{"id":5165,"date":"2011-07-14T20:24:03","date_gmt":"2011-07-14T20:24:03","guid":{"rendered":"http:\/\/crashtext.org\/misc\/5165.htm\/"},"modified":"2013-02-14T19:37:36","modified_gmt":"2013-02-15T00:37:36","slug":"tuberculosis","status":"publish","type":"post","link":"https:\/\/crashingpatient.com\/medical-surgical\/infectious-disease\/tuberculosis.htm\/","title":{"rendered":"Tuberculosis (Consumption)"},"content":{"rendered":"
M. Bovis, M. Africanum, M. Tuberculosis<\/p>\n
Stage I-macrophage ingests<\/p>\n
Stage II-reproduction leads to lysis, repeat, to tubercle, transmitted to lymph nodes, kidneys, long bones, meninges, apical portions of lungs<\/p>\n
Stage III-2-3 weeks.\u00a0 Cd4 kill Tb forming granulomas.\u00a0 Can survive in the granuloma.\u00a0 Walled off by epitheloid cells.<\/p>\n
Stage IV-Reactivation-Erosion of bronchial walls.\u00a0 In the immunocompetent 5% will progress in the first three years then another 5% later in life.<\/p>\n
Cough, sputum, night sweats, weight loss<\/p>\n
<\/p>\n
Complication-pneumo, empyema, endobronchial spread, superinfection of cavities (aspergillus), massive hemoptysis,<\/p>\n
C-XR:\u00a0 primary infiltrate shows increased hilar or mediastinal nodes, Ghon focus is a healed calcified scar.\u00a0 If associated c large hilum then Ranke Complex. Post-primary upper lung infiltrate or consolidation+-cavitation.\u00a0 Irregular angular lesions c strands extending towards hilum.<\/p>\n
Detection of TB with normal chest radiograph (Chest 1999;115:445) Only 1 out of 518 patients was smear + and cxr neg, though 22 were cx + (non-infectious)<\/p>\n
Dx c sputum or bronch<\/p>\n
PPD + 3-8 weeks after infection .1 cc dose<\/p>\n