Doctor Reza - The Tuberculosis Specialist for Full Treatment of TB

To get the best treatment for TB, you are advised to consult a specialist doctor, who has many years of professional experience in diagnosing TB symptoms of different types and curing patients infected with various drug-resistant mutants of TB bacteria.

Kolkata has numerous TB patients with multiple types of TB and therefore provides the required conditions for the creation of TB specialists with extensive knowledge, training, and skills, resulting from the study of numerous cases of TB.

Based on my extensive experience as a Pulmonologist and TB Consultant in medical facilities in the UK and Kolkata, I have provided here some important information about the conditions, organ specific symptoms, quick diagnosis, and complete treatment of different types of TB.

Globally, TB is one of the commonest infectious diseases in the world, especially in the poorer countries. TB is very common in India, especially in the crowded cities like Kolkata. Poor nutrition, poor housing, poor general health, and the AIDS epidemic are the main reasons why it is so common.

What is Tuberculosis ?

Tuberculosis is an infection caused by the bacteria (germ) called Mycobacterium Tuberculosis. TB usually affects the lungs but any part of your body like the bones and joints, lymph glands, skin and kidneys may be affected.

How Does Tuberculosis Infection Occur

TB can infect anyone, even you. It is an air-borne disease. Most TB cases affect the lungs at first. TB bacteria are coughed or sneezed into the air by people with active TB disease. They are carried in the air as tiny water droplets. If you breathe in some TB bacteria, then they may multiply in your lungs. There are three ways that the infection may progress:

  • Minor Infection with No Symptoms - Occurs In Most Cases
    The TB is killed off or made inactive by the immune system in the lungs. There may be mild or no symptoms and the infection is halted. No active TB develops
  • Infection Progressing Into Active Disease
    Active TB disease with symptoms occurs in about 1 in 20 people who breathe in some TB bacteria. In these people, the immune system does not win the battle and halt the invading bacteria. The TB bacteria multiply and spread to other parts of the lungs and body. Symptoms of active TB then develop about 6-8 weeks after first breathing in the bacteria
  • Reactivated (Secondary) Infection Causing Active Diseases
    You may develop active TB months or years after a minor TB infection had been halted. The immune system at first stops the bacteria from multiplying (as described above). However, a failing immune system and Reactivated TB is more likely to occur if you:
    • Are elderly or frail
    • Are malnourished
    • Have diabetes
    • Take steroids or immunosuppressant medication
    • Have kidney failure
    • Are alcohol dependent (‘alcoholic’)
    • Have AIDS.
How Infectious Is Tuberculosis

If you have active TB disease, you will cough and sneeze TB bacteria into the air, and this can infect others. You normally need ‘close contact’ and ‘heavy exposure’ to an affected person to catch TB. It is commonly passed to people who live with a person with active TB disease, who coughs a lot in a badly ventilated home. The spread of TB is more common in the poorer areas of the world due to:

  • Overcrowding
  • Poor sanitation
  • Poor housing.

If you have been exposed to someone with TB, consult me to find out if you have been infected or not.

Understand your Symptoms of Active TB

Cough is usually the first and most marked symptom of TB. The cough often starts as a dry and irritating cough. But it tends to continue for months and gets worse. The cough usually becomes ‘productive’ and you tend to cough up a lot of sputum (phlegm), which may contain blood.

You maybe infected by the TB germ if you also have other symptoms like:

  • Fever
  • Sweats - specially at night
  • Feeling unwell
  • Feel tired
  • Pains in the chest
  • Weight loss
  • Loss of appetite.

You may become breathless as the infection progresses and damages the lungs. If left untreated, complications may develop such as fluid collecting between the lung and the chest wall (pleural effusion). This can make you very breathless.

Diagnosis of Tuberculosis

Based on your symptoms, I as your consultant chest specialist and Tuberculosis specialist, will want to be sure that you have contracted TB infection. The TB germ is usually found in body fluid or organ. Typical symptoms and changes in the chest X-Ray may suggest active TB. But, tests are done to prove the diagnosis.

  • Tuberculin Skin Testing (Mantoux Or Heaf Test)
    This is a very useful test that shows if you have been in contact with TB bacteria at some point in your life, or if you have had active TB in the past. However, IT CANNOT PROVE YOU HAVE CURRENT ACTIVE TUBERCULOSIS AND REQUIRE TREATMENT
  • Proving A Current Active Infection requiring treatment
    3 sputum samples are usually taken to see if you have active TB. However, it takes 6-8 weeks to grow the bacteria, as the TB bacteria grow very slowly before they can be detected in the lab. As it can take weeks to prove the infection, many people with suspected active TB (with typical symptoms and X-Ray changes) are started on treatment before the sputum test result is back. This is to prevent the disease from progressing and to prevent spread to other people. However, TB medicine should not be started without sending sputum samples as rampant use of TB medicines on people who do not have TB leads to Multi Drug Resistant Tuberculosis
  • Samples can also be obtained from Lymph nodes, bone, pleural fluid, brain, kidneys or any other organs that might have been affected by the tuberculosis. The TB bacteria can be seen and grown from all these samples for confirmation of the diagnosis
  • Some blood tests like TB IgM, IgG, Quantiferon TB Gold Test, etc. do not confirm active TB, which require treatment but should be interpreted exactly as the Skin Test mentioned above.
Treatment for TB

‘Normal’ antibiotics do not kill TB bacteria. You need to take a combination of special antibiotics. Standard treatment is:

  • A combination of 3-4 antibiotics for 6-9 months or longer
  • Variations on this treatment plan may be advised on individual circumstances.

Treatment failure is commonly due to not taking medicines properly and regularly.

It is vital that you follow the instructions as directed by the doctor. Continue the TB medicines, even if you feel much better after a few weeks (as many people do). You must finish the full course of treatment.

Side Effects of TB Medicines and Follow Up

The medicines used to treat TB have a good safety record. Sometimes side effects occur. If you observe side effects, consult me immediately. As your specialist lung doctor, I may prescribe an alternative antibiotic rather than just stopping your treatment.

Friends and Family of TB Patients May Need Checking

Household members and regular, close contacts of a person with active TB maybe advised to have tests, too. This may include a chest X-Ray and a Tuberculin skin test.

The Outlook (Prognosis) If You Have Active Tuberculosis

With treatment, most people make a full recovery.

If left untreated, about half the people with active TB eventually die of the infection. TB bacteria multiply quite slowly when compared to other bacteria. Therefore, active TB tends to be a slowly progressing illness. Some people survive without treatment or may even fully recover.

Multi Drug Resistant TB (MDR TB)

This is a form of TB where outcome, even after treatment, is usually quite poor. Patients suffer for many years and most die. This usually occurs because of rampant use of TB medicines even in people who do not have TB. Patients with proven TB, who stop their medicines by themselves or take medicines very irregularly also contribute to this form of TB. Treatment for this form of TB continues for up to 2 years and its quite expensive.

Remember
  • An X-ray does not diagnose TB
  • Anyone suspected of having Lung TB should have sputum test done
  • A mantoux positive does not mean you have active TB which requires treatment
  • Once I start you on TB medicine take them regularly and do not stop by yourself.
** This site is for patient information only **