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d
v
Other names
Symptoms
Bacterial
species
Evolution
Transmission
Pathogenesis
Diagnosis
Progression
Treatment
Prevention
Vaccines
Epidemiology
History
Folklore
Study and
treatment
.Tuberculosis (abbreviated as TB for tubercle
bacillus) is a common and deadly
infectious disease caused by
mycobacteria, mainly
Mycobacterium tuberculosis. Tuberculosis most commonly
attacks the lungs (as
pulmonary
TB) but can also affect the
central nervous system, the
lymphatic system, the
circulatory system, the
genitourinary system,
bones,
joints
and even the
skin.
Other mycobacteria such as
Mycobacterium bovis,
Mycobacterium africanum,
Mycobacterium canetti, and
Mycobacterium microti can also cause tuberculosis, but
these species do not usually infect healthy adults.
In the past, tuberculosis was called consumption,
because it seemed to consume people from within, with a
bloody cough, fever,
pallor, and long relentless wasting. Other names included
phthisis (Greek for consumption) and phthisis pulmonalis;
scrofula (in adults), affecting the lymphatic system and
resulting in swollen neck glands; tabes mesenterica, TB of
the abdomen and
lupus vulgaris, TB of the skin; wasting disease;
white plague, because sufferers appear markedly pale;
king's evil, because it was believed that a king's touch would
heal scrofula; and
Pott's disease, or gibbus of the spine and joints.[7][8]
Miliary tuberculosis – now commonly known as
disseminated TB– occurs when the infection invades the
circulatory system resulting in lesions which have the appearance
of
millet seeds on X-ray
TUBERCULOSIS TREATMENT
The standard "short" course treatment for tuberculosis
(TB), if it is active, is
isoniazid,
rifampicin,
pyrazinamide, and
ethambutol for two months, then isoniazid and rifampicin alone
for a further four months. The patient is considered cured at six
months (although there is still a relapse rate of 2 to 3%). For
latent tuberculosis, the standard treatment is six to nine
months of
isoniazid alone.
Drugs
All first-line anti-tuberculous drug names have a
standard three-letter and a single-letter abbreviation:
Other drugs that may be useful, but are not on the WHO list of
SLDs:
- 9H—Isoniazid
for 9 months is the gold standard and is 93% effective.
- 6H—Isoniazid for 6 months might be adopted by a local TB
program based on cost-effectiveness and patient compliance. This
is the regimen currently recommended in the UK for routine use.
The US guidance exclude this regimen from use in children or
persons with radiographic evidence of prior tuberculosis (old
fibrotic lesions). (69% effective)
- 6 to 9H2—A twice-weekly regimen for the above 2
treatment regimens is an alternative if administered under
Directly observed therapy (DOT).
- 4R—Rifampicin
for 4-months is an alternative for those who are unable to take
isoniazid or who have had known exposure to isoniazid-resistant
TB.
- 3HR—Isoniazid and rifampicin may be given for three months.
- 2RZ—The two month regimen of rifampicin and
pyrazinamide is no longer recommended for treatment of LTBI
because of the greatly increased risk of drug-induced hepatitis
and death
Some supplements may be useful as adjuncts in the treatment of
tuberculosis, but the for the purposes of counting drugs for MDR-TB,
they count as zero (if you already have four drugs in the regimen,
it may be beneficial to add arginine or vitamin D or both, but you
still need another drug to make five).
The drugs listed below have been used in desperation and it is
uncertain whether they are effective at all. They are used when it
is not possible to find five drugs from the list above.
Current research
There is currently some evidence from animal[73]
and clinical studies[74]
that suggests that MXF-containing regimens as short as four months
may be as effective as six months of conventional therapy.[75]
Bayer
is currently running a Phase II trial in collaboration with the
TB Alliance to evaluate shorter treatment regimens for TB;[76]
encouragingly, Bayer have also promised that if the trials are
successful, Bayer will make moxifloxacin affordable and accessible
in countries that need it.
The follow drugs are experimental compounds that are not
commercially available, but which may be available from the
manufacturer as part of a clinical trial or on a compassionate
basis. Their efficacy and safety are unknown:
|
Bacterial diseases (primarily
) |
|
G+/Firmicutes |
Clostridium (Pseudomembranous
colitis,
Botulism,
Tetanus,
Gas gangrene) -
Streptococcus A and
B (Scarlet
fever,
Erysipelas) -
Staphylococcus (Toxic
shock syndrome) -
Bacilli (Anthrax,
Listeriosis) |
|
G+/Actinobacteria |
Mycobacterium:
Tuberculosis (Ghon
focus,
Ghon's complex,
Tuberculous meningitis,
Pott's disease,
Scrofula,
Bazin disease,
Lupus vulgaris,
Miliary tuberculosis) -
Leprosy -
Lady Windermere syndrome -
Buruli ulcer -
Actinomycetales:
Actinomycosis -
Nocardiosis -
Diphtheria -
Erythrasma |
|
G-/Spirochetal |
Syphilis (Bejel)
-
Yaws -
Pinta -
Relapsing fever -
Noma -
Trench mouth -
Lyme disease -
Rat-bite fever (Sodoku)
-
Leptospirosis |
|
G-/Chlamydiae |
Chlamydia -
Lymphogranuloma venereum -
Psittacosis -
Trachoma |
|
G-/α
Proteobacteria |
Rickettsioses (Typhus,
Scrub typhus,
Rocky Mountain spotted fever,
Boutonneuse fever,
Q fever,
Trench fever,
Rickettsialpox) -
Brucellosis -
Cat scratch fever -
Bartonellosis (Bacillary
angiomatosis) |
|
G-/β&γ
Proteobacteria |
Salmonella (Typhoid
fever,
Paratyphoid fever,
Salmonellosis) - other
intestinal (Cholera,
Shigellosis) -
Zoonotic (Bubonic
plague,
Tularemia,
Glanders,
Melioidosis,
Pasteurellosis) - Other:
Pertussis -
Meningococcus (Meningococcemia,
Waterhouse-Friderichsen syndrome)
-
Legionellosis -
Brazilian purpuric fever -
Chancroid -
Donovanosis -
Gonorrhea |
|
|
