Bone tuberculosis, when the TB bacteria have spread to the bones

Definition

What is bone tuberculosis?

So far, what we often hear is about tuberculosis or pulmonary tuberculosis. But, it turns out that TB does not only attack your lungs, but can also spread and attack the bones, known as bone tuberculosis. If left untreated, TB can spread to all parts of your body through the bloodstream, including the bones.

Bone tuberculosis occurs when your body is infected with the bacteria that causes TB, namely Mycobacterium tuberculosis, then the bacteria spread outside the lungs. Generally, tuberculosis can be transmitted from one person to another through the air.

When you have been exposed to the tuberculosis bacteria, the bacteria can move through your bloodstream from your lungs or lymph nodes to your bones, spine, or joints.

Tuberculosis bacteria generally attack bones with a high blood supply, such as long bones and spine. One type of bone TB that is quite common is tuberculosis of the spine, which is also called Pott's disease or tuberculosis spondylitis.

In this condition, TB bacterial infection occurs in the middle and lower spine (thoracic and lumbar).

How common is bone tuberculosis?

Tuberculosis is one of the most common respiratory infections. This disease is one of the top 10 causes of death in the world. The cases are mostly found in developing countries.

Meanwhile, bone tuberculosis itself is a type of tuberculosis that is quite rare. According to European Spine Journal, this disease is more common in patients aged 55-60 years and over, especially in patients who also have HIV / AIDS.

Bone TB can be treated by controlling the existing risk factors. To find out more information about this disease, you can consult a doctor.

Signs and symptoms

What are the signs and symptoms of bone tuberculosis?

Bone tuberculosis usually affects adults or children over 6 years of age, although children as young as one year old and older people can also be infected.

People with bone TB will complain that one or more of their joints is painful and stiff for several weeks. This is the most common early symptom of this disease. Patients can also feel weak bones.

The pain is mild to moderate. The type of pain experienced by the sufferer also depends on the exact location of the TB attack.

Spinal tuberculosis that attacks the spine usually affects the thorax (back of the chest), causing back pain and a protruding shape of the spine such as a hunchback. This condition is also known as a gibus.

Meanwhile, TB that attacks the joints can cause pain and painful stiffness in the bones around the joints. The infected joint fills with fluid and the muscles around it can peel off.

Other common symptoms that may or may not appear as a result of bone tuberculosis include:

• Fever
• Night sweats
• Loss of appetite and weight
• Fatigue

Bone tuberculosis that attacks the spine usually experiences the general symptoms above. However, people with bone tuberculosis that attack the joints usually do not experience these common symptoms.

When should I see a doctor?

You need to be alert for the following signs and symptoms:

• Nervous system complications
• Paraplegia or paralysis in one or more parts of the body
• The legs or arms shorten, usually in children
• Bone defects

Each sufferer's body shows signs and symptoms that vary. In order to get the most appropriate treatment and according to your health condition, have any symptoms checked by your doctor or the nearest health service center.

Cause

What causes bone tuberculosis?

TB or tuberculosis is caused by bacteria Mycobacterium tuberculosis. These bacteria can spread from person to person through the air. A person who is infected with TB (the lungs are infected with the bacteria that causes TB) can cough, sneeze, and even talk by releasing the bacteria into the air, so that they can infect the surrounding people.

TB transmission is more likely if you live in a densely populated place where there are a lot of TB sufferers or if you are close to someone with TB where the room is not well ventilated.

The bacteria that enter your body can then stay in your lungs. People with weak immune systems can easily become infected and develop symptoms of active TB.

Untreated pulmonary TB can then spread to other parts of the body outside the lungs via the bloodstream. One of them is spreading to the bones, making the bones sore and causing bone TB.

Almost all bones can be affected, but the bones most often attacked are the spine and joints, such as the hips, knees, feet, elbows, wrists, and shoulders.

Although about half of all patients with bone TB have also been infected with pulmonary TB, usually when they experience bone tuberculosis, pulmonary TB disease is no longer active. Thus, most people with bone tuberculosis do not experience TB symptoms such as coughing and do not suspect that they have TB.

Since most people with bone tuberculosis do not experience a cough that can spread active viral particles, bone tuberculosis is generally not contagious.

Risk factors

What are the factors that can increase my risk of getting this disease?

