Phthisiatrician

It has been scientifically confirmed that a third of the inhabitants of our planet is the carrier of the tuberculosis bacterium, and during each second a new patient becomes ill, who has contracted tuberculosis. Agree, this is a fairly common infection. That is why a doctor who deals with all issues related to tuberculosis is identified in a separate specialty - phthisiatrician.

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Who is a phthisiatrist?

This is a specialty of a doctor with a higher medical education, who studies various measures for the prevention, diagnosis and treatment of all possible forms of tuberculosis. Such a specialist is competent in the causes of development, the mechanisms of transmission of tuberculosis infection, the course of pathological processes. It conducts preventive, epidemiological, therapeutic and rehabilitation measures, as well as the necessary diagnostic procedures.

When should I contact a TB specialist?

The phthisiatrician should be contacted in case of contact with a tuberculosis patient, with a positive response to a tuberculin test, if suspicious symptoms suggest a disease.

Adult people, unfortunately, for a long time can not pay attention to the signs of the disease. Pathology in them is discovered by chance, when passing a planned X-ray study. However, the phthisiatrician recommends that you consult him for advice if you have the following symptoms:

• rapid fatigue, increasing by evening;
• poor appetite;
• unnatural sweating, not dependent on time of day;
• sudden and significant weight loss;
• pain in the interblade zone;
• constant attacks of cough, dry or with a translucent foamy sputum, in advanced cases hemoptysis; cough intensifies when trying to take a deep breath, after screaming or a long conversation;
• growing hoarseness and pain when swallowing, heavy breathing;
• cyclic temperature increase.

In addition, the phthisiatrician can be consulted about the consultation and decoding of the radiographic picture of the lungs.

What tests should I take when I call on the TB doctor?

Immediately before visiting the phthisiatrist, it is recommended to undergo a chest X-ray. Women should visit a gynecologist. The remaining necessary analyzes and studies, if necessary, will be assigned by the phthisiatrist.

If you have already had any tests for reasons related to suspected tuberculosis infection, take the results of the tests and studies with you so that the doctor can evaluate them and provide a complete picture of your condition.

What methods of diagnosis does the TB officer use?

Laboratory methods of diagnosis, which the phthisiatrician uses, include carrying out bacteriological and bacterioscopic analyzes, biological and allergic reactions. Sometimes it is possible to use serological tests.

For microscopy, bacteriology or biological samples, those materials that are directly related to the localization of the tuberculosis focus are used. It can be particles of pus, urine samples, saliva and cerebrospinal fluid, fecal secretions collected in a special container.

• Homogenization procedure: The daily amount of sputum isolated by the patient is taken into a container, the same amount of 1% solution of caustic soda is added, clogged and vortexed for 10-15 minutes. The resulting mixture is subjected to a centrifuge treatment, after which a more dense layer is neutralized by adding 2 drops of 10% hydrochloric acid or 30% acetic acid. The drug is used in the form of smears and stains according to Tsiol-Nielsen.
• Flotation procedure: In the same way, prepared and shaken daily volume of sputum is maintained for half an hour in a water bath at a temperature of 55 ° C. After that add 1-2 ml of benzene (or gasoline) and again shake. The resulting mixture should be kept at a temperature of 22-24 ° C: at this time, the benzene particles go up, grabbing the microbial flora. This layer is separated and placed on a section of slide that is placed on additional glass, heated to 60 ° C. The material is applied in several layers and subjected to fixation and painting according to Tsil-Nielsen.
• Bacteriology: a successful technique that is actively used when the bacterioscopy turned out to be negative. To the material taken are added two volume doses of 6% sulfuric acid, agitate for about 10 minutes. After that, the mixture is processed in a centrifuge in special containers, the denser lower layer is separated and subjected to neutralization reaction with 3% sodium hydroxide. If feces are studied, they are treated with 4% sodium hydroxide, the material is lowered into a thermostat, treated and the dense layer is treated with 8% hydrochloric acid. Subsequently, the drug can be sown on special media.

Such investigational drugs as, for example, a sample of cerebrospinal liquor, particles of purulent discharge, blood elements are not preliminarily processed. They are applied to nutrient media and kept in a thermostat for 2 months. The first colonies can be found after 10-30 days.

• Investigation of deep growth: seeding of secretions is carried out in containers with citrated blood. After a week, the medium is placed in a centrifuge and a dab is made from a dense lower layer.
• The allergological method is used to detect the actual tuberculous mycobacteria. Produce a tuberculin injection, which can confirm the presence of infection, but does not provide the characteristics of the process itself. Such methods include intradermal Mantoux test and Pirke skin reaction.
• The serological study is the reaction process of the Barde-Zhang complementary ligament. Used infrequently.

