Good morning/afternoon/evening, Mr Johanis Blatan, I

want introduce my self,

My name Is : Ananda Zusanty Putri Natsir,
My NPM : 08220100189, class JKT 21
I want to reading about TBC.

Tuberculosis

Tuberculosis is a bacterial infection that is also

known as TB. It can be fatal if not treated. TB most
often affects your lungs, but can also affect other
organs like your brain.

Overview
What is tuberculosis?

Tuberculosis is an infectious disease that can

cause infection in your lungs or other tissues. It
commonly affects your lungs, but it can also affect
other organs like your spine, brain or kidneys. The
word “tuberculosis” comes from a Latin word for
"nodule" or something that sticks out.
Tuberculosis is also known as TB. Not everyone
who becomes infected with TB gets sick, but if you
do get sick you need to be treated.
If you’re infected with the bacterium, but don’t
have symptoms, you have inactive tuberculosis or
latent tuberculosis infection (also called latent TB). It
may seem like TB has gone away, but it’s dormant
(sleeping) inside your body.
If you’re infected, develop symptoms and are
contagious, you have active tuberculosis or
tuberculosis disease (TB disease).
The three stages of TB are:
1.Primary infection.
2.Latent TB infection.
3.Active TB disease.

How common is tuberculosis?

About 10 million people became ill with TB

throughout the world, and about 1.5 (One Point
Five) million people died from the disease in 2020
(Two Thousand Twenty). TB was once the leading
cause of death in the U.S. but the number of cases
fell rapidly in the 1940s (Nineteen Forty) and 1950s
(Nineteen Fifty) after researchers found treatments.
Statistics show that there were 7,860 (Seven
Thousand Eigh Hundred Sixty) tuberculosis cases
reported in the U.S. in 2021 (Two Thousand Twenty
One). The national incidence rate is 2.4 (Two Point
Four) cases per 100,000 (One Hundred Thousand)
people.

Are there different kinds of tuberculosis?

In addition to active or inactive, you might hear

about different kinds of TB, including the most
common, pulmonary (lung) tuberculosis. But the
bacterium can also affect other parts of your body
besides the lungs, causing extrapulmonary
tuberculosis (or TB outside of the lung). You might
also hear about systemic miliary tuberculosis, which
can spread throughout your body and cause:
1.Meningitis, an inflammation of your brain.
2.Sterile pyuria, or high levels of white blood cells
in your urine.
3.Pott’s disease, also called spinal tuberculosis or
tuberculosis spondylitis.
4.Addison’s disease, an adrenal gland condition.
5.Hepatitis, a liver infection.
6.Lymphadenitis in your neck, also called scrofula
or TB lymphadenitis.
Symptoms and Causes
What causes tuberculosis?

TB is caused by the bacterium Mycobacterium

tuberculosis. The germs are spread through the air
and usually infect the lungs, but can also infect
other parts of the body. Although TB is infectious, it
doesn’t spread easily. You usually have to spend a
lot of time in contact with someone who is
contagious in order to catch it.

How is tuberculosis spread?

TB can be spread when a person with active TB

disease releases germs into the air through
coughing, sneezing, talking, singing or even
laughing. Only people with active pulmonary
infection are contagious. Most people who breathe in
TB bacteria are able to fight the bacteria and stop it
from growing. The bacterium becomes inactive in
these individuals, causing a latent TB infection.
As many as 13 (Thirteen) million people in the
U.S. have latent TB. Although the bacteria are
inactive, they still remain alive in the body and can
become active later. Some people can have a latent
TB infection for a lifetime, without it ever becoming
active and developing into TB disease.
 However, TB can become active if your immune
system becomes weakened and cannot stop the
bacteria from growing. This is when the latent TB
infection becomes active TB. Many researchers are
working on treatments to stop this from happening.

What are the signs and symptoms of

tuberculosis?

People with inactive TB do not exhibit

symptoms. However, they may have a positive skin
reaction test or blood test.
Those with active TB can show any of the following
symptoms:
1.Bad cough (lasting longer than two weeks).
2.Pain in your chest.
3.Coughing up blood or sputum (mucus).
4.Fatigue or weakness.
5.Loss of appetite.
6.Weight loss.
7.Chills.
8.Fever.
9.Night sweats.
Diagnosis and Tests
What kinds of tests are used to diagnose
tuberculosis?

