What kind of pediatrician is a TB doctor, what does he do?

Who is a phthisiatrician?

Phthisiology or phthisiology (translated from Greek, means “treatment of consumption”) is a science that deals with the treatment of tuberculosis.

A phthisiatrician is a specialized doctor who studies the origin and development of a disease such as tuberculosis in the human body, and also treats patients infected with the causative agent of tuberculosis - Koch's bacillus .

A phthisis specialist is a doctor who treats tuberculosis.
In addition to tuberculosis, a specialist in this profile treats diseases such as leprosy and sarcoidosis .

The responsibilities of a phthisiatrist include:

• BCG vaccination;
• chemoprophylaxis of tuberculosis;
• referral of patients to sanatorium and resort treatment, and assistance in their employment;
• determination of disability group.

What kind of doctor is a phthisiatrician?

Lately we have been hearing this word more and more often.
And the growing number of tuberculosis diseases is to blame. After all, a phthisiatrician is a specialist who diagnoses and treats tuberculosis and several other diseases. It is generally accepted that tuberculosis affects only the lungs - but this is an erroneous statement, because in the lungs there is a focus of inflammation that can cause complications in any other organs. Phthisiology is a field of medicine that deals with a narrow range of issues that relate to the patterns of development and course of pathology caused by Koch's bacillus or mycobacterium. This disease is called tuberculosis.

https://www.youtube.com/watch?v=https:accounts.google.comServiceLogin

A phthisiatrician is a doctor who works with people suffering from a persistent cough, which can eventually develop into hemoptysis. The doctor is engaged in the diagnosis, treatment, prevention and restoration of the health of people exposed to the relevant pathogen.

In addition to tuberculosis, which is traditionally accompanied by cough, slight temperature fluctuations and other specific symptoms, a phthisiatrician works with patients with leprosy (leprosy) and sarcoidosis. However, the number of patients in this group is tens of times less than the pathology caused by Koch's bacillus.

It is generally accepted that a phthisiatrician is a doctor who treats adult patients. However, tuberculosis does not select victims based on age. Mycobacteria can attack any unprotected organism. In the case of children, the pathology is often milder, which is associated with the onset of the development of the problem. However, the progression of tuberculosis at an early age threatens with unpleasant consequences.

A pulmonologist and a phthisiatrician are specialties that overlap. In both cases, doctors work with people suffering from cough, fluctuations in body temperature, and general weakness.

The fundamental difference remains the causes of these symptoms. Phthisiatrician is a narrower concept aimed at working with a specific group of patients who require long-term (up to 6-12 months) and aggressive treatment. The cause of tuberculosis is mycobacterium.

Parents should visit a TB doctor if their child has:

• increase in body temperature to subfebrile for no apparent reason and for a long time;
• general weakness and increased fatigue, although the load on the child’s body was not increased;
• loss of appetite, up to complete refusal of food, and weight loss;
• increased sweating.

It is imperative to make an appointment with a phthisiatrician by phone if you have a cough with sputum that contains blood fibers - this is one of the obvious signs of tuberculosis, although it may also mean the development of other diseases.

It is imperative that the child be taken to a specialist in the event of communication with a patient with tuberculosis. In addition, there are several more points that relate to mandatory reasons for visiting a TB doctor:

• the Mantoux test at school showed the first positive reaction (before this there had been no such reaction for several years);
• compared to the previous result, the papule has increased by 6 mm or more;
• within 3-5 years (the Mantoux test is done annually), the compaction either remains or increases by 10 mm or more;
• after 3-4 years of BCG vaccination (it is done in the maternity hospital in the first days after the birth of the baby), the size of the seal exceeds 12 mm;
• a hyperergic reaction is noted.

A referral to a phthisiatrician is given either by a local pediatrician (if the child is being raised/educated at home) or by a nurse from a kindergarten/school.

