Tuberculosis: consumption from ancient times to todayCough, hemoptysis, fever, chest pain, tiredness, loss of appetite and weight loss ("Learn...): all the symptoms of a disease that has devastated humanity since ancient times: tuberculosis. Often called MTB or simply TB (short for tubercle bacillus), tuberculosis is an often fatal infectious disease caused by assorted strains of mycobacteria, the most common of which is Mycobacterium tuberculosis (note the direct use of the disease's lay name) (Kumar 516-522). This genus of bacteria is aerobic and largely nonmotile, meaning they thrive in the air but are largely nonmotile, with the exception of Mycobacterium marinum, which appears to be motile within macrophages (Ryan). This point provides information on how tuberculosis spreads: through the air. The bacteria involved in tuberculosis infection are released when gas or liquid leaves the lungs of an infected individual. As such, tuberculosis is quite difficult to contract if you are not constantly exposed to it. In fact, the Center for Disease Control – henceforth referred to as “CDC” – maintains that tuberculosis is not spread by “shaking someone's hand, sharing food or drinks, touching bedding or toilet seats, sharing toothbrushes or kissing” (“Learning…). As dubious as these claims may seem, the organization “The Truth About TB” reaffirms this position, stating in its “Questions and Answers” column that it is necessary to have “close contact” with an individual's “lungs or throat” infected with tuberculosis. until you get exposure to the bacteria causing the infection. And even in the event of exposure, the article goes on to point out that approximately sixty percent of the immune system of healthy adults is capable of killing the mycobacterium if they inhale it (“My…”). This phenomenon is due to the fact that tuberculosis is caused by strains of bacteria and therefore is not as contagious as a disease transmitted through viral means such as the common cold or the human immunodeficiency virus (HIV). Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay But this information raises the question of what happens when an individual is truly infected with tuberculosis — and is not asymptomatic, as many are. The infection begins when mycobacteria establish themselves in the pulmonary alveoli, an anatomical structure found in the lung. Here the bacterium invades and replicates in the endosomes of bronchial macrophages. If successful – not eliminated by the macrophage endocytosis response – tuberculosis will begin to affect the sick person (Kumar). The disease is primarily a lung disorder and, therefore, in case of active infection, it will mainly affect the lungs and throat (“Learn…). Tuberculosis is known to cause mild to extremely prolonged chest pain and coughing fits that produce sputum (also known as phlegm) and, in some cases, hemoptysis, which is coughing up blood. Expulsion of blood from the lungs is often caused by straining from the coughing fits common in tuberculosis infections, but, although rare, may be the result of an inflammatory aneurysm of the pulmonary artery. Danish physician Fritz Waldemar Rasmussen first observed eleven cases of pulmonary aneurysms in individuals suffering from tuberculosis in 1868, giving the event the name "Rasmussen's aneurysm". The aneurysm in question is an important cause of unusually massive hemoptysis in individuals with tuberculosis (Corr). Like most infections, tuberculosis causes fever in its host; however, more unique symptoms include night sweats and what the CDC calls “lackof appetite". All these symptoms, of course, raise the question of how the disease kills an individual it has infected. Tuberculosis is classified as a granulomatous inflammatory disease. In infections such as these, macrophages, Tlymphocytes, B lymphocytes and fibroblasts “ coact” to form granulomas, surrounded by lymphocytes. This results in eventual necrosis in the lungs: to the naked eye, this necrosis appears to be compared to a soft white cheese. This is called caseous necrosis (Grosset). The infection also induces the formation of tubercles, small nodules that are signs of tuberculosis infection in the lungs. The center of these tubercles exhibits “abnormal cell death,” which contributes heavily to the necrotic tendencies of the disease (Kumar). the most common way to die from tuberculosis is lung failure; however, suffocation due to phlegm buildup and immune system complications are also common causes of death in people with tuberculosis. Indeed, populations with high rates of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) have the problem of tuberculosis infections running rampant throughout their communities. In sub-Saharan Africa, where HIV/AIDS is incredibly common, approximately 5-10% of people with HIV/AIDS will develop tuberculosis in their lifetime. In most cases, a successful tuberculosis infection in a person with HIV/AIDS will mean the death of the individual (Corbett). If the tuberculosis mycobacterium manages to enter the bloodstream through tissue that has been damaged, it spreads and produces many areas of infection throughout the body, each of which appears as small, pale tubercles in the tissues it has infected (Crowley 374). This form of tuberculosis is incredibly dangerous, but is more common in people with underdeveloped or weakened immune systems, such as children or HIV/AIDS patients (Corbett). Even with treatment, this form of the disease has a high mortality rate, approximately 30% (Crowley 374). As in most cases, “miliary tuberculosis,” as it is called, is often fatal, but can be fatal in a shorter period of time than in common “interpretations” of the disease. This remains inconvenient for those who have tuberculosis in the first place, because it is hardly an ideal situation. However, those who have had tuberculosis in the past appear to have a tougher situation than those who have it today. There are certainly ways to successfully treat tuberculosis – which we'll talk about later – but the reality is that Mycobacterium tuberculosis has been a pretty big thorn in the collective side of humanity for some time now. Spinal column fragments collected from Egyptian mummies, dead since 2400 BC, show “definite signs” of tuberculosis infection (“A Story…). The term, a favorite of the present author, "phthisis," defined as "consumption," was first used in Greek literature. Around 460 BC Hippocrates declared consumption a sort of pandemic, “the most widespread disease of the times” (“A history…). He even went so far as to write something slightly controversial, a warning to his fellow doctoral students who advised against seeing tuberculosis patients in the advanced stages of the disease for fear that their subsequent death might damage the reputation of the treating doctors. But all was not lost when it came to tuberculosis – that is, as long as one believes that two thousand years of inept stumbling in medical obscurity on the subject of tuberculosis should be considered progress. It was in fact Sylvius, in his Opera Medica of 1679, who first began to specify the pathological and anatomical details of the disease.
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