When the illness has moved from one area of your body to another through your blood, it is known as disseminated tuberculosis (TB). Widespread symptoms such as night sweats, unexplained weight loss, and stomach pain are brought on by this.
contamination by the bacterium The most well-known form of Mycobacterium tuberculosis is pulmonary (lung) TB. However, the infection can also affect your kidney, brain, or spine, among other organs. Extrapulmonary TB is the term for tuberculosis that develops outside of the lungs.
When TB infection spreads to other areas of your body through the blood, it is referred to as disseminated TB. Although the lungs are not always involved, extrapulmonary and pulmonary forms of disseminated tuberculosis are usually present.
Diagnosing disseminated tuberculosis can be challenging. It may show up symptomless, and imaging scan results may show signs that are similar to those of other illnesses. To find out more about the signs, causes, and treatments of disseminated tuberculosis, continue reading.
Disseminated vs. miliary TB
Although there is considerable confusion between the categories, military and disseminated tuberculosis are not the same.Miliary TB is a potentially fatal variant of disseminated TB that appears on a chest X-ray as 1-2 mm-long, millet-seed-sized patches.About 85–90% of all cases of disseminated TB are caused by miliary TB.
What are the symptoms of disseminated TB?
It is challenging to identify the spread of TB. The illness may manifest as pulmonary tuberculosis (TB) symptoms, such as a persistent cough lasting three weeks or more.
However, symptoms could potentially appear based on the infection's spread. You could contract disseminated TB if you:
- liver
- spleen
- bone marrow
- thyroid
- central nervous system
- lymphatic system
- kidney
- adrenal glands
- eyes
The course of symptoms can vary between adults and children and take days to weeks to manifest:
| Symptoms more common in adults | Symptoms more common in children |
|---|---|
| fatigue shortness of breath (dyspnea) night sweats fever abdominal pain coughing up blood (hemoptysis) headache | diarrhoea vomiting seizures jaundice headache neck stiffness sensitivity to light (photophobia) |
Additionally, particularly in cases with miliary TB, you might detect flattened or elevated regions of discoloured skin.
Additionally, physicians may see several symptoms in both adults and children:
| Signs more common in adults | Signs more common in children |
|---|---|
| anorexia mental changes pleural effusion ascites swollen lymph nodes (lymphadenopathy) | enlarged liver (hepatomegaly) enlarged spleen (splenomegaly) |
A tuberculosis infection might sometimes exist without any symptoms. We refer to this as latent TB. Experts advise therapy even if you have latent tuberculosis to stop the illness from becoming active.
How do doctors diagnose disseminated TB?
To diagnose tuberculin (TB), doctors usually use an interferon-gamma release assay (IGRA) test or a tuberculin skin test. These, however, frequently fail to identify latent infections from active ones or to identify widespread tuberculosis.
The initial step is usually a chest X-ray since it can show the characteristic cell pattern, or "seed," of miliary TB. However, that pattern can also be brought on by other illnesses like sarcoidosis. Furthermore, not every instance of the spread of TB exhibits that pattern.
A physician may also employ the following imaging tests:
- abdominal ultrasound
- echocardiography
- PET-CT scan
- abdominal CT scan
- abdominal MRI
Verifying the existence of Mycobacterium tuberculosis—usually using an acid-fast smear or mycobacterial sputum stain—is the only method to confirm the spread of tuberculosis.
What is the treatment for disseminated TB?
A lengthy course of antibiotics is used to treat disseminated TB, and it consists of the following:
- 2 months of rigorous pyrazinamide, isoniazid, rifampin, streptomycin, or ethambutol treatment
- 4 months of rifampin and isoniazid therapy
If you have difficulties during therapy or if you have another medical condition, such as HIV or AIDS, more interventions may be required. These actions could consist of:
- antiretroviral medications
- surgery
- mechanical ventilation
A patient's course of treatment may be more than six months.
What causes disseminated TB?
One complication of TB is disseminated TB. It happens when a blood infection caused by Mycobacterium tuberculosis spreads.
For TB to be diagnosed as widespread, it must impact one of the following:
- at least two organs not next to each other
- your bone marrow
- your liver
- your blood
Who’s at risk of disseminated TB?
Elderly people adolescents and young adults are more likely to contract milder forms of tuberculosis.
Your chance of developing disseminated tuberculosis may also be increased by illnesses, surgeries, or drugs that compromise your immune system. Among the variables connected to a higher risk are:
- malnutrition
- history of childhood infections
- silicosis
- diabetes
- cancer
- alcohol use disorder
- having had a recent surgery
- recently completed pregnancy
- HIV or AIDS
- chronic kidney disease
- history of organ transplant
- connective tissue disorders
- tobacco use
The following medications may make you more susceptible to spreading tuberculosis:
- corticosteroids
- immunomodulator drugs
- immunosuppressive and cytotoxic drugs
What is the outlook for people with disseminated TB?
Most patients with disseminated tuberculosis may recover with appropriate care. Nonetheless, a 2019 assessment found that 25–30% of patients with disseminated TB pass away in hospitals.
If you have disseminated tuberculosis and there are other contributing variables, such as:
- headache, neck stiffness, and photophobia
- other underlying health conditions
- changes in mental state
- night sweats
- liver cirrhosis
- low or high white blood cell count
- advancing age
Takeaway
When the TB-causing bacteria travel via your blood to other areas of your body, it is known as disseminated tuberculosis. It usually originates in the lungs and spreads to the liver or bone marrow, or at least two additional distant organs.
Individuals with specific medical disorders, such as diabetes, chronic kidney disease, or HIV, may have an increased risk of developing disseminated tuberculosis. Taking drugs that weaken or modulate the immune system may potentially increase your risk.
Disseminated tuberculosis is treated by doctors with antibiotics for a minimum of six months.
FAQs
Here are some commonly asked questions about disseminated TB.
Is disseminated TB the same as extrapulmonary TB?
There are frequently pulmonary and extrapulmonary locations in disseminated, or miliary, tuberculosis.
Can disseminated TB be cured?
Most forms of disseminated TB respond well to treatment.
What is another name for disseminated TB?
miliary TB
Can a person with TB go to work?
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