There are two kinds of screening tests for TB:

the Mantoux tuberculin skin test (TST) and the
blood test, called the interferon gamma release assay
(IGRA).
For the TST, a healthcare provider will inject a
small amount of a substance called purified protein
derivative (PPD) under the skin of your forearm.
After two to three days, you must go back to the
healthcare provider, who will look at the injection
site.
For the IGRA, a healthcare provider will draw
blood and send the sample to the lab.
Further tests to determine if an infection is active
or if your lungs are infected include:
1.Lab tests on sputum and lung fluid.
2.Chest X-ray.
3.Computed tomography (CT) scans.
How do I know if I should get tested for
tuberculosis?

You may want to get tested for TB if:

1.You are a resident or employee in group settings
where the risk is high, such as jails, hospices,
skilled nursing facilities, shelters and other
healthcare facilities.
2.You work in a mycobacteriology laboratory.
3.You’ve been in contact with someone who’s
known or suspected to have TB disease.
4.Your body's resistance to illness is low because
of a weak immune system.
5.You think you might already have TB disease
and have symptoms.
6.You’re from a region or have lived in a region
where TB disease is prevalent, such as Latin
America, the Caribbean, Africa, Asia, Eastern
Europe and Russia.
7.You’ve injected recreational drugs.
8.Your healthcare provider recommends testing.
Others who are at risk for TB include:
1.People with immature or impaired immune
systems, such as babies and children.
2.People with kidney disease, diabetes, or other
chronic (long-term) illness.
3.People who have received organ transplants.
 4.People being treated with chemotherapy for
cancer or other types of treatments for immune
system disorders.
The incidence rates for minority groups in the U.S.
are higher than the incidence rates for whites.

Management and Treatment

How is tuberculosis treated?

TB infection and disease is treated with these drugs:

1.Isoniazid (Hyzyd®).
2.Rifampin (Rifadin®).
3.Ethambutol (Myambutol®).
4.Pyrazinamide (Zinamide®).
5.Rifapentine (Priftin®).
You must take all of the medication your provider
prescribes, or not all of the bacteria will be killed.
You will have to take these medications for as long
as you're told — sometimes up to nine months.
Some forms of TB have become resistant to
medications. It’s very important and likely that your
provider will use more than one drug to treat TB. It’s
very important to finish your entire prescription.
Complications/side effects of treatment

Some people have side effects from the drugs used

to treat TB that may include:
1.Skin rashes and other reactions.
2.Nausea and stomach upset.
3.Itchy skin.
4.Yellow skin or eyes (jaundice).
5.Dark urine.
Talk to your provider about any side effects
because some might mean that you're experiencing
liver damage.

How soon after starting treatment for active TB

will I feel better?

It will probably take weeks before you start

having more energy and fewer days with symptoms.
However, it will take longer than that to complete
your treatment. You’ll need to take your medications
for at least six to nine months.
Can tuberculosis be cured?

Yes, TB is curable.

Prevention
What can you do to prevent spreading
tuberculosis?

You usually have to be in contact with someone

with active TB for a long time before becoming
infected. It helps to follow infection prevention
guidelines like:
1.Washing your hands thoroughly and often.
2.Coughing into your elbow or covering your
mouth when you cough.
3.Avoiding close contact with other people.
4.Making sure you take all of your medication
correctly.
5.Not returning to work or school until you’ve been
cleared by your healthcare provider.
In the hospital, the most important measures to
stop the spread of TB are having proper ventilation
and using the correct types of personal protective
equipment.
Is there a vaccine to prevent tuberculosis?

Some countries (but not the U.S.) use a TB

vaccine called Bacillus Calmette-Guerin (BCG). The
vaccine is mostly given to children in countries with
high rates of TB to prevent meningitis and a serious
form of TB called miliary tuberculosis. The vaccine
may make skin tests for TB less accurate.

Outlook / Prognosis
What is the outlook (prognosis) for someone with
tuberculosis?

If you have tuberculosis and you’re treated, your

outlook is good if you’ve followed directions and
taken your medications for as long as you should
and in the way you were told.

Living With
When should I see my healthcare provider?

If you’ve been exposed to TB, you should talk to

your healthcare provider right away. They can help
you make a decision about getting tested. That
decision is more important if you’ve developed any
symptoms of illness that could mean you’re
contagious. Remember, even though tuberculosis
can be treated, it can also be fatal if it’s not treated.
 Tuberculosis

Overview
Tuberculosis (TB) is a serious illness that mainly
affects the lungs. The germs that cause tuberculosis
are a type of bacteria.