Bone tuberculosis is a disease that can occur in almost anyone, regardless of age and racial group. However, there are several factors that can increase a person's risk of suffering from this condition.

It is important for you to know that having one or more risk factors does not mean that you will definitely suffer from a disease. Risk factors are only conditions that can increase your chances of contracting a disease.

The following are risk factors that can trigger a person to develop bone TB:

• Infants and children with immature immune systems
• Living with someone who has tuberculosis
• Living or visiting countries with a high incidence of tuberculosis, such as countries in Asia and Africa
• Suffering from HIV / AIDS
• Have had an organ transplant procedure
• Suffer from chronic diseases, such as diabetes or kidney disease
• Suffered from cancer and is undergoing chemotherapy
• Suffer from a disease that results in autoimmune disorders, such as rheumatoid arthritis or Crohn's disease

Complications

What are the complications caused by bone tuberculosis?

If bone tuberculosis is not treated promptly, several health problems may arise, including:

1. Neurological complications

About 10-27% of cases of spinal TB are accompanied by symptoms of paraplegia or paralysis, especially in the upper (cervical) and middle (thoracic) spine.

Paralysis is generally caused by the presence of injured tissue in the spine, swelling accompanied by pus, or fluid build-up (edema) in rare cases.

2. Bone defects

Bone defects, particularly spinal curvatures (kyphosis), are also found in patients with bone tuberculosis. According to a study from the University of Delhi, India, kyphosis has the potential to even get worse even when patients have undergone treatment for tuberculosis.

3. The infection spreads to other parts of the body

Just like regular TB, untreated bone TB has the potential to affect other organs in the body, such as:

• Membrane tissue that covers the brain, causing meningitis
• Joint damage
• Liver and kidney damage

Diagnosis and treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How is this disease diagnosed?

Bone tuberculosis is generally quite difficult to diagnose. This is because this disease has characteristics that resemble other health conditions, such as spinal tumors, septic arthritis, multiple myeloma, or a spinal abscess.

However, just like regular TB, bone TB can be detected through a skin test or blood test. A skin test is done by injecting tuberculin fluid into your arm. Then, you will be asked to return within 48-72 hours of the injection.

When a lump or thickened skin appears, you may have been exposed to bacteria M. tuberculosis. However, this test cannot detect whether the bacteria have developed into active or latent TB.

Meanwhile, a blood test is done to find out how your immune system reacts to the TB bacteria. However, as with the skin test, the results of the blood test cannot show whether you have active bone TB, or if the bacteria are still "sleeping" in your body.

In addition to skin tests, the doctor may also recommend other tests, such as imaging tests (CT scan or MRI),

How is bone tuberculosis treated?

Bone tuberculosis does cause pain and potential complications. Fortunately, this disease can be overcome if you use the right combination of TB drugs.

In some cases, sufferers may need to undergo a surgical procedure, such as a laminectomy. Laminectomy is done by removing several parts of the spine.

However, surgery is usually only done if you are at risk of complications. Therefore, surgery is not the main treatment option when a person is diagnosed with bone TB. You will of course be treated with drugs first.

Bone TB treatment usually lasts 6-18 months, depending on your health condition. Bone TB treatment that will be given by the doctor or medical team includes:

• Rifampicin
• Ethambutol
• Isoniazid
• Pyrazinamide

You need to be careful and have to spend the drug according to the doctor's instructions. If there is a dosage error, or if you stop taking your medication before it's finished, there is a chance that you will develop drug resistance.

Irregular TB treatment causes your body to not react to previous medications, making it harder for TB bacteria to be eradicated.

Prevention

How to prevent bone tuberculosis?

By preventing pulmonary TB disease you are also preventing bone TB. Start with yourself, always keep yourself clean and eat foods with balanced nutrition to boost your immune system.

So, your body can easily handle it if any bacterial or viral infection enters your body.

If you have pulmonary tuberculosis, you should treat your disease properly. We recommend that you follow the treatment given by your doctor. That way, your pulmonary TB disease can heal quickly and does not spread to cause bone TB. In addition, make sure you get a special TB vaccination called a vaccine Bacillus Calmette-Guerin (BCG).

Don't forget to also eat lots of foods with balanced nutrition so that your immune system gets stronger against disease.

If you have any questions, consult your doctor for the best solution to your problem.