Primary and Secondary Lung Tuberculosis

TUBERCULOSIS Communicable, chronic granulomatous disease caused by myanhactrium tukuranlois tooptagele inkestial tulierculosis M Bouis +Acid fast stany + isk - Immuncomprisel Priantı, HIU/AIDS, Poverty, Mariutrition, Malnutrition populatio Healthcare workes MODE OF TRANSMISSION Inhalator source:- open active case of TB to a susp host Tuborile Bacilli expelled inhale droplets lodyy Ling Infection Vingertion non-pasterized millk post Mortex examination, Rave TUBERCULIN (MANTOUX TEST) Int by micobarria der of delay hypersensiting delected) tubeculon skin test About 2-4 weeks aftk infection, Introcutaneous injection of OIML of purified protein derivative (PPP) of M. tukrubsis produces visible and podpalle Indarestia of loom diamet or moe Time: 48-72 hrs - Significance Porth test: well mediatel mmug to in Tularul entijans False →→ viral infections, sarcandosis, matondition False (+)→ BCG vaccination, A typical mycobactriz k PRIMARY T Initial infection that occurs on in on unsensitized individuel. first exposure to the organisms. source:-Exogenous MORPHOLOGY (Putts) sites:-LangIntestine, Kidney, tonsil, & skin cue Rune) Ghon Lesion ✓ Sites of deposit lower part of the upper loke uppert of lowe Loke ner the plural surface. Ghon Focus Afk 2-4 weeks afpt the infection, a circumscribed gre white ares of about 1-105 cm develop in the lung Known as Ghon Focus conte of which undergo careous necrosis ✓ Regional Lymphadenitis Tubercle (Free or within macrophages) are Corried along the lymphatics to the regiond draing nodes often shows necrosis Ghon complex Ghion Focus + Regional lymph node + Aling with draj Lymphatiess. • Healing:- Majoro (951) Cell-mediated immunis contrats the infection and i tuberculosis heals. The hallmark of healing is FIBROSIS, Ahm complex undago progressive Fibuxis followel & Rediographicy detectable CRANKE COMPLEX) CALCIFICATION • SPREAD First few weeks, Lymphatics and hematogenous spread / dissemination occurs to thers organs. ports of body. MICROSCOPY Granuloma in Te is called TUBERCLE. Tubercle may show central willen multiple grondorna coalesce grossif identified area of Caseous necrosis 10 may not show caseatin [caseating granuloma/sofl-tubercle] CASEATING GRANULOMA comast of - I central area of caseous necrosis. currb epitheliod cells (MM) some of them fase to fore multinuclento CAIANT CELLS Giant cell may be Langhans type (H-S-T) (nuclei in the center) of foreign bod type epitheliod cells ar surrounded by rim of Lymphocytes Granubmas enclosed within fibroblasts SECONDARY TUBERCULOSIS Source of infection: Reactivation of latest infection MORPHOLOGY mvalues EME Lungs, apex of Lobes, of one of both the lungs, within 1-2 cm of apical pleara ( Initial small foules (<20m)m diamet consolidaten, shopt circumses gf-whit yellou Perieel Lymph node Inv less prominest MICRO carst granulome & Acid fast show Tubercle bacilli FATE Healing - Foves heal with Fibrow's & calcification Erosion inh Bronchi rely of contsal orce of caseous necrosis 11h apical cavity surrf Fibrous frosion of BV, Hemoptysia//..' SPREAD Platal Tubercaloss amphysema oblikah fibrous Pleuritis dived, Loc/spread direct spread vie Mucasal Laryngeal TB Endotrachal TB Endo branchial TB lining Shallong Infecled Intersibal TUBERCULOSK asion-Melkiplasmall Jellow nodelos lesia in Ling Brechyna of both Lungs. (Lymphatic Spreed Thoraciddet Vonous circulatia MILIARY TUBERCULISIS OF LUNG spread vid Bronchi/ spread to attr posts of scom lung TUBERCULOυς PNEUMONIA spread via Blood versels TU BERULOUS CYMPHADENITIS ⇒ preq. presentation of exta pulmay tubetalerts (CERVICAL) Ran, yellow-whits Consolidation millet seeds' HMUCHIC Multifocal astemic disear Bruin SYSTEMIC MILIARY TUBERCULOSIS COMPLICATIONS OF SECONDARY 13 HEMOPTYSIS erosion inte puerimos arteries adj to tuberculous covits BRONCHO PLEURAL FISTULA: Tuberculous cavity in the subpleural region rupturer into pleural space. Lead+ Preumothorax ✓ ASPERGILLOMA: Fungal mass produced due to open cavif with aspergillus CLINICAL FEATURES Syst. 1° TB -Non-specilia-Maliese, Anorexia, Weight loss, Feve Low gra de SPUTUM Romittent fen & night sweats mucoid then purulent Hemoptysis (50.1) 7B Pleuritic pain. #CHARACTERISTICS TYPE OF INFECTION SOURCE SITE INVOLVED REGIONAL LN INVOLVEMENT SPUTUM For AFD CAVITY FORMATION. HEALING EXTRA PULMONARY CLASSIFICATION PRIMAPY TB Initial infection M unsensitizal ind. EXOGENOUS Lowr part of UL Upps pict of LL Prominent roves + Rore CALCIFICATION veg common 2 TB int in prew. seas. ind endogenous Activation Apex-PSUL SS LL (+) COMMON FIBROSIS Localized to Lung.