Tuberculosis can spread when a person with the

illness coughs, sneezes or sings. This can put tiny
droplets with the germs into the air. Another person
can then breathe in the droplets, and the germs
enter the lungs.

Tuberculosis spreads easily where people gather

in crowds or where people live in crowded
conditions. People with HIV/AIDS and other people
with weakened immune systems have a higher risk
of catching tuberculosis than people with typical
immune systems.

Drugs called antibiotics can treat tuberculosis.

But some forms of the bacteria no longer respond
well to treatments.

Symptoms
When tuberculosis (TB) germs survive and
multiply in the lungs, it is called a TB infection.
A TB infection may be in one of three stages.
Symptoms are different in each stage.

Primary TB infection.

The first stage is called the primary infection.

Immune system cells find and capture the germs.
The immune system may completely destroy the
germs. But some captured germs may still survive
and multiply.

Most people don't have symptoms during a

primary infection. Some people may get flu-like
symptoms, such as:

1.Low fever.
2.Tiredness.
3.Cough.

Latent TB Infection.

Primary infection is usually followed by the stage

called latent TB infection. Immune system cells
build a wall around lung tissue with TB germs. The
germs can't do any more harm if the immune system
keeps them under control. But the germs survive.
There are no symptoms during latent TB infection.
Active TB Disease.

Active TB disease happens when the immune

system can't control an infection. Germs cause
disease throughout the lungs or other parts of the
body. Active TB disease may happen right after
primary infection. But it usually happens after
months or years of latent TB infection.

Symptoms of active TB disease in the lungs

usually begin gradually and worsen over a few
weeks. They may include:

1.Cough.
2.Coughing up blood or mucus.
3.Chest pain.
4.Pain with breathing or coughing.
5.Fever.
6.Chills.
7.Night sweats.
8.Weight loss.
9.Not wanting to eat.
10. Tiredness.
11. Not feeling well in general.

Active TB disease outside the lungs.

TB infection can spread from the lungs to other

parts of the body. This is called extrapulmonary
tuberculosis. Symptoms vary depending on what
part of the body is infected. Common symptoms may
include:

1.Fever.
2.Chills.
3.Night sweats.
4.Weight loss.
5.Not wanting to eat.
6.Tiredness.
7.Not feeling well in general.
8.Pain near the site of infection.
Active TB disease in the voice box is outside the
lungs, but it has symptoms more like disease in the
lungs.

Common sites of active TB disease outside the

lungs include:

1.Kidneys.
2.Liver.
3.Fluid surrounding the brain and spinal cord.
4.Heart muscles.
5.Genitals.
6.Lymph nodes.
7.Bones and joints.
8.Skin.
9.Walls of blood vessels.
10. Voice box, also called larynx.
 Active TB disease In Children.
Symptoms of active TB disease in children vary.
Typically, symptoms by age may include the
following:
 Teenagers.
Symptoms are similar to adult symptoms.
 1- to 12-year-olds.
Younger children may have a fever that won't go
away and weight loss.
 Infants.
The baby doesn't grow or gain weight as
expected. Also, a baby may have symptoms from
swelling in the fluid around the brain or spinal cord,
including:
1.Being sluggish or not active.
2.Unusually fussy.
3.Vomiting.
4.Poor feeding.
5.Bulging soft spot on the head.
6.Poor reflexes.
When To See a Doctor
The symptoms of tuberculosis are similar to
symptoms of many different illnesses. See your
health care provider if you have symptoms that don't
improve with a few days of rest.

Get emergency care if you have:

1.Chest pain.
2.Sudden, severe headache.
3.Confusion.
4.Seizures.
5.Difficulty breathing.
Get immediate or urgent care if you:
1.Cough up blood.
2.Have blood in your urine or stool.

Causes
Tuberculosis is caused by a bacterium called
Mycobacterium tuberculosis.

People with active TB disease in the lungs or

voice box can spread the disease. They release tiny
droplets that carry the bacteria through the air. This
can happen when they're speaking, singing,
laughing, coughing or sneezing. A person can get an
infection after inhaling the droplets.
 The disease is more likely to spread when people
spend a lot of time together in an indoor space. So
the disease spreads easily in places where people live
or work together for long periods. Also, the disease
spreads more easily in crowded gatherings.

A person with a latent TB infection cannot pass

the disease to other people. A person taking drugs to
treat active TB disease usually can't pass the disease
after 2 to 3 weeks of treatment.

