Tuburculosis

Tuberculosis, MTB or TB (short for tubercle bacillus) is a common and in some cases deadlyinfectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis in humans. When the disease becomes active, 75% of the cases involve infection in the lungs (pulmonary TB). Symptoms include chest pain, coughing up blood, and a productive, prolonged cough for more than three weeks. Systemic symptoms include fever, chills, night sweats, appetite loss, weight loss, pallor, and fatigue.[9] In the other 25% of active cases, the infection moves from the lungs, causing other kinds of TB, collectively denoted extrapulmonary tuberculosis.[10] This occurs more commonly inimmunosuppressed persons and young children. Extrapulmonary infection sites include the pleurain tuberculosis pleurisy, the central nervous system in meningitis, the lymphatic system inscrofula of the neck, the genitourinary system in urogenital tuberculosis, and bones and joints inPott's disease of the spine. An especially serious form is disseminated TB, more commonly known as miliary tuberculosis. Extrapulmonary TB may co-exist with pulmonary TB as well The bacillus causing tuberculosis, Mycobacterium tuberculosis, was identified and described on 24 March 1882 by Robert Koch. He received the Nobel Prize in physiology or medicine in 1905 for this discovery.
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Koch did not believe that bovine (cattle) and human tuberculosis were similar, which delayed the

recognition of infected milk as a source of infection. Later, this source was eliminated by the pasteurizationprocess. Koch announced a glycerine extract of the tubercle bacilli as a remedy for tuberculosis in 1890, calling it "tuberculin". It was not effective, but was later adapted as a test for presymptomatic tuberculosis.

Tuberculosis, or "consumption" as it was commonly known, In 1815, one in four deaths in England was of consumption; by 1918 one in six deaths in France were still caused by TB. In the 20th century, tuberculosis killed an estimated 100 million people It was not until 1946 with the development of the antibiotic streptomycin that effective treatment and cure became possible.

The common antitubercular drugs are Isoniazid, Rifampicin, ethambutol and Pyrizanamide. They are first line drugs used for treating tuberculosis. In short course treatment of tuberculosis the Isoniazid, Rifampicin, pyrazinamide and ethambutol is given for 2 months followed by Isoniazid and Rifampicin alone for 4 months.

Second line drugs for treatment of tuberculosis

Aminoglycosides like Amikacin, kanamycin. Polypeptides like capreomycin. Fluoroquinolones like ciprofloxacin, levofloxacin, moxifloxacin Thioamides like ethionamide, prothionamide Cycloserine Para aminosalicylic acid Rifabutin Macrolides like clarythromycin Linezolid Thioacetazone Vitamin D Thioridazine

Third line drugs for tuberculosis

Use of steroids in tuberculosis

Steroids like predinisolone and dexamethasone are used in tubercular meningitis, tubercular pericarditis and tubercular peritonitis.

Adverse effects of antitubercular drugs

Nausea Vomiting Loss of appetite Itching Joint pains Burning sensation in feet Jaundice Skin rash Angina Constipation Seating

Sleeplessness Bitter taste Body pain