Tuberculosis: Treatment of Tuberculosis Infection

What is tuberculosis?
Tuberculosis (say: too-burr-cue- low-sis), also called TB, is an infection caused by a bacteria (a germ). Tuberculosis usually affects the lungs, but it can spread to the kidneys, bones, spine, brain and other parts of the body.

How does my doctor check for tuberculosis?
The most commonly used method to check for tuberculosis is the PPD skin test. If you have a positive PPD, it means you have been exposed to a person who has tuberculosis and you are now infected with the bacteria that causes the disease.
After you have a positive PPD skin test, you must have a chest x-ray and a physical exam to find it whether have active disease or are contagious (able to spread the disease). It usually takes only a few days to tell whether you're contagious. Most people with a positive skin test aren't contagious.

If I have a positive PPD test, do I have tuberculosis?
Not necessarily. A person can be infected with the bacteria that causes tuberculosis but not actually have tuberculosis disease. Many people are infected with the bacteria that causes tuberculosis, but only a few of these people (about 10%) go on to develop the disease. People who do have the disease are said to have "active" tuberculosis.
Healthy people who get infected with the tuberculosis bacteria are able to fight off the infection and do not get tuberculosis disease. The bacteria is dormant (inactive) in their lungs. If the body is not able to fight off the infection and the bacteria continues to grow, active tuberculosis develops.

How will my doctor treat the tuberculosis infection?
To be sure that you remain healthy, your doctor may recommend that you take medicine for 6 months to kill the tuberculosis infection. If you don't take the medicine, the bacteria will remain in your lungs, and you will always be in danger of getting active tuberculosis. The medicine used to treat tuberculosis infection is isoniazid (say: eye-so-nye-ah- zid), which is also called INH. You need to take 1 pill every day for 6 months. It is very important that you take the medicine every day. Keep the medicine in a place where you will always see it. Take it at the same time every day. Ask your doctor what to do if you forget to take a pill.
People who take INH may have side effects, but not very often. Side effects include a skin rash, an upset stomach or liver disease. Ask your doctor about other side effects that might happen. Don't drink alcohol or take paracetamol/ acetaminophen when you're taking INH. Always check with your doctor before you take any other medicine because some drugs interact with INH and cause side effects.
Every month you will need to visit your doctor to get another prescription of the medicine you are taking and to be sure you don't have any side effects or problems from the medicine. If you are feeling well, your doctor will give you a prescription for the next month.

Could I still get active tuberculosis after I take the medicine for 6 months?
Even after you take the medicine every day for 6 months there is a small chance that you could develop active tuberculosis disease, because some bacteria are resistant to the medicine. Staying healthy depends on having sensible living habits. You need enough sleep and exercise and a healthy diet to keep up your health and resistance to the tuberculosis bacteria.

Would I know if I developed active tuberculosis?
You might not know that you have active tuberculosis. Tuberculosis bacteria can grow in your body without making you feel sick. However, most people with active tuberculosis don't feel well. People with tuberculosis often feel tired and have a cough that won't go away. They may also lose weight, have a fever or break out in a sweat during the night (called "night sweats"). They may have trouble breathing.
If you have active tuberculosis, you will have to get regular checkups and chest x-rays for the rest of your life to make sure you stay free of disease, even after you have taken tuberculosis medicine.

What is the treatment for active tuberculosis?
If you have active TB, your doctor may recommend that you take 4 medicines:

• Isoniazid
• Rifampin
• Ethambutol
• Pyrazinamide
  

It's very important that you take all the medicine given to you. For the medicines to work at curing your tuberculosis, you must not skip a single dose.
Avoid drinking alcohol or taking paracetamol/ acetaminophen while you're taking the tuberculosis medicine. Tell your doctor about any other medicines you may be taking.
Your doctor may also order several sputum and blood tests to be done while you are being treated for tuberculosis. (Sputum is phlegm coughed up from deep inside the lungs.) These tests can be done by the nurse or at a clinic.
Call your doctor immediately if you have any of the symptoms listed here:

• Abdominal pain
• Blurred vision
• Continued loss of appetite
• Dark (coffee-colored) urine
• Fever
• Nausea
• Rash or itching
• Tingling or burning feeling in your hands or feet
• Tiredness without reason
• Vomiting
• Yellow color of eyes or skin
  

(AAFP)