PULMONARY TUBERCULOSIS

Drexter A. Curitana

BSN 2B
 What is pulmonary tuberculosis?

• The bacterium Mycobacterium tuberculosis causes tuberculosis (TB), a contagious, airborne infection that destroys
body tissue. Pulmonary TB occurs when M. tuberculosis primarily attacks the lungs. However, it can spread from
there to other organs. Pulmonary TB is curable with an early diagnosis and antibiotic treatment.

• Pulmonary TB, also known as consumption, spread widely as an epidemic during the 18th and 19th centuries in
North America and Europe. After the discovery of antibiotics like streptomycin and especially isoniazid, along with
improved living standards, doctors were better able to treat and control the spread of TB.

• Since that time, TB has been in decline in most industrialized nations. However, TB remains in the top 10 causes of
death worldwide, according to the World Health Organization (WHO)Trusted Source, with an estimated 95 percent
of TB diagnoses as well as TB-related deaths occur in developing countries.

• That said, it’s important to protect yourself against TB. Over 9.6 million people have an active form of the disease,
according to the American Lung Association (ALA). If left untreated, the disease can cause life-threatening
complications like permanent lung damage.
What are the symptoms of pulmonary TB?

If you or someone you know has pulmonary TB, they will commonly:

• cough up phlegm
• cough up blood
• have a consistent fever, including low-grade fevers
• have night sweats
• have chest pains
• have unexplained weight loss

There may also be other symptoms of pulmonary TB, such as fatigue. Your doctor will be able to
tell you whether you should be tested for TB after reviewing all your symptoms.
How is pulmonary TB diagnosed?
During your examination, your doctor will:

• conduct a physical exam to check for fluid in your lungs

• ask about your medical history
• schedule a chest X-ray
• order a medical test to confirm pulmonary TB

To diagnose pulmonary TB specifically, a doctor will ask a person to perform a strong cough and produce sputum up to
three separate times. The doctor will send the samples to a laboratory. At the lab, a technician will examine the sputum
under a microscope to identify TB bacteria.

In addition to this test, a doctor can also “culture” a sputum sample. This means they take a portion of the sputum
sample and put it in a special material that makes TB bacteria grow. If TB bacteria grow, this is a positive culture.

Doctors can also order a polymerase chain reaction (PCR) assay to be performed. This tests the sputum for the
presence of certain genes from the germs that cause TB.
Other exams
• These exams can also look for pulmonary TB, which may be hard to diagnose in children, and in people who have
HIV or multidrug-resistant TB (MDR-TB).

TESTS
CT SCAN an imaging test to check lungs for signs
of an infection
BRONCHOSCOPY a procedure that involves inserting a
scope through your mouth or nose to
allow your doctor to see your lungs and
airways
THORACENTESIS a procedure that removes fluid from the
space between the outside of your lungs
and the wall of your chest
LUNG BIOPSY a procedure to remove a sample of lung
tissue
Treatment for latent TB and pulmonary TB
It’s important to get treatment for latent TB even if you have no symptoms. You can still develop pulmonary TB disease in the future. You may only need one TB
drug if you have latent TB.
If you have pulmonary TB, your doctor may prescribe several medicines. You’ll need to take these drugs for six months or longer for the best results.

The most common TB medicines are:

• isoniazid
• pyrazinamide
• ethambutol (Myambutol)
• rifampin (Rifadin)

Your doctor might recommend an approach called directly observed therapy (DOT) to ensure that you complete your treatment. Stopping treatment or skipping
doses can make pulmonary TB resistant to medicines, leading to MDR-TB.

With DOT, a healthcare professional meets with you every day or several times a week to administer your medication so that you don’t have to remember to
take it on your own.

If you aren’t on DOT, make a schedule for taking your medicines so that you don’t miss a dose. Here are some tips to help you remember to take your
medicines:

• Take medicines at the same time every day.

• Make a note on your calendar each day to show that you’ve taken your medicine.
• Ask someone to remind you to take your medicine every day.
• Keep your medicines in a pill organizer.

You won’t need to go to the hospital unless you’re unable to take the medication at home or have a bad reaction to the treatment.
Nutrition and Tuberculosis
Good eating habits are important for controlling tuberculosis (TB). The foods you choose can affect how well your body
heals itself. Here are some tips for healthy eating:

Follow Canada's Food Guide to Healthy Eating:

• Be generous with the food you eat. Your body needs extra energy for healing.
• Choose a variety of foods to be sure you are getting all the nutrients your body needs.

Choose foods high in the following nutrients:

• Vitamin B6 pyridoxine
• Vitamin A
• Vitamin C
• Iron
• Protein
• Calcium
Choose foods high in protein such as meat, poultry, fish, milk, and dried beans, peas and lentils.
You need to increase your servings of meat and alternatives to three to four per day.

See food choices below.

When you are taking isoniazid be aware that it may cause itchy skin, headaches, and light-headedness when you eat some cheeses
and fish. If this happens, contact your doctor or public health nurse.

Avoid alcohol:
• Alcohol has calories, but no other nutrients.
• It is also hard on your liver, especially if you are taking isoniazid (INH), pyrazinamide (PZA), or rifampin (RMP)

Food choices:

Foods high in vitamin B6 (pyridoxine):

Foods high in iron:
• liver, chicken, pork, beef, fish
• dried fruit (raisins, dates, figs) liver, kidney
• hazelnuts, walnuts, peanuts cream of wheat, whole grain cereals
• brussel sprouts, cauliflower, peas, broccoli meat: beef, pork, veal, ham
• chick peas, soybeans dried peas, beans and lentils
• prune juice, prunes, dates, dark green leafy vegetables
wheat germ, whole grain cereals, oatmeal
Tip: Iron is taken up by the body best when eaten with
• bananas, cantaloupe, grapes foods high in vitamin C.
Foods high in vitamin A:
• broccoli, carrots, squash, sweet potatoes
• spinach and other dark green leafy vegetables
• liver, dairy products, eggs
• cantaloupe, apricots
Foods high in vitamin C:
• citrus fruit and juice
• tomato, baked potatoes
• broccoli, sweet peppers, kale
• cantaloupe, strawberries, cabbage, cauliflower

Tip: Steam or cook vegetables in a small amount

of water just until tender-crisp. This will help
High protein foods:
you get the most amount of vitamin C from the
• beef, pork, lamb, veal, ham vegetables.
• milk, yogourt, cheese
• poultry and fish
• dried peas, beans and lentils
• eggs Foods high in calcium:
• Tip: Add skim milk powder to soups, milk and • milk, yogourt, and cheese
casseroles. • soya beans, tofu
• broccoli, kale
• sardines and salmon with bones
• baked beans (canned)
references:

• https://www.kflaph.ca/en/resource-catalogue/Nutrition-and-
Tuberculosis.aspx#:~:text=Choose%20foods%20high%20in%20protein,three%20to%20four
%20per%20day

• https://www.healthline.com/health/pulmonary-tuberculosis#diagnosis