 35 years.
Symptoms of tuberculosis bronchi
This kind of TB can develop gradually (in this case, the symptoms may resemble symptoms of bronchogenic carcinoma) or severe, with symptoms resembling asthma symptoms or pneumonia
. Two of the most characteristic symptoms of tuberculosis of the bronchi - wheezing and "barking" cough
. Such a cough persists for several weeks, and dealing with it does not help people's money, or OTC drugs
. If active tuberculosis bronchi observed bronhoreya - coughing up large amounts of mucus, often - with blood
. Sometimes tuberculosis bronchi also cause a dull or sharp pain in the chest and shortness of breath
. Chest pain is usually associated with an increase or rupture of the lymph nodes in the chest when one patient has tuberculosis and bronchial lymph nodes
. These are typical symptoms of pulmonary tuberculosis as fever, weight reduction, anorexia, or heavy sweating at night, with tuberculosis of the bronchi usually are mild or nonexistent
.
Diagnostics
Because the symptoms of TB
Symptoms of TB - how to recognize the disease
bronchi are similar to the symptoms of other diseases, to diagnose it can be difficult. In the process of differential diagnosis is necessary to exclude violations such as atelectasis, bronchial asthma, pneumonia
Pneumonia - Symptoms and Causes
, Endobronchial actinomycosis. Sarcoidosis can also lead to inflammation, resembling those observed in patients with tuberculosis of the bronchi. In patients with AIDS, and the need to eliminate this disease as Kaposi's sarcoma.
The first diagnostic procedure, which is used for the detection of tuberculosis of the bronchi - after the Mantoux test - is the analysis of sputum. This test is given to all patients who are suspected tuberculosis bronchi. It has a rather high accuracy, however, to confirm the diagnosis usually requires radiography and / or computed tomography of the thorax. These methods of medical imaging allow us to see some tumors, the occurrence of which is associated with tuberculosis, and set the stage of the disease.
In addition, today for the diagnosis of tuberculosis is increasingly used bronchi bronchoscopy. During this procedure, you can produce sputum and tissue sampling for laboratory tests, as well as identify the various tumors in the bronchi, such as erythema, granulomas, tubercles, and so on. In the later stages of the disease can be detected by tuberculous ulcers and stenosis of the bronchus. Results Radiography, computer tomography or bronchoscopy in combination with the results of analyzes of sputum, as a rule, is sufficient to diagnose tuberculosis bronchi.
Complications of tuberculosis bronchi
Stenosis (abnormal narrowing of the bronchial tubes) and strictures of bronchi are the most common and, moreover, irreversible complications of tuberculosis of the bronchi, which can develop despite adequate treatment. Bronchoconstriction occurs in 60-95% of patients with a history of tuberculosis bronchi. Another common complication of tuberculosis bronchi - bronchiectasis (abnormal enlargement of the bronchial tubes); in most cases it is a violation of asymptomatic. If bronchiectasis causes symptoms, it is most often, hemoptysis and chest pain
Chest pain is one symptom - a lot of diseases
.
The most serious complication of tuberculosis bronchus is airway obstruction, which in the absence of immediate medical care could result in death by suffocation.
Treatment of tuberculosis of the bronchi
Early detection and treatment of pulmonary tuberculosis usually can effectively control the disease and the development of its complications. For drug therapy uses the same drugs that are used for the treatment of pulmonary tuberculosis - isoniazid, rifampicin, pyrazinamide and ethambutol. The course of treatment lasts six to nine months.
Moreover, corticosteroids may be used, and surgical therapies such as bronchial dilation balloon or special metallic stent. Such treatments are very effective in bronchial stenosis, but are used only in those cases where other therapies were ineffective. Corticosteroids are used when tuberculosis bronchial tubes led to severe inflammation, but has not yet been proven that these drugs actually help prevent the development of stenosis of the bronchi. However, there is evidence that corticosteroids help reduce the likelihood of developing long-term complications of bronchoconstriction. Local injections of corticosteroids, which make using the endoscope, may contribute to more rapid recovery of patients with tuberculosis of the bronchi.
In the recent study conducted by the use of streptomycin in combination with corticosteroids contributed to the rapid healing of tubercular ulcers and helps reduce the risk of bronchoconstriction, but while this combination of drugs is rarely used.
In some cases, such as when anti-TB drugs are ineffective and the patient develops bronchial obstruction, to maintain the normal functioning of the respiratory system may require bronhoplasticheskaya operation. An alternative to this operation can be laser bronchoscopy.
Tuberculosis bronchus in special cases
Children bronchi tuberculosis is often a primary infection. The most characteristic symptom of the disease in children is usually wheezing and / or noise during breathing, because of what a doctor can assume that in the child's airway foreign object stuck. To exclude the possibility that necessary X-rays or CT scans. In the treatment of children with tuberculosis bronchi used anti-TB drugs, and, in many cases, prednisone, which, according to the results of several studies, increases the likelihood of a successful outcome of the disease in young patients.
The elderly tuberculosis bronchus in 90% of cases are caused by reactivation of a primary infection. The most common symptom of this disease in the elderly is a cough. Other symptoms such as fatigue, poor appetite and fatigue, many patients for a long time ignored, attributing them to his age.
In HIV-infected TB patients
Tuberculosis - a full recovery is not guaranteed
bronchi, as well as other types of tuberculosis, is supposed to occur more frequently than others, but evidence for this yet. Perhaps the reason for this is that HIV-positive people whose sputum examination for TB bacteria tested positive, a bronchoscopy is rarely prescribed (because of the increased risk of complications). Thus, they are diagnosed with pulmonary tuberculosis, and secondary infection - tuberculosis of the bronchi - remains undetected.
