3.6
Longtuberculose I
Tuberculose, vaak TB genoemd, is een besmettelijke ziekte die voornamelijk wordt veroorzaakt door Mycobacterium tuberculosis. Het tast vooral het long…
Tuberculosis or TB is an infectious disease caused by Mycobacterium tuberculosis primarily affecting the lung parenchyma.
It can also affect other body parts, such as the meninges, kidneys, bones, and lymph nodes.
The disease spreads through airborne droplets released when infected individuals breathe, talk, sing, sneeze, or cough.
These droplets evaporate, leaving tiny nuclei, ranging from 1-5 µm in size, suspended in the air for durations varying from minutes to hours. Inhaling these nuclei spreads the infection to others.
Several factors increase the risk of tuberculosis transmission.
Close contact with someone with active TB heightens the risk of inhaling airborne nuclei, depending on exposure duration, proximity, and ventilation conditions.
Healthcare workers performing high-risk procedures, such as bronchoscopy and suctioning, are particularly vulnerable.
Immunocompromised individuals, such as organ transplant recipients, people undergoing hemodialysis, and people with HIV, substance use disorders, or long-term diabetes, can heighten susceptibility to tuberculosis.
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Q1: What organism causes tuberculosis and how does it spread?
Mycobacterium tuberculosis, a slow-growing acid-fast aerobic rod, causes tuberculosis. It spreads through respiratory droplets released when infected individuals breathe, talk, sing, sneeze, or cough. As droplets evaporate, tiny nuclei measuring 1-5 µm remain suspended in air for minutes to hours, transmitting infection when inhaled by others.
Q2: Why is tuberculosis not highly contagious despite airborne transmission?
TB transmission requires close, frequent, or prolonged exposure. Brief contact with few tubercle bacilli rarely causes infection. Transmission probability depends on microorganism concentration, exposure duration, ventilation conditions, and the individual's immune system. TB cannot spread through touch, food sharing, kissing, or physical contact.
Q3: Which body parts can tuberculosis affect beyond the lungs?
While TB primarily affects lung parenchyma, it can also involve the meninges, kidneys, bones, and lymph nodes. The disease spreads systemically through airborne droplet nuclei inhaled into the respiratory tract, potentially seeding infection in multiple organ systems throughout the body.
Q4: What factors increase tuberculosis transmission risk in healthcare settings?
Healthcare workers performing high-risk procedures face increased TB exposure. These include administering aerosolized medications, bronchoscopy, suctioning, caring for immunocompromised patients, and anesthesia-related procedures like intubation. Risk depends on exposure duration, proximity to infected patients, and ventilation conditions in clinical environments.
Q5: How does immunocompromised status increase tuberculosis susceptibility?
Immunocompromised individuals, including HIV-positive persons, organ transplant recipients, those undergoing hemodialysis, and people with long-term diabetes, have weakened immune systems unable to effectively fight TB infection. Substance use disorders and prolonged corticosteroid therapy similarly impair immune function, significantly increasing TB development risk.
Q6: What social and environmental factors contribute to tuberculosis transmission?
Overcrowded and substandard housing, institutionalization, and poorly ventilated spaces like prisons increase TB concentration and transmission. Immigration from or recent travel to high-prevalence countries, limited healthcare access, malnourishment, chronic kidney disease, and diabetes also elevate TB risk through environmental exposure and compromised health status.
Q7: How does HIV infection specifically increase tuberculosis risk?
Untreated HIV causes substantial reduction in CD4+ T-cells critical for immune response, creating severe immunosuppression. This makes individuals far more vulnerable to opportunistic infections including TB. Intravenous drug use increases HIV transmission risk through needle sharing, compounding TB susceptibility in affected populations.