结核病(tuberculosis (TB))

旧称consumption

一些分歧杆菌（结核杆菌）造成的细菌病。古埃及的记录以及希波克拉底都提及结核病，从古至今全世界都不断出现。在18至19世纪快速工业化与城市化的西方世界，到达接近传染病的比例，直到20世纪早期在这些地区都还是主要的死亡原因。1980年代结核病卷土重来，由爱滋病患传播给他人，特别是在监狱、游民收容所与医院等地因密闭的设计助长传播。结核病遍布全球各地，仍是许多国家的主要死因。身体会在结核杆菌的周围形成小型结核来隔离结核杆菌，通常这样可以阻止结核病的病情发展，但要是没有经过治疗，可能不久之後会复发且带传染性。主要类型（大多数是孩童）通常不严重，但是可能在身体各处传播，在许多器官产生结核，这样就有可能致命。次要类型（主要是青年）开始时会丧失活力、体重下降、咳嗽不断。随着咳嗽增加、严重出汗，可能还有肋膜炎（参阅thoracic cavity）和吐血，健康情况恶化。增大的结核块会杀死肺脏组织，使得呼吸作用无法供给身体足够的氧气。其他器官也会受害，如并发脑膜炎。弱化细菌疫苗有助於防治感染，但是及早发现治疗结核病，防止暴露於细菌威胁则更为有效。由於许多种细菌对药物有抗药性，治疗至少需要对病人细菌有效的两种药物，持续至少半年，不当的治疗会让具有抗药性的结核杆菌繁殖。多重抗药性细菌品种造成的急性病非常难治癒，通常会致命。

English version：

tuberculosis (TB)

Bacterial disease caused by some species of mycobacterium (tubercle bacillus). Mentioned in ancient Egyptian records and by Hippocrates, it has occurred throughout history worldwide. In the 18th-19th century it reached near-epidemic proportions in the rapidly industrializing and urbanizing West, where it was the leading cause of death until the early 20th century. TB resurged in the 1980s, spreading from AIDS patients to others, especially in prisons, homeless shelters, and hospitals, since enclosed settings promote spread. It occurs worldwide and is still a major cause of death in many countries. The body isolates the bacilli by forming tiny tubercles (nodules) around them. This often arrests TB's progress, but if not treated, it may become active—and contagious—later. The primary form (mostly in children) is often mild but may spread through the body, producing tubercles in many organs; it can be fatal. The secondary form (mainly in young adults) starts with loss of energy and weight and persistent cough. Health deteriorates, with increasing cough, heavy sweating, and possibly pleurisy (see thoracic cavity) and spitting up blood. Growing tubercle masses may destroy so much lung tissue that respiration cannot supply the body with enough oxygen. Other organs can be affected, with complications including meningitis. A vaccine with weakened bacteria has helped control infection, but preventing exposure by recognizing and treating active TB early is more effective. Because many strains are resistant to drugs, treatment requires at least two drugs to which the patient's strain is sensitive for at least six months; inadequate treatment lets resistant bacilli multiply. The acute disease caused by multidrug-resistant (MDR) strains is very hard to cure and usually fatal.

参考文章

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