Pulmonary tuberculosis


Is tuberculosis contagious?
Tuberculosis (TB) is only infectious in some patients who have a large amount of tubercle bacilli in their sputum. In fact, many patients with active pulmonary tuberculosis are not infectious. For more patients with active pulmonary tuberculosis, tubercle bacilli cannot be found in their sputum, so the actual situation must be considered. In fact, to determine if pulmonary tuberculosis is infectious, it is simple: look for acid-fast bacilli in the sputum. If the sputum acid-fast staining is positive, it indicates infectiousness. Infectious pulmonary tuberculosis requires systematic and standardized anti-tuberculosis treatment.


Can tuberculosis be cured?
Tuberculosis can actually be completely cured, primarily through anti-tuberculosis treatment. If it is confirmed to be active tuberculosis, systematic and standardized anti-tuberculosis treatment is required. Through scientific and reasonable anti-tuberculosis treatment and taking medication on time and according to guidelines, most tuberculosis patients can be cured, with a cure rate reaching 85%. The treatment includes an intensive phase of anti-tuberculosis treatment and a consolidation phase, with the total course of treatment being about six months. After being cured, it is not easy to relapse, but it is essential to take medications on time, adjust nutrition, modify work and rest schedules, and rest well.


How is tuberculosis diagnosed?
The diagnosis of tuberculosis primarily involves combining relevant clinical symptoms, such as whether there is cough, expectoration, low fever, night sweats, and blood in phlegm. It also requires considering the patient's chest imaging features, whether there is obvious infection, fresh exudation, cavities, as well as sputum tests. For example, if the sputum stain for acid-fast bacilli is positive, and the sputum culture is positive, using these comprehensive diagnostic methods, tuberculosis can be diagnosed, after which anti-tuberculosis treatment should be initiated.


How to test for tuberculosis
To examine pulmonary tuberculosis, it is essential to understand that it pertains to tuberculosis changes in the lung tissue, airways, bronchi, and pleura. The pathogen causing tuberculosis is Mycobacterium tuberculosis, also known as the tubercle bacillus. There are multiple tests available for people with pulmonary tuberculosis, as the disease can vary based on location and type. Therefore, such patients generally require numerous tests. The most commonly used are imaging studies for the chest, including X-rays and CT scans. In imaging studies, most patients will show some lesions, but there are instances where tuberculosis in the airways and bronchi might not be clearly visible on CT or X-rays, necessitating more invasive tests like bronchoscopy. Additionally, bacteriological examinations, such as sputum smear and pleural fluid smear, as well as culture for Mycobacterium tuberculosis, are typically conducted for patients. Nowadays, hospitals equipped with the necessary facilities conduct molecular biological tests, namely nucleic acid testing for Mycobacterium tuberculosis DNA. Furthermore, some patients with complex conditions may require a histopathological biopsy, commonly referred to as tissue sampling, at the site of the lesion to observe under a microscope for characteristic changes indicative of tuberculosis. There are also immunological tests that assist in diagnosing tuberculosis, such as the gamma interferon release assay (commonly known as the T-SPOT), tuberculin skin test, and traditional antibody tests against Mycobacterium tuberculosis.


How is tuberculosis treated?
The primary treatment for tuberculosis is still chemotherapy, also simply called chemo, but the chemotherapy for tuberculosis is completely different from the anti-tumor chemotherapy we talk about in cancer, and the medications are also completely different. There are about more than ten anti-tuberculosis drugs, which can be divided into first-line and second-line drugs, and currently, there are third-line drugs under research. Chemotherapy for patients with pulmonary tuberculosis should be started early and administered in combination. The types of combined medication for patients with pulmonary tuberculosis generally involve three or more drugs. Some patients may exhibit drug resistance or intolerance to some drugs' side effects, and thus, second-line drugs may be used. Additionally, some patients, due to special conditions, may require four or five types of anti-tuberculosis drugs. It is crucial to strictly follow medical advice regarding how to medicate and treat. Furthermore, patients with pulmonary tuberculosis must ensure complete medication adherence, as the treatment duration for tuberculosis is quite long, typically requiring at least six months, and some patients may need one or even two years. Regular medication intake is very important because some patients might experience symptoms like coughing up blood or others, such as those with pleurisy, who might develop pleural effusion. Therefore, treatments targeted at other symptoms are necessary. Patients who cough up blood might need hemostatic drugs, while those with severe hemoptysis may even require interventional surgery. Some with tuberculous pleurisy might need to have pleural effusion drained. Additionally, some patients with pulmonary tuberculosis might experience adverse reactions to medications, such as liver or kidney failure, visual impairment, or numbness in the hands, which would require adjustments to their medication or changes based on their complications. Treatment should also be targeted toward these adverse reactions.


