My sister had TB around four years ago and she is completely alright but the doctor says, she has calcified regions. Can the disease return and should she be careful?

Tuberculosis is a deadly and infectious disease that is caused by Myobacterium tuberculosis, the species of myobacteria that causes tuberculosis in humans. Tuberculosis is contagious and spreads much like the common cold - through the air. When someone who is infectious sneezes or coughs, they propel TB germs or bacilli into the air. The major symptoms of TB are severe cough with bloody sputum, fever, cold sweats and loss of weight. It is also important to note that people who are infected with the TB bacilli may not necessarily become ill. The TB bacilli could stay dormant in the body for several years on account of being 'walled off' by the immune system. The strength of a person's immunity is thus a primary factor with regard to TB infection. Persons with compromised immune systems, like HIV infected persons, are at a greater risk of becoming ill with TB.

It is possible that a person may once again develop TB long even after successful treatment. This can occur on account of a weak immune system or some other problem. This is usually thought to be a case of 'reactivation', where the bacteria that caused the original infection start to cause an infection again. The other way in which a person can develop TB again is through re-infection. Re-infection is when a person is infected a second time by a new strain of TB, different from the original one. While this was believed to be rare occurrence, recent studies have shown that this is in fact a far more common reason for the recurrence of TB. Re-infection is yet again linked to a weak immune system, as it implies that being infected by one strain of TB does not protect you from being infected again.

You have not specified what the prognosis of the calcified regions is. Calcification does not necessarily indicate a diagnosis of TB. You may need to clarify this with your doctor, as the precise nature of the calcification needs to be understood. In general, to ensure safety from re-infection, you should take steps to strengthen your immunity. TB medications can be very intensive and can make the patient weak over time. However, it is important to complete the prescribed course of treatment for TB in order to be successfully cured and avoid reactivation. In the meanwhile, it is important to eat healthy - increase your consumption of fresh fruits and vegetables, eat foods that are rich in protein and fat. Drink lots of milk as it is rich source of calcium, an effective cure for a weakened immune system. Fruits like apples and oranges are a rich source of vitamins and also help strengthen the immunity.

answered by M W

Calcified regions in a tuberculosis patient do not always lead to active tuberculosis again and usually cannot be cured - the patient can only be made more comfortable. Calcification usually occurs with tuberculosis of the lungs and of the kidneys and is inevitably detected at a very late stage. You have not provided the exact details of where the calcified regions lie within your sister's body and it is important to know more so that you can determine if they need to be treated or not. For example, a condition known as Adhesive Pericarditis may follow a severe attack of tuberculosis because the effusions do not get absorbed completely and the residue begins to be organized and form into adhesions. The degree of adhesion does vary and if the tuberculosis has involved the heart, the calcification can be quite great. If the effusions have contained pus, the pericardium becomes calcified.

Calcification is a vital symptom of renal tuberculosis which is usually not diagnosed quickly. The kidney will, in due course of time, become heavily calcified, badly scarred, and non-functional. There is no way to treat this but you can combat this to at least an extent by ensuring that your sister lives in a warm, dry climate. She should also avoid physical exertion and stress. You must consult with your doctor and ensure that this calcification is not malignant and will not cause any of these complications.

answered by G M