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Tuberculosis

Treating tuberculosis (The Times of India- 13 may 2010)

TB can involve any part of the body, but lung tuberculosis is the commonest as TB bacteria
spreads by airborne methods (cough), says Dr Avdhesh Bansal

Tuberculosis is a global disease. In India alone, 3,30,000 patients die every year. TB can involve
any part of the body, but lung tuberculosis is the commonest as TB bacteria spreads by airborne
methods (cough). Patients generally have symptoms like weight loss, loss of appetite, low to
medium grade fever for more than three weeks. Diagnosis of tuberculosis can be a very
challenging task.

It’s done through:

Chest X Ray

Sputum examination for AFB (Acid Fast Bacilli) in typical patients. If these investigations are
negative, then diagnosis can be very difficult as TB can be a differential diagnosis in virtually all
infective diseases

In countries like India, where TB is rampant, many a times it is a diagnosis by exclusion

In spine, brain, bone and abdominal tuberculosis, CT scans of specific areas can be very
helpful

Treatment

Lasts for at least 6-9 months. In bone TB, it can take up to 18 months. With proper compliance,
response to anti-TB drugs is very good and most patients recover completely

Not taking first line drugs properly results in drug resistance and emergence of MDR-TB
(MTB resistant to Rifampicin and Isoniazide). In MDR-TB, second line anti-TB drugs are used
for nearly 18 to 24 months and unfortunately, not with good results

You may have TB

If you have undiagnosed fever and cough for more than 3 weeks. If you have blood in your
sputum

Also remember

Always take complete treatment for 6-9 months

 Stopping treatment midway, even if you feel well, can promote MDR-TB, a very difficult
disease to treat
Never add one or two second line anti-TB drugs to a failing first line regime, as it will only
promote MDR-TB.