est x-ray, and bacteriologic examination. A medical history includes asking the patient whether they have been exposed to a person with TB, symptoms of TB disease, if they have had TB infection or TB disease before, or risk factors for developing TB disease. The symptoms of pulmonary TB disease include:* coughing* pain in the chest when breathing or coughing* coughing up sputum or blood.The general symptoms of TB disease (pulmonary or extrapulmonary) include:* weight loss* fatigue* malaise* fever* night sweats.During the middle of World War II, the greatest development towards the elimination of tuberculosis was developed. This treatment was known as chemotherapy. Streptomycin was the drug initially used in this treatment and was very effective. However, soon after doctors began administering Streptomycin strands of drug resistant TB began to appear. New drugs rapidly began to be developed which when used in conjunction could prevent the development of drug resistant tuberculosis. Following streptomycin, p-aminosalicylic acid (1949), isoniazid (1952), pyrazinamide (1954), cycloserine (1955), ethambutol (1962) and rifampin (rifampicin; 1963) were introduced as anti-TB agents. Aminoglycosides such as capreomycin, viomycin, kanamycin and amikacin, and the newer quinolones (e.g. ofloxacin and ciprofloxacin) are only used in drug resistance situations. Exposed to a single effective anti-TB medication, the predominant bacilli, sensitive to that drug, are killed; the few drug resistant mutants, likely to be present if the bacterial population is large, will, multiply freely. Since it is very unlikely that a single bacillus will spontaneously mutate to resistance to more than one drug, giving multiple effective drugs simultaneously will inhibit the multiplication of these resistant mutants. This is why it is absolutely essential to treat TB patients with the recommended four drug regimen of isoniazid, rifampin, pyrazinamide and ethambutol ...
