Dr. M.J. Bazos, MD. Patient Handout

TUBERCULOSIS, PULMONARY


About Your Diagnosis
Pulmonary tuberculosis is a lung infection that is produced by an acid-fast bacillus (AFB) called Mycobacterium tuberculosis. Tuberculosis continues to be one of the most common infectious diseases around the world, especially in low-income countries and areas of AIDS. The tuberculosis organism is most often transmitted through the air by coughing. Patients with live organisms detected in their sputum or in any skin lesions are considered potentially contagious, and special precautions are necessary. The diagnosis of tuberculosis is suspected in patients who have unexplained cough, lung infiltrates, weight loss, or fever. Your doctor will inquire about places you have been or individuals you have spent a lot of time with, usually within 3 months of developing symptoms; any prior tuberculosis history or skin test results; coexisting risk factors (especially human immunodeficiency virus [HIV] risks); foreign travel; use of medications that suppress the immune system; and job situation. Tuberculosis can involve any organ or organ systems, but most often the upper lung areas. Your doctor may order a chest x-ray, sputum sampling, bronchoscopy, and a tuberculosis skin test. Testing for HIV may also be advised. Although preliminary sputum (AFB stain) results may be obtained within a few hours, routine tuberculosis culture and drug susceptibility results take several weeks. Rapid diagnostic testing for tuberculosis is now available in some countries and will greatly help detection and isolation/ control efforts. Most patients with tuberculosis can be cured with earlier detection, improved control, and compliance with effective drug treatment.

Living With Your Diagnosis
The importance of early diagnosis and effective long-term treatment of this very serious public health problem (tuberculosis) is critical, especially in individuals with HIV. The emergence of multiple drug-resistant tuberculosis is a real challenge for patients, their families, and the public. In most individuals with active tuberculosis, symptoms and infectivity rapidly dropped with the taking of antituberculous medication. It is extremely important to work with your health care provider and maintain close follow-up to ensure complete response to treatment. In a small proportion of cases, surgical removal of the infected area is required. Family members and other close contacts, as well as caregivers, may also require screening for tuberculosis after an exposure.

Treatment
The treatment of tuberculosis involves notifying public health officials, starting a minimum of three antituberculosis drugs, and monitoring for any drug effects. Your doctor will likely request additional tests including blood work, sputum samples, chest xrays, and an eye examination as part of the monitoring while you are taking tuberculous medications. Treatment often is prolonged, with a minimum of 6 months.

The DOs
Anyone concerned about being exposed to tuberculosis should seek medical attention as soon as possible. If you have received a diagnosis of tuberculosis, it is very important to follow the isolation and treatment program outlined by your health provider. Taking the right amount of medication for the right time is very important while maintaining close contact with your health care provider. Do try to understand your tuberculosis problem and how it may impact others as well as yourself.

The DON’Ts
• Do not forget to take your tuberculous medications as prescribed.
• Do not forget to notify your health care provider if you have any concerns about possible medication side effects or if you miss more than one or two doses of medication.
• Do not assume you are not infective unless informed by your doctor.
• Do not drink any alcohol or take other medication unless previously discussed with your physician.
• Do not forget that tuberculosis can involve areas other than the lung.
When to Call Your Doctor
• If you have excessive thirst, urination, or weight change.
• If coughing brings up discolored sputum or blood.
• If you have fever or chills.
• If you have any concerns about the effects of medications.
•If persistent or worsening symptoms are present despite starting antituberculous medication.
• To clarify when to return to work, school, or a health care facility.
Websites: American Lung Association: www.lungusa.org