More information about in what cases a consultation with a TB specialist and the schedule of a TB specialist at a children's clinic in the desired area is necessary can be found on our Dobrobut website. com.

In order to protect yourself and your children from tuberculosis, TB specialists recommend following a number of preventive measures. These include:

• Activities that increase immunity (nutritious and varied diet, active lifestyle, work and rest schedule, cessation of drinking alcohol and smoking);
• Activities aimed at improving living and working conditions (ventilation of premises, support of sanitary and hygienic standards, etc.);
• Prophylactic administration of chemotherapy drugs to prevent the onset of the disease (prescribed to persons who are in constant contact with bacteria-shedding patients, as well as in the presence of unfavorable living conditions, chronic diseases, etc.);
• Anti-tuberculosis vaccination.

Phthisiatricians claim that it is impossible to become infected with tuberculosis by shaking hands with a patient - the bacteria are transmitted only by airborne droplets, however, rooms with stale, immobilized air, the use of shared household items and tactile contact significantly increase the risk of infection.

What diseases does a phthisiatrician treat?

It is known that tuberculosis exists not only in the pulmonary form. The responsibilities of a doctor in this profile include the treatment of pulmonary and extrapulmonary tuberculosis. Mainly:

• Tuberculosis, which affects the musculoskeletal system . In this case, the patient’s bones and joints are destroyed and he stops walking;
• Meningitis . This is not just inflammation of the cerebral cortex, it occurs due to Koch's bacillus, which moves by lymph to the cerebral cortex. In the absence of proper treatment, a person may die.
• Ocular tuberculosis - affects the eyeballs and deprives the patient of vision;
• Intestinal form of tuberculosis. A person with a pulmonary form can swallow infected sputum, or a healthy person can eat contaminated food, and Koch's bacillus settles in the intestines. Diarrhea, fever, and ulcerative process in the intestines occur.
• Skin tuberculosis - Koch's bacillus affects the skin.
• Damage by the pathogen to the genitourinary system and kidneys ;
• Addison's disease is an autoimmune disease characterized by insufficient functioning of the adrenal glands. The main symptom is darkening of the skin and nails .
• Women are often diagnosed with genital tuberculosis . A phthisiogynecologist also deals with this.

What treatment methods are used in phthisiology?

Tuberculosis can only be treated in a special hospital. The treatment regimen is selected individually. Very often it includes chemotherapy with drugs such as Ethambutol, Streptomycin, Isoniazid, Rifampicin, Piraniazid. These medications can also be prescribed separately. At the same time, concomitant diseases are treated. Some patients are prescribed hormonal (Prednisolone), detoxification (laser blood irradiation, plasmapheresis), and immunomodulatory treatment.

After the course of basic treatment is completed, maintenance therapy is carried out throughout the year. During this period, the patient must take at least three medications that effectively suppress Mycobacterium tuberculosis.

The treatment provided by a phthisiatrician also includes physiotherapy, physical therapy, tuberculin therapy, and vaccine therapy. He helps to organize proper nutrition for the patient.

Modern practice involves (in certain cases) artificial pneumothorax (gas is injected into the lungs). If conservative methods do not give positive dynamics, then surgical treatment is resorted to.

Phthisiatrician

– a trained specialist in the prevention, detection, treatment and management of patients with the disease –
tuberculosis
.
The work of such doctors is based on phthisiopulmonology, an in-depth study of the behavior of the pathogen, its symptoms and natural treatment.
A phthisiatrician provides treatment to patients in special sanatoriums, dispensaries, and departments of multidisciplinary hospitals. Moreover, if necessary, therapy for sarcoidosis and leprosy is provided. A tuberculosis doctor works with all systems of the patient’s body, especially those affected by mycobacteria. A phthisiatrician is one of the most necessary physicians, which is reflected in the incidence of the disease, which ranks second in the World; for this, this doctor is highly revered by doctors of other specialties. To make a diagnosis, you need to know about what a phthisiatrician treats – tuberculosis (TB). Tuberculosis

