Tuberculosis diagnosis

Ordinarily, tuberculosis affects only the lungs, but the infection can spread to other organs and tissues. This is called extra-pulmonary tuberculosis. The disease can progress in this state when the immune system can’t contain the infection solely in the lungs. This type of tuberculosis can affect other components of the respiratory system, like the larynx or the pleura (the lining of the lungs), or it can extend to other sites in the body. Most common places for extra-pulmonary tuberculosis are:

· Skin
· The spinal cord
· Kidneys
· Meninges – the inflammation of the central nervous system
· The genitor-urinary tract
· Bones and articulations etc.

Symptoms for extra-pulmonary tuberculosis vary with the location of the infection and also with the degree in which the disease evolved in the body. For example, in spinal tuberculosis, the patient has extensive back pains and low mobility. But for tuberculosis meningitis, persistent headaches (for about two to three weeks), metal confusion and blurry vision may manifest quite rapidly. If the disease affects the kidneys, then the patient has pains in that area, frequent urination, even unexplained weight loss and appetite loss.

For pulmonary tuberculosis, the test is simple: the microscopically examination of fluids from the lungs and the skin test. But diagnosing extra-pulmonary tuberculosis depends on the place of the infection. The main samples that must be examined are:

· Urine – in renal tuberculosis;
· Cerebro-spinal fluid – in spinal tuberculosis ( method: spinal aspiration) and in tuberculosis meningitis;
· Liquid from the pleura;
· Biopsies from various parts (a biopsy is when a small part of the infected tissue is taken from the organ for testing) – in many types of extra-pulmonary tuberculosis; etc.

The treatment is basically similar to pulmonary tuberculosis, the administration of various antibiotics, following a serious regime. In more severe cases, physicians opt for surgery; for example in spinal tuberculosis and rarely in renal tuberculosis.

To efficiently diagnose tuberculosis, medical doctors initially take the patients full and detailed medical history. This should consist of general risk factors, general symptoms and pulmonary symptoms, but also symptoms from others organs. Afterwards, there is the physical examination of the patient, which gives information about the general health state of the patient.

If the physician suspects tuberculosis, other test will narrow the search. The analysis most used is the skin test, this evaluates if a person has immunity for the various strain of bacteria. Furthermore, complex blood tests are necessary to assess is the disease is active of dormant. To double check for this disease, a small sputum secretion is examined using specific cultures, to determine the strain of bacteria the patient has and also the response for various types of antibiotics- this helps to evaluate the proper treatment scheme. For more details about the degree of evolution of the disease and also to basically see the exact areas affected, doctors use chest X-rays or CT scans.

Tuberculosis diagnosis is very hard to establish, there are so many types of this disease and so difficult to tract each of them. It’s even harder to diagnose children with it, the signs are quite relative and interpretative – because they are based on the patients observation through time, they may not have a accurate skin test result and also it is very hard to examine the sputum (sputum is the mucous material excreted when coughing).