PULMONARYPULMONARY

INTRODUCTIONINTRODUCTION

Pulmonary Tuberculosis (TB) is an infectious Pulmonary Tuberculosis (TB) is an infectious disease that mainly affect the lungs parenchyma.disease that mainly affect the lungs parenchyma.TB is a contagious bacterial (M. tuberculosis) TB is a contagious bacterial (M. tuberculosis) infection that mainly affects the lungs infection that mainly affects the lungs parenchyma, but may spread to other organs.parenchyma, but may spread to other organs.TB is an ancient disease. Signs of skeletal TB TB is an ancient disease. Signs of skeletal TB (pott disease) were evident in Europe from (pott disease) were evident in Europe from Neolithic times, ancient egypt, and in the pre-Neolithic times, ancient egypt, and in the pre-Columbian New World.Columbian New World.Physicians in ancient Greece called this illness as Physicians in ancient Greece called this illness as “phthisis” reflecting its wasting character.“phthisis” reflecting its wasting character.

TB has remained an enemy of human society TB has remained an enemy of human society for all age.for all age.

TB is not only a problem for the person TB is not only a problem for the person suffering from it or their families but a public suffering from it or their families but a public health problem of the entire world.health problem of the entire world.

DISEASE CLASSIFICATIONDISEASE CLASSIFICATION

INFLAMMATORYDISEASE

•It is a Chronic specific Inflammatory infectiousDisease caused byMycobacterium TuberculosisIn human.•Usually attacks the lungs butIt can also effect any part of The body.

ETIOLOGYETIOLOGY

TB is caused by the bacteria M. TB is caused by the bacteria M. tuberculosis (most common cause).tuberculosis (most common cause).

Other than tuberculosis – includes;Other than tuberculosis – includes;M. avium intracellulareM. avium intracellulare

M. kansasiM. kansasi

M. scrofulaceuruM. scrofulaceuru

M. ulceransM. ulcerans

M. marinum and etc.M. marinum and etc.

It also caused by breathing in It also caused by breathing in air droplets from a cough or air droplets from a cough or sneeze of an infected person sneeze of an infected person this is called Primary TB.this is called Primary TB.

Risk factors of tuberculosis is;Risk factors of tuberculosis is;

Elderly Elderly

InfantsInfants

Low socioeconomic statusLow socioeconomic status

Crowded living conditionsCrowded living conditions

Disease that weakens Disease that weakens immune system like HIVimmune system like HIV

AlcoholismAlcoholism

Recent Tubercular Recent Tubercular infection (within last 2 infection (within last 2 years) and ect.years) and ect.

TB spread from person to person by airborne TB spread from person to person by airborne transmission. Infected person release droplet transmission. Infected person release droplet nuclei (1-5 micro meter in diameter) through,nuclei (1-5 micro meter in diameter) through,

TalkingTalking

Coughing Coughing

SneezingSneezing

LaughingLaughing

SingingSinging

• If not treated properly, TB can be fatal.If not treated properly, TB can be fatal.

PATHOGENESISPATHOGENESISSusceptible

OrMycobacterium

Tuberculosis

LatentInfection

Recovery

Reactivation

Activetuberculosis

Miliarytuberculosis

ExtrapulmonaryTuberculosis

PULMONARYTUBERCULOSIS

MANIFESTATIONS-MANIFESTATIONS-symptomssymptoms

The primary stage of TB usually doesn’t cause The primary stage of TB usually doesn’t cause symptoms. When symptoms of TB occur, they symptoms. When symptoms of TB occur, they may includes;may includes;

FatigueFatigue

FeverFever

Unintentional weight lossUnintentional weight loss

Other symptoms that may occur Other symptoms that may occur with this disease;with this disease;

Breathing difficulty Breathing difficulty

Chest painChest pain

Wheezing.Wheezing.

MANIFESTATIONS- MANIFESTATIONS- signssigns

Cough up of mucus and bloodCough up of mucus and blood Excessive sweating at night.Excessive sweating at night.

SIGNIFICANT LAB TESTSIGNIFICANT LAB TEST

Tuberculin skin test (PPD test);Tuberculin skin test (PPD test); Injecting a small amount of protein Injecting a small amount of protein

from tuberculosis bacteria between from tuberculosis bacteria between the derived layer of the skin (usually the derived layer of the skin (usually forearm).forearm).

Sputum examination and Sputum examination and Cultures;Cultures;

Is examined under a microscope to Is examined under a microscope to look for tuberculosis bacteria and look for tuberculosis bacteria and used to grow the bacteria in a culture.used to grow the bacteria in a culture.

Interferon-gamma Blood testInterferon-gamma Blood test;;A simple blood is mixed with synthetic A simple blood is mixed with synthetic

proteins similar to those produced by proteins similar to those produced by the tuberculosis bacteria.the tuberculosis bacteria.

If people are infected with tuberculosis If people are infected with tuberculosis bacteria, their white blood cells produce bacteria, their white blood cells produce certain substances (interferons) in certain substances (interferons) in response to the synthetic proteins.response to the synthetic proteins.

IMAGING CONSIDERATION IMAGING CONSIDERATION

Chest CT ScanChest CT Scan Chest X-rayChest X-ray

RADIOLOGICAL APPERNCERADIOLOGICAL APPERNCE

• Young male Young male patient with fever patient with fever and cough has and cough has focal opacity in focal opacity in the left lower lobe the left lower lobe that looks like a that looks like a pneumonia. This is pneumonia. This is a case of primary a case of primary tuberculosis in an tuberculosis in an adult.adult.

ReferencesReferences• www.medicinet.comwww.medicinet.com• www.nlm.nih.govwww.nlm.nih.gov• http://www.e-radiography.nethttp://www.e-radiography.net• www.learningradiology.comwww.learningradiology.com