Can people with tuberculosis eat beef?
Patients with tuberculosis need to appropriately increase their intake of high-quality proteins, such as beef, duck, fish, pork, and lean meat. These foods can provide the body with abundant proteins and the raw materials for amino acid synthesis. It is also necessary to appropriately consume fresh vegetables and fruits to obtain a rich supply of vitamins, fibers, and minerals. The variety of food should be diversified, nutrition should be balanced, and meals should be evenly distributed. Moreover, systematic and standardized anti-tuberculosis treatment with scientific and reasonable methods, combined with nutritional adjustments, can lead to a cure in most cases.


Can people with tuberculosis drink alcohol?
Whether patients with tuberculosis can drink alcohol, first of all, it is important to know that tuberculosis is a chronic infectious disease and a consumptive disease that consumes the body's calories. Drinking alcohol can affect the body's absorption of energy. Moreover, most patients with tuberculosis need to take anti-tuberculosis medication, most of which are metabolized through the liver and can cause varying degrees of liver damage. Drinking alcohol can exacerbate liver damage and reduce the effectiveness of the medication. Additionally, since there are many types of anti-tuberculosis medications for tuberculosis patients, some medications may cause adverse reactions when drinking alcohol. Therefore, all tuberculosis patients must strictly abstain from drinking alcohol during treatment.


Can tuberculosis be cured completely?
Whether tuberculosis can be completely cured varies from person to person. Most cases of tuberculosis, especially initial occurrences of pulmonary tuberculosis, can be cured in more than 80 to 90 percent of patients if they undergo standardized anti-tuberculosis treatment. However, it is essential that the treatment is standardized; it is not appropriate to simply take medication for one or two months and then stop when symptoms seem to disappear. The treatment duration for pulmonary tuberculosis is considered to be at least six months, and for some patients, it may even extend to a year. However, not all cases of pulmonary tuberculosis can be completely cured. A small percentage of patients may not achieve complete eradication due to resistance to tuberculosis bacteria or intolerance to the side effects of tuberculosis medications. In such cases, the prognosis might be poor, and some individuals may succumb to tuberculosis due to these factors.


Can people with tuberculosis eat lamb?
Tuberculosis is a very common infectious disease in our country. After contracting tuberculosis, symptoms often include coughing, phlegm, hemoptysis, chest pain, low fever, night sweats, fatigue, poor appetite, and weight loss. Generally speaking, as long as one is not allergic to mutton, it can be consumed. However, if the patient has significant poor appetite and weak digestive function, it is better to eat less or avoid mutton to prevent worsening the symptoms due to indigestion. If the digestive function is still relatively good, eating mutton is alright as it is nutritious and can provide energy, benefiting the patient's recovery.


How is tuberculosis treated?
The treatment of tuberculosis generally involves two aspects: etiological treatment and symptomatic management. Etiological treatment targets the tuberculosis bacteria with medication. Modern anti-tuberculosis chemotherapy regimens are quite mature, employing strategies such as early and combined use, appropriate dosing, regular administration, and full-course treatment, which result in a very high cure rate. Additionally, there is symptomatic management, for example, cough suppressants for patients with a cough, expectorants for those with excessive sputum, antipyretics if there is fever depending on the situation, and hemostatic drugs for patients coughing up blood, among others. The treatment of pulmonary tuberculosis is comprehensive and must be conducted under the guidance of a physician. It is crucial not to interrupt treatment casually to avoid affecting the effectiveness of the therapy, increasing the recurrence rate, and the emergence of drug resistance.