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Published on: May 22, 2020
1 minute read
By: Dr Rajan Choudhary

Corona Virus In Young Patients And Kids

Kids seem to be relatively unaffected by COVID, but this does not mean they are invulnerable. As with adults, some children have pre-existing cardiac, respiratory, or metabolic conditions, and are therefore more vulnerable to the effects of COVID. Interestingly, children appear to have one more symptom when infected with coronavirus – COVID Toes.

I personally came across this phenomenon recently, with a young patient asymptomatic for COVID who presented with unusual symptoms of dark bruises on his toes. This had been present for just a few days. He did not have any pain, itching, swelling, no recent trauma, or injury to the feet. Circulation to his feet was normal, with no other rashes or skin changes, no other abnormal features in the history to note. It was certainly an odd presentation and certainly could have been an example of COVID toes.

This new phenomenon was noticed in April and has not gained as much notoriety because it is fairly rare compared to the major COVID symptoms, such as fever, cough, and lethargy. Doctors have described lesions on the feet of young people, usually purple-colored, around the tips of the toes. They have been compared to chilblains, painful swellings on feet, and toes that appear in the cold. Similarly to chilblains they do not cause any permanent damage and usually regress in days to weeks.

It's not clear why they occur or the mechanism behind the discoloration, because the presentation is rare and in healthy patients. We know COVID can cause systemic inflammation and can increase the risk of clot formation. It may be that localized inflammation is occurring in the toes, causing the vessels to clamp down and reduce blood flow to the area. This is similar to the mechanism for chilblains forming in the foot. Micro-clotting could also be partially responsible for this phenomenon.

COVID Toes is not the only skin symptoms related to COVID. In a paper published in the British Journal of Dermatology, researchers described five common skin presentations in 375 COVID patients. These were:

Asymmetrical chilblain like lesions in the hands and feet, found in younger patients lasting up to 2 weeks.
Small itchy blisters in the trunk and limbs, found in middle-aged patients before they present with symptoms, lasting about 10 days
Pink or white areas of raised skin, itchy, usually on the body
Raised bumps called macropapules, lasting about a week, seen in more severe infections.
Mottled, blotchy red-blue skin (known as livedo) seen in patients with severe illness.

So if you are currently suffering from COVID or have recently recovered from an infection, and suddenly notice odd colored toes, you too may have a case of COVID toes.

Dr Rajan Choudhary, UK, Chief Product Officer, Second Medic Inc

www.secondmedic.com

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Tuberculosis Symptoms and Treatment: Early Signs, Diagnosis, and Recovery

Tuberculosis (TB) is one of the oldest known infectious diseases and continues to be a major public health concern, especially in developing countries. India accounts for a significant proportion of global TB cases, despite advances in diagnosis and treatment. The good news is that tuberculosis is preventable, treatable and curable when detected early and managed properly.

Understanding tuberculosis symptoms and treatment is critical for reducing disease spread, preventing complications and achieving complete recovery.

What Is Tuberculosis?

Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. It primarily affects the lungs (pulmonary TB) but can also involve other parts of the body such as:

lymph nodes
bones and joints
kidneys
brain

TB spreads through the air when an infected person coughs, sneezes or speaks.

Why Tuberculosis Remains a Major Health Issue

According to the World Health Organization and ICMR data:

millions of new TB cases are reported annually
delayed diagnosis increases transmission
incomplete treatment leads to drug resistance

Early detection and treatment are key to TB control.

Common Tuberculosis Symptoms

TB symptoms often develop gradually and may be mild in the early stages, leading to delayed diagnosis.

Persistent Cough

A cough lasting more than two to three weeks is a hallmark symptom of pulmonary TB.

The cough may:

be dry or productive
worsen over time
sometimes produce blood

Fever and Night Sweats

Low-grade fever, especially in the evenings, is common.

Night sweats that soak clothing or bedding are a classic TB sign.

Unexplained Weight Loss

TB increases metabolic demand and reduces appetite, leading to significant weight loss.

Fatigue and Weakness

Persistent tiredness and reduced stamina occur due to chronic infection.

Chest Pain

Chest discomfort or pain may occur during coughing or breathing.

Symptoms of Extra-Pulmonary TB

When TB affects organs outside the lungs, symptoms depend on the site involved and may include:

swollen lymph nodes
bone or joint pain
headaches or neurological symptoms
urinary issues

Why TB Symptoms Are Often Ignored

Many TB symptoms resemble common infections or general weakness.

This leads to:

delayed medical consultation
prolonged transmission
disease progression

Awareness improves early detection.

How Tuberculosis Is Diagnosed

Diagnosis involves a combination of:

sputum tests
chest X-ray
molecular tests such as CBNAAT
blood tests and imaging for extra-pulmonary TB

Early and accurate diagnosis is essential for effective treatment.

Tuberculosis Treatment Explained

TB treatment involves a combination of antibiotics taken over a fixed duration.

Standard TB Treatment

For drug-sensitive TB, treatment typically lasts:

6 months

The regimen includes multiple antibiotics taken in phases to ensure complete bacterial clearance.

Importance of Treatment Adherence

TB bacteria are slow-growing and resilient.

Stopping treatment early can result in:

incomplete cure
relapse
drug-resistant TB

Completing the full course is essential.

Drug-Resistant TB

If TB bacteria become resistant to standard drugs, treatment becomes longer and more complex.

Drug-resistant TB requires:

specialised medications
longer treatment duration
close medical supervision

Prevention of resistance depends on correct treatment from the start.

Side Effects of TB Treatment

Some individuals may experience side effects such as:

nausea
loss of appetite
mild liver enzyme changes

Most side effects are manageable with medical guidance and do not require stopping treatment.

TB and Public Health

TB is not just an individual health issue but a community concern.

Effective TB control requires:

early diagnosis
treatment adherence
contact tracing
public awareness

India’s national TB elimination programmes focus on these strategies.

Preventing Tuberculosis

Preventive measures include:

early detection and treatment of active TB
improving nutrition and immunity
adequate ventilation in living spaces
screening close contacts

BCG vaccination offers partial protection, especially in children.

Living With and Recovering From TB

With proper treatment:

symptoms gradually improve
infection becomes non-contagious
normal life can be resumed

Regular follow-up ensures complete recovery.

When to Seek Medical Help

Consult a healthcare provider if experiencing:

cough lasting more than two weeks
unexplained weight loss
persistent fever or night sweats
blood in sputum

Early action saves lives and prevents spread.

Long-Term Outlook After TB Treatment

Most individuals who complete treatment:

recover fully
regain normal lung function
return to daily activities

Long-term complications are rare with timely care.

Conclusion

Tuberculosis symptoms and treatment must be understood clearly to combat this preventable and curable disease. Persistent cough, fever, night sweats and weight loss should never be ignored. Early diagnosis, complete treatment adherence and regular follow-up are essential for curing TB and preventing transmission. With proper medical care and public awareness, tuberculosis can be effectively controlled and eliminated as a public health threat.

References

Indian Council of Medical Research (ICMR) – Tuberculosis Epidemiology and Treatment Guidelines
World Health Organization (WHO) – Global Tuberculosis Report
National Tuberculosis Elimination Programme (NTEP) – Government of India
Lancet Infectious Diseases – TB Diagnosis and Treatment Outcomes
National Family Health Survey (NFHS-5) – Infectious Disease Indicators
Statista – Global Tuberculosis Burden and Trends

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