All about Tuberculosis PULMONARY TUBERCULOSIS Diagnosis Signs and Symptoms with Treatment

All about Tuberculosis , pulmonary or extra-pulmonary.

  • Details about PULMONARY TUBERCULOSIS Diagnosis Signs and Symptoms with Treatment.
pulmo  tuberculer
Detail about PULMONARY TUBERCULOSIS Diagnosis Signs and Symptoms with Treatment

 

PULMONARY TUBERCULOSIS Primary disease:

 

PULMONARY TUBERCULOSIS Primary disease


Primary pulmonary tuberculosis –

  • Is due to first infection with the tubercular  bacilli. It is seen in chil­dren. It involves middle and lower lung zones
  • Lesion is peripheral with hilar or paratracheal lymphadenopathy .
  • Lesions heal and remain as a calcified nodule called Ghon lesion.
Primary pulmonary tuberculosis

 

Progressive primary tuberculosis –

  • In children and persons with low immunity, malnutrition, HIV infec­tion, primary pulmonary tuberculosis progresses to pleural effusion, necrosis of central part, cavity for­mation, hilar and mediastinal lymphadenopathy, com­pression of bronchi, segmental or lobar collapse of lung called Progressive Primary Tuberculosis.
  • Spread by blood, called haematogenous dissemina­tion, results in severe primary tuberculosis infection.
  • Bacilli enter the blood stream from lungs and lymph nodes and spread to various organs where they pro­duce granulomatous lesions.
  • Healing may occur, or miliary tuberculosis and men­ingitis may occur.
Post Primary PULMONARY TUBERCULOSIS Disease


Post Primary Disease:

  • It occurs in adults due to reactivation.
  • This is called secondary tuberculosis or post primary disease due to endogenous reactivation of infection. It found in apical and posterior segments of upper lobe of lungs.
  • This is due to the high oxygen content in these re­gions favoring growth of bacteria.
  • There is infiltration, and cavity formation containing necrotic contents, which can spread to other parts of the lungs. Tubercular pneumonia may occur.
  • The disease may be fatal in a few weeks or become chronic in several months.
Tuberculosis PULMONARY TUBERCULOSIS detail

The lung lesions may be —

  • Pneumonia
  • Cavity
  • Fibrosis
  • Calcification Pleural effusion

PULMONARY TUBERCULOSIS Symptoms are

  • Fever,
  • night sweats,
  • weight loss,
  • anorexia,
  • malaise,
  • weakness,
  • cough,
  • purulent spu­tum or blood stained sputum,
  • massive hemoptysis,
  • pleuritic chest pain and dyspnoea.
PULMONARY TUBERCULOSIS Diagnosis Signs and Symptoms


PULMONARY TUBERCULOSIS Physical findings:

  • There may be no findings.
  • Crepts or rales may be present especially after cough­ing.
  • Ronchi may be present due to bronchial obstruction. Amphoric breathing is heard over a cavity communi­cating with bronchus.
  • Fever – low grade, wasting, anaemia, pallor, finger clubbing, leucocytosis;and hyponatraemia are seen.
  • Syndrome of inappropriate ADH (SIADH) may occur. Acute respiratory distress syndrome (ARDS) may oc­cur rarely.
  • Rasmussen’s aneurysm (dilated vessel in a cavity) is rare.
PULMONARY TUBERCULOSIS Diagnosis Signs and Symptoms


PULMONARY TUBERCULOSIS TREATMENT Case definitions

  • 1. Tuberculosis suspect : Any person with symp­toms or signs suggestive of tuberculosis like cough more than 2 weeks.
  • 2. Case of tuberculosis: A patient in whom tuber­culosis is confirmed bacteriologically
  • 3. Definite case of tuberculosis : A patient with positive culture for M. tuberculosis complex or patient with 2 sputum smears showing AFB

History of Tuberculosis treatment – Definitions for diagnosis

  • 1. New -A patient who has never taken antituber­cular treatment or taken for less than a month.
  • 2. Relapse -A patient treated for TB and declared cured, or full treatment taken but smear or cul­ture for tuberculosis is positive.
  • 3. Treatment after failure – A patient given An again, after failed previous treatment
  • 4. Treatment after default – If a patient, bacterio­logically positive, interrupts treatment for 2 moths or more and starts An again.
  • 5. Transfer in – A patient transferred from another TB centre for continuation of treatment.
  • 6. Other – Any other case like chronic case, spu­tum positive at the end of repeat treatment.
  • Sometimes pulmonary and extra pulmonary relapse cases may be smear-negative.

 

DRUGS – ATT (ANTITUBERCULAR TREATMENT)

There are 3 main properties of antituberculous drugs:

  1. Bactericidal action
  2. Sterilizing activity
  3. To prevent resistance.

The Tuberculosis first line agents consist of

Tuberculosis Second line drugs have lower efficacy and more toxicity.

  • streptomycin,
  • kanamycin,
  • amikacin,
  • capreomycin,
  • ethionamide,
  • cycloserine, and PAS(Paraamino salicylic acid).
  • Complete TUBERCULAR TREATMENT
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