TUBERCULOSIS (TB) |
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DESCRIPTIONTuberculosis is an acute or chronic contagious bacterial infection. The lungs are primarily involved, but the disease may spread to other organs. Childhood tuberculosis is usually confined to the middle of the lungs, but it may spread to cause meningitis.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications.
SIGNS & SYMPTOMS
Early stages: no symptoms (often); symptoms that resemble those of influenza.
Second stages: low fever; weight loss; chronic fatigue; heavy sweating, especially at night.
Later stages: cough with sputum that becomes progressively bloody, yellow, thick, or gray; chest pain; shortness of breath; reddish or cloudy urine (sometimes).
CAUSES
Infection by the germ mycobacterium tuberculosis. The germ is transmitted in the air from one person to another. Cattle are also susceptible and can transmit TB through non-pasteurized milk.
RISK FACTORS
Infancy; chronic illness that has lowered your child's resistance; use of cortisone or immunosuppressive drugs may reactivate inactive TB in your child; crowded or unsanitary living conditions.
PREVENTING COMPLICATIONS OR RECURRENCE
Vaccination with BCG, a strain of the tuberculosis bacteria. This may prevent infection, or it may shorten and diminish the severity of the infection.
Preventive treatment for several months with isonicotinic acid if your child's tuberculin skin test is positive.
OTHER
Health authorities recommend vaccination and preventive treatment for the following groups:
Persons who have positive reactions to TB tests, but show no symptoms of disease--especially children under age 5.
Children with negative reactions to TB tests in areas where 20% or more of classmates have positive reactions.
Persons traveling to countries where TB is prevalent.
Persons who must take immuno-suppressive or cortisone drugs for a long time.
Post-gastrectomy patients whose X-rays show evidence of inactive TB.
Persons with silicosis.
BASIC INFORMATION
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; tuberculin skin test; laboratory cultures of your child's sputum and urine; X-rays of the child's chest; pulmonary function studies. This disease must be reported to the health department. All family members and close associates need tuberculin skin tests and treatment if needed.
POSSIBLE COMPLICATIONSLung abscess; bronchiectasis; COPD (See Glossary); spread of infection to other organs (brain, bone, spine, and kidneys); respiratory failure.
PROBABLE OUTCOME
Usually curable with treatment. Without treatment, it can be fatal to your child.
TREATMENT
HOME CARE
It may not be necessary to isolate or hospitalize a child with TB. The disease is usually spread before diagnosis. Patients are probably not infectious after 10 days to 2 weeks of treatment.
Occasionally you will need to collect a 24-hour sputum specimen from your child for laboratory analysis to see if the TB is still active.
MEDICATION
Your doctor may prescribe anti-tubercular drugs, including INH (isonicotinic acid hydrizide), ethambutol, para-aminosalicylic acid, or rifampin.
ACTIVITY
Your child should rest in bed until symptoms disappear and tests show TB germs are gone. You may need to restrict the child's activities for 6 months.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?When all signs, symptoms, and laboratory studies verify complete healing. Various health departments have varying policies or laws to obey. Check with them before sending your child back.
CALL YOUR DOCTOR IF
Your child has symptoms of tuberculosis.
Symptoms persist or worsen, despite treatment.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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