Drug-Resistant TB
Some forms of the TB bacteria have become
drug resistant. This means that drugs that once
cured the disease no longer work.

This happens, in part, because of naturally

occurring genetic changes in bacteria. A random
genetic change in a bacterium might give it some
quality that makes it more likely to survive the
attack of an antibiotic. If it does survive, then it can
multiply.

When antibiotic drugs aren't used correctly — or

drugs fail to kill all the bacteria for another reason
— the conditions are ideal for more-resistant
versions of the bacteria to get established and
multiply. If these bacteria are passed on to other
people, a new drug-resistant strain can grow over
time.
 Problems that can lead to such drug-resistant
strains of bacteria include the following:
 People didn't follow directions for taking the drugs
or stopped taking the drugs.
 They weren't prescribed the right treatment plan.
 Drugs were not available.
 The drugs were of poor quality.
 The body didn't absorb the drugs as expected.

Risk Factors
Anyone can get tuberculosis, but certain factors
increase the risk of getting an infection. Other
factors increase the risk of an infection becoming
active TB disease.

The Centers for Disease Control and Prevention

recommends a TB test for people who have an
increased risk of TB infection or active TB disease.
Talk to your health care provider if you have one or
more of the following risk factors.

Risk of TB Infection
Certain living or working conditions make it
easier for the disease to pass from one person to
another. These conditions increase the risk of getting
a TB infection:
1.Living with someone with active TB disease.
 2.Living or traveling in a country where TB is
common, including several countries in Latin
America, Africa, Asia and the Pacific Islands.
3.Living or working in places where people live
close together, such as prisons, nursing homes
and shelters for homeless people.
4.Living in a community identified as being at high
risk of tuberculosis.
5.Working in health care and treating people with
a high risk of TB.

Risk of active TB Disease

1.A weakened immune system increases the risk

of a TB infection becoming active TB disease.
Conditions or treatments that weaken the
immune system include:
2.HIV/AIDS.
3.Diabetes.
4.Severe kidney disease.
5.Cancers of the head, neck and blood.
6.Malnutrition or low body weight.
7.Cancer treatment, such as chemotherapy.
8.Drugs to prevent rejection of transplanted
organs.
9.Long-term use of prescription steroids.
10. Use of unlawful injected drugs.
11. Misuse of alcohol.
 12. Smoking and using other tobacco products.

Age and Active TB Disease

The risk of a TB infection becoming
active TB disease changes with age.
 Under 5 years of age. Until children reach age 5,
they have high risk of a TB infection becoming
active TB disease. The risk is greater for children
under age 2. Tuberculosis in this age group often
leads to serious disease in the fluid surrounding
the brain and spinal column, called meningitis.
 Age 15 to 25. People in this age group have an
increased risk of developing more-severe
active TB disease in the lungs.
 Age 65 and older. The immune system weakens
during older age. Older adults have a greater risk
of active TB disease. Also, the disease may be
more difficult to treat.

Prevention
If you test positive for latent TB infection, you
may need to take drugs to prevent active TB disease.

Preventing the spread of disease

If you have active TB disease, you'll need to take
steps to prevent other people from getting an
infection. You will take drugs for four, six or nine
months. Take all of the drugs as directed during the
entire time.

During the first 2 to 3 weeks, you will be able to

pass TB bacteria to others. Protect others with these
steps:
1.Stay home. Don't go to work or school.
2.Isolate at home. Spend as little time as possible
among members of your household. Sleep in a
separate room.
3.Ventilate the room. Tuberculosis germs spread
more easily in small, closed spaces. If it's not too
cold outdoors, open the windows. Use a fan to
blow air out. If you have more than one window,
use one fan to blow air out and another to blow
air in.
4.Wear face masks. Wear a mask when you have
to be around other people. Ask other members of
the household to wear masks to protect
themselves.
5.Cover your mouth. Use a tissue to cover your
mouth anytime you sneeze or cough. Put the
dirty tissue in a bag, seal it and throw it away.

Vaccinations
In countries where tuberculosis is common,
infants often are vaccinated with the bacille
Calmette-Guerin (BCG) vaccine. This protects
infants and toddlers who are more likely to have
active TB disease in the fluid surrounding the brain
and spinal cord.

The vaccine may not protect against disease in

the lungs, which is more likely in the United States.
Dozens of new TB vaccines are in various stages of
development and testing.