- an incredibly dangerous airborne disease caused by infection when exposed to Koch bacilli.
Koch bacteria
is a terrible pathogen that penetrates from the lungs to other human organs.
The disease is very universal and affects not only the lungs, but almost all systems: the urinary, digestive, bone, genitourinary systems of women - the ovaries, fallopian tubes, of men - the prostate gland, liver cells, the membrane lining the abdominal cavity.
Phthisiologists refer to these types of disease as extrapulmonary TB. Therefore, a tuberculosis specialist works with all systems of the patient’s body, especially those affected by the Koch bacterium. The most common infection occurs when air filled with a virulent dose of microorganisms (sufficient for disease) enters from the patient’s sputum, with which one can infect oneself. The basis of TB therapy is:

1. pulmonary tuberculosis;
2. tuberculosis, kidney and urinary tract;
3. genital tuberculosis;
4. eye tuberculosis;
5. lupus;
6. intestinal tuberculosis;
7. tuberculous meningitis;
8. tuberculosis of the musculoskeletal system;
9. tuberculosis of the lymphatic system;
10. sarcoidosis;
11. leprosy;
12. tuberculosis of the nervous system.

Appointment with a phthisiatrician

The doctor sees only in a medical institution. Before you get an appointment, you need to do a general blood test and fluorography. During the appointment, the doctor questions the patient for complaints, checks tests, and identifies symptoms of the disease.

If there is a suspicion of infection, additional tests are prescribed . After the doctor receives the results, he makes a conclusion about the presence or absence of a diagnosis.

If the disease is confirmed, the doctor determines its form and prescribes treatment.

In the open form of tuberculosis, the patient must be isolated from his immediate environment , since the risk of infection is very high. The doctor independently determines the treatment regimen. If tuberculosis is detected, there are two treatment options: inpatient treatment or additional tests.

How do you feel about people with tuberculosis?

What does he do at the reception?

The phthisiatrician usually does the following at the appointment:

1. Checks medical documentation and laboratory data.
2. Examines the patient, collects anamnesis and patient complaints.
3. Auscultates and percusses the lungs, finding foci of pathology.
4. Prescribes and interprets specific tests: Mantoux test, Diaskin test, blood and sputum, cerebrospinal fluid and urine cultures for mycobacteria, CT and X-ray of the lungs, etc.
5. Selects a treatment regimen for tuberculosis and its complications.
6. Provides recommendations for patient rehabilitation.

If you are referred to this specialist, this does not necessarily mean that you have tuberculosis. The doctor will examine you, check all the data and make his conclusion. If, nevertheless, the disease is identified, the specialist will select adequate treatment.

What tests does the TB doctor prescribe?

The main methods for determining tuberculosis are fluorography or tomography. If there is a suspicion that a tuberculosis infection is developing in the lungs, additional tests are prescribed, after which an individual treatment method is selected.

Fluorography is the main method for determining tuberculosis.
List of tests that a doctor may ask you to do:

• Mantoux test. This procedure determines whether there is a tuberculosis bacillus in the body. The patient is injected with tuberculin under the skin, and the reaction is checked after 48-72 hours. If the area of ​​hyperemia is more than 15 mm, there is a suspicion that the tuberculosis bacillus has settled in the body. However, this does not mean that the person is necessarily sick.
• Microbiological culture of pus, sputum, urine, ulcer cover, rinsing water . Depends on in which organ the infection is suspected;
• If a pulmonary form is suspected, a sputum analysis ;
• Taking blood for a liver test;
• Urinalysis - if there is a suspicion of a renal form of the disease.

When should you make an appointment with a TB specialist?

The main symptoms of tuberculosis include weakness, poor health, cough with a small amount of yellowish or greenish sputum, increased sweating at night, shortness of breath resulting from the presence of fluid or air in the pleural cavity. As the disease progresses, the amount of sputum increases and may contain traces of blood. If you find characteristic symptoms in yourself or your loved ones, you should go for a consultation with a phthisiatrician.

