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- The etiological agent is Mycobacterium tuberculosis(Atuigun et al. 2023).
- The microbe is a bacterium/bacteria.
- It is a tubercle bacillus
- Usally attacks the lungs, but can attack any part of the body(Ly et al. 2020).
- Tuberculosis is spreadable if someone has an active infection.
- Spread through air particles.
- Tuberculosis is gram-positive, technically.
- Tuberculosis is unusual in that it has a waxy-type of coating on the surface of the cell, mainly due to mycolic acid(Mayo Clinic, 2023).
- Due to this coating, the cell can repel against the gram-stain, and thus can appear to be gram-positive(Mayo Clinic, 2023).
- TB is acid-based.
- TB is also non-motile.
- Obligate - aerobic(Ly et al. 2020).
- M. tuberculosis is a very adaptable microbe(Chai et al. 2018).
- In the TB latency phase, the microbe utilizes effector proteins to cloud the immune system before it starts to influence where it will eventually infect(Chai et al. 2018).
- Tuberculosis shares some similarities with influenza, hepatitis, and mumps.
- Most of these diseases share symtoms but are distinguished by disgnostic tests, since it has lots of common symptoms with other diseases(St. Lukes Hospital, N.D).
- Fever
- Weight loss
- Swelling in certain areas
- Feelings of sickness
- Feelings of weakness
- Night sweats
- Cough
- Coughing up blood
- Chest Pain
- Chills
-Loss of appetite
- Coughing up blood
- Severe Chest Pain
- Sweating and chills
- Fever
(May Clinic, 2023)
- Mainly the lungs
Can Also Attack:
- Lymphnodes
- Bones
- Kidneys
- Brain
- Spine
- Possibly skin
(Adigun et al. 2023)
- Secretion Factors
- Enzymes in Cellular Metabolism
- Cell Surface Components
- Transcription Regulators
- Surface Exposed Lipids
(CDC, 2022)
(MDPI, 2021)
1) The patient must be exposed to a person with active TB.
2) At this point roughly 75% of individuals will be uninfected, the other 25% will be(Luo et al. 2019).
3a) Within the 25% who become infected, 90% will develop host immune control, and develop a latent infection, of which nearly 1.8 billion people have worldwide(Luo et al. 2019).
3b) The remaining 10% will have an early progression and a failed immune control, resulting in an active infection of tuberculosis, of which nearly 10.4 million people globally are affected(Luo et al. 2019).
4)It is important to note, most latent TB infections will result in the formation of a granuloma.
- An M. tuberculosis is caused when a few bacilli that have been put into the air by a patient with active TB, is inhaled and reaches the alveoli in the lungs(Delogu et al. 2013).
- Once in the alveoli, the bacteria is usually quickly phagocytized by alveolar macrophages due to the innate immune response(Delogu et al. 2013).
- If the bacteria surives this first defense mechanism, it starts to replicate immediately in macrophages, reaching a high bacterial burden after only a few weeks(Luo et al. 2019).
- The immune response then typically further responses causing the formation of a granuloma, however some of the bacilli may remain encapsulated and thus remain, producing an active infection(Delogu et al. 2013).
- Bacille Calmette-Guerin vaccine or BCG is the vaccine used for TB.
- Is not widely used in the United States.
- Often given to infants and small children in countries where TB is still common.
- BCG is only given to patients who meet specific criteria in the U.S(ALA, n.d).
- The vaccine can help prevent infection for up to 20 years.
- It was first administered in 1921.
- The U.S never widely administered BCG, simply because TB was never as much as an issue, and the U.S focuses more on prevention and detection fo the latent TB(Ly et al. 2020).
- Most central and south American countries have universal BCG vaccines.
- It is the only vaccine available for TB.
- The type of Tuberculosis determines the treatment.
- In a latent infection, the most common treatment is administeration of a daily dose of the antibiotic isoniazid(INH) in pill form for six to nine months(CDC, 2023).
- In an active infection, a combination of anti-bacterial medications will be used including the INH anti-biotic, and commonly rifampin, pyrazinamide, and ethambutol. Treatment will last roughly 6-12 months. As with many diseases, failure to take the medications as perscribed could lead to drug-resistent TB(Adigun et al. 2023).
- There is also a multi-drug resistent TB that is espicially dangerous, and may have to be treated over the course of 20-30 months.
- Two types of tests are used to detect the M. tuberculosis bacteria including a skin test or a blood test.
- A positive skin or blood test only indicates the person was infected with TB; it does not distinguish between latent or active disease.
- It is not often recommended to use both a skin and blood test at once.
- A TB skin test involves injecting the patient with a small amount of tuberculin under the skin on the lower area of the arm. The patient needs to return 48-72 hours later to look for a reaction. Result depends on the size of the raised, hard area(CDC, 2023).
- The only way to distinguish between an active infection or latent disease, is if the patient is having signs or symptoms.
(2022). Retrieved from https://www.cdc.gov/tb/topic/basics/vaccines.htm#:~:text=TB%20Vaccine%20(BCG),protect%20people%20from%20getting%20TB.
(2023). Retrieved from https://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-causes/syc-20351250
(N.d.). Retrieved from https://www.stlukes-stl.com/health-content/medicine/33/000527.htm
Adigun, R., & Singh, R. (2023). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK441916/
Association, A. L. (n.d.). Retrieved from https://www.lung.org/lung-health-diseases/lung-disease-lookup/tuberculosis/treating-and-managing#:~:text=If%20you%20have%20an%20active,%E2%80%94rifampin%2C%20pyrazinamide%20and%20ethambutol.
Chai, Q., Zhang, Y., & Liu, C. H. (2018). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5962710/
Delogu, G., Sali, M., & Fadda, G. (2013). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867229/
Luo, Y., Suliman, S., Asgari, S., & Amariuta, T. (2019). Retrieved from https://www.researchgate.net/publication/335310093_Early_progression_to_active_tuberculosis_is_a_highly_heritable_trait_driven_by_3q23_in_Peruvians
Ly, A., & Liu, J. (2020). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312605/