The most modern and fast method used by phthisiatricians is considered to be luminescent microscopy. The material is color-treated with auromine at a rate of 1: 1000. After that, the color is removed with hydrochloric alcohol and again stained with magenta. As a result, tubercular bacilli will glow with a light greenish-golden hue on a darker background.

What does the phthisiatrist do?

Tubercular clinics, hospitals, phthisiatric rooms, specialized sanatoria are the places where the TB specialist works. In such institutions it is possible to receive his advice or assistance related to timely detection, treatment and preventive measures that reduce the risk of tuberculosis.

Unfortunately, the presence of significant and numerous cavernous tuberculous formations, the neglected tuberculosis stage is not always successfully treated with the help of phthisiology. Such pathological changes in the lung tissue and bronchi are usually cured exclusively by an operative route. In such cases, the patient can be redirected by a phthisiatrician to a thoracic surgeon.

We summarize the main activities of the phthisiatrician:

• prevention of epidemics and the spread of tuberculosis infection;
• rendering of anti-tuberculosis care, carrying out of explanatory work among the population;
• genetic, immunological and immunomorphological issues of tuberculosis infection;
• biochemical processes in the etiology of tuberculosis;
• carrying out of medical actions, introduction of new technologies in therapeutic methods at a tuberculosis.

What diseases does the tuberculosis doctor cure?

Tuberculosis is a serious and dangerous disease that can affect almost all organs and systems of the human body. Most often, tuberculosis affects the respiratory system. However, other organs are also quite common: for this reason, the TB doctor closely cooperates with other specialists - a pulmonologist, dermatologist, ophthalmologist, orthopedist, etc. The phthisiatrist is engaged in the treatment of all forms of tuberculosis, including the following pathologies:

• disseminated form of tuberculosis of the lungs;
• infiltrative form of pulmonary tuberculosis;
• focal form of pulmonary tuberculosis;
• cavernous form of pulmonary tuberculosis;
• diagnosed with pulmonary tuberculosis;
• tubercular lesions of the eyes, keratitis, conjunctivitis, diffuse forms of tuberculous uveitis (irites, iridocyclitis);
• metastatic tuberculosis of the eyes;
• inducible form of tuberculous skin lesions (tuberculosis erythema);
• colliquated form of cutaneous tuberculosis (manifestations of scrophuloderma);
• lichenoid form of cutaneous tuberculosis (scrotala);
• Papularcrotic form of cutaneous tuberculosis;
• warty form of tuberculous lesions of the skin;
• miliary-ulcerative form of tuberculous lesion of cutaneous and mucous membranes;
• lupus erythematosus of the skin;
• manifestations of tuberculous mesadenitis;
• tuberculosis lesions of bronchi, trachea;
• tubercular bronchoadenitis;
• tuberculous defeat of the nose, oral cavity and nasopharynx;
• tuberculous bowel disease;
• tuberculosis of the esophagus;
• tuberculous lesion of the prostate and testes;
• tuberculous inflammation of the meninges;
• tuberculous lesion of bones and joints (musculoskeletal system);
• urogenital form of tuberculosis (damage to the uterus, appendages, cervix and vagina, urethra, bladder);
• tuberculous kidney disease.

Advices of phthisiatrician

To tuberculosis bypasses you and your family, listen to the recommendations of a phthisiatrician:

• consult a doctor if you suffer from a regular cough, hilar pain, increased sweating, and difficulty breathing;
• if you have had contact with a tuberculosis patient, consult a doctor about prevention and screening;
• Regularly every two years, take medical examinations (in educational institutions and at work, at the place of work) with compulsory x-ray;
• Some categories of the population should be examined for up to 2 times a year. These categories include active military personnel, nurses of the maternity ward, people who are in constant contact with tuberculosis patients, patients who have been ill with tuberculosis, AIDS patients, former prisoners;
• lead a healthy lifestyle, temper, eat a healthy balanced diet;
• refrain from smoking and drinking alcohol;
• Regularly ventilate industrial and household premises, observe the rules of public and personal hygiene;
• timely treat acute and chronic pathologies in the body;
• refrain from buying dairy products that have not been tested by the Sanitary and Epidemiological Station. Such products can be obtained from a cow suffering from tuberculosis.

The phthisiatrician is a very interesting, necessary and demanded medical specialty. This doctor has a great responsibility for the health and full life of people, is doing everything possible to prevent the development of the epidemic of tuberculosis - one of the most ancient infections, which is dangerous in the present time.