If tuberculosis is suspected, the TB doctor prescribes the following tests:

• Mantoux test (or tuberculin skin test), indicating the presence of infection;
• Examination of sputum for the presence of microbes;
• Microbiological cultures of sputum, pus, urine, cerebrospinal and pleural fluids and other biological material;
• Sowing on Lowenstein-Jensen medium;
• Liver test;
• Eye examination;
• Hearing acuity test;
• Urine culture to detect renal tuberculosis.

During the consultation, the phthisiatrician suggests conducting an X-ray examination (fluorography), which allows for differential diagnosis between tuberculosis and other lung diseases - silicosis, abscess, pneumonia, to determine the nature of tissue damage (focal, infiltrative, cavernous, disseminated), the localization and extent of the process. In addition to fluorography, a phthisiatrician can prescribe such types of diagnostics as:

• Biopsy;
• Microbiological diagnostics;
• Tuberculin diagnostics;
• Diagnosis of extrapulmonary tuberculosis;
• Cerebrospinal fluid examination;
• MRI;
• CT scan.

In large medical institutions, a phthisiatrician may specialize in the treatment and diagnosis of certain organs. For example, pulmonary tuberculosis is dealt with by phthisiopulmonologists, kidney tuberculosis by phthisiourologists, and larynx tuberculosis by phthisio-otolaryngologists. Children with tuberculosis are treated by a pediatric phthisiatrician - a phthisiopediatrist.

How long does it take to study to become a phthisiatrician?

To study as a phthisiatrician, you must graduate from a medical school .

Today, in Russia, a profession can be mastered in the following educational institutions:

• St. Petersburg State Pediatric Medical University;
• First Moscow State Medical University named after Sechenov;
• Altai State Medical University; Voronezh State Medical Academy named after Burdenko;
• Russian State Medical Academy of Postgraduate Education

Duration of study: 5 years at the university and 2 years of residency.

Children's phthisiatrician - what he treats, when you need to contact him

All children undergo a Mantoux test every year. This is a test that determines the child’s body’s response to receiving a small dose of the tuberculosis pathogen. It is absolutely harmless (in the absence of contraindications) and helps to adequately assess the child’s predisposition to this disease.

It is also worth remembering that the Mantoux reaction can be a false positive if certain rules are not followed (for example, if moisture gets into the injection site) or if there is a disease (ARVI). But the specialist who performs the Mantoux test must make sure in advance that there are no diseases that may affect the test results.

In any case, only a doctor can confirm or refute the diagnosis.

A pediatric phthisiatrist deals with the problems of identifying, treating and preventing tuberculosis in children. During the consultation, the phthisiatrist finds out what the child has been ill with throughout his life, evaluates his living conditions, the results of Mantoux, fluorography, and examines the peripheral lymph nodes. Most often, primary infection is detected in children, which means that Mycobacterium tuberculosis enters the body, but not direct infection with the disease.

When, nevertheless, is it worth seeking advice from a phthisiatrician?

Considering how qualified only he, a TB doctor, can identify the symptoms of various forms of tuberculosis, you should not ignore his help and it is better to get a consultation from him. To promptly and correctly carry out the necessary tests for tuberculosis. The following symptoms may be a cause for concern:

1. pain in the chest area from the back, lungs;
2. persistent cough (at least three weeks);
3. discharge when coughing (such as mucus or phlegm);
4. a sharp decrease in appetite for a long time;
5. significant weight loss for no apparent reason;
6. expectoration with blood;
7. profuse sweating, especially during sleep;
8. general weakness and fatigue, regardless of the degree of exertion;
9. feeling unwell for no reason for a long time;
10. severe exhaustion of the body;
11. elevated temperature from time to time.