What are the signs and symptoms of MDR-TB?
Tuberculosis or TB is still causing so many deaths all over the world. This disease is now no longer only affecting the third world countries and developing countries. Tuberculosis is now the burden of developed countries too. This is because the migration rate is high nowadays. The mode of transportation and digital technologies have made travelling and migration much easier. People travel for so many reasons. The examples are for education, job, vacation, and medical attention. Signs of MDR-TB can help the population and medical professionals to reduce the burden of Tuberculosis and Multidrug Resistance Tuberculosis (MDR-TB) altogether.
To confirm that someone is having tuberculosis, history taking, physical examination, and investigations are needed. History taking and physical examination are important to detect and analyze the signs and symptoms of a patient. The signs and symptoms of Tuberculosis and Multidrug Resistance Tuberculosis (MDR-TB) are the same. They are:
- Shortness of breath
- Unintentional weight loss
- Painful ulcer in a few sites of the body
- Coughing out blood
- Night sweats
- Abnormal findings on chest and lung examination
- Abnormal findings from general physical examination
Resistance to anti-tuberculosis medications is one of the reasons why there is still a high number of Tuberculosis (TB) cases all over the world. Resistance to anti-tuberculosis medications has a few different definitions. The definitions are:
- Drug-resistant TB is when the causative organism is resistant to any of the first-line anti-TB medications
- Multidrug-resistant TB is when the causative organism is resistant to isoniazid, rifampicin, and other possible medications
- Pre-extensively drug-resistant TB is when the causative organism is resistant to isoniazid, rifampicin, and quinolones or other injectable medications
- Extensively drug-resistant TB is when the causative organism is resistant to isoniazid, rifampicin, fluoroquinolones, and aminoglycosides or capreomycin or both.
- Drug-resistant TB is when the causative organism is resistant to all medications
- Primary drug resistance is when a patient developed resistance even before receiving any anti-TB medications before
- Secondary drug resistance is when a patient developed resistance after receiving anti-Tb medications before
China, India, Russia, and the countries of the former Soviet Union are the countries which reported to have the highest number of Multidrug Resistance Tuberculosis (MDR-TB) cases. Risk factors for Multidrug Resistance Tuberculosis (MDR-TB) are:
- Persistent abnormal chest x-ray findings despite being under treatment
- Blood cultures are still positive although been treated for at least 3 months
- Not compliance with anti-TB medications
- Poorly supervised treatment
- Previous history of treatment failure
- Exposure to the patient with Multidrug Resistance Tuberculosis
- Travel to countries with a high number of Multidrug-Resistant Tuberculosis cases
- Woking in any place with reported Multidrug-Resistant Tuberculosis cases
Multidrug-Resistant Tuberculosis patients will require a different treatment plan and approach. They need to be on an expanded empiric treatment regimen for drug-resistant TB. There are few options for an expanded empiric treatment regimen for drug-resistant TB. The selection of the suitable treatment option depends on many factors, evidence, and clinical judgment of a physician.
The success of Multidrug-Resistant Tuberculosis treatment is depending on the following factors:
- Treatment duration of at least 18 months
- Directly observed therapy throughout the entire treatment course
- Surgical removal of the damaged portion of the lung
- The use of fluoroquinolone
- No previous history of receiving TB treatment
Signs of MDR-TB are really important in helping the population and medical professionals to reduce the burden of Tuberculosis and Multidrug Resistance Tuberculosis (MDR-TB) altogether.