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PULMONARY TUBERCULOSIS
Submitted by- Sabyasachi Jena
Guided by- Dr. Sayantan Chowdhury
DEFINITION
• It is a contagious bacterial(mycobacterium
tuberculosis) infection that involves the lungs.
It may spread to ...
TYPES
1. Primary PTB
2. Cavitary PTB(post primary)
3. Miliary PTB(post primary)
1.PRIMARY PTB
• Primary PTB occurs in an individual who has
never been exposed to the tuberculosis
bacteria before. This t...
Etio-pathogenesis
• From the primary site of infection, bacilli
are carried to the lymph nodes via lymphatics,
and the hil...
• The parenchymal lesion is subpleural and
usually located in lower part of the upper
lobe, upper part of lower lobe or th...
• Bacilli in alveoli also invade and replicate
within alveolar macrophases that interact with
T-lymphocytes, resulting in ...
• In the granuloma, CD4+ T-lymphocytes
secrete cytokines, such as interferon, which
activate macrophages to destroy the ba...
SYMPTOMS
Majority are asymptomatic
A brief ‘flu-like’ febrile illness, which lasts 7-14
days
Reduced apetite, weight lo...
PHYSICAL SIGNS
Majority, no abnormal signs
General debility, thin, pale and fretful child
Glossy hair and less elastic ...
Bluish red, raised tender, cutaneous lesions on
the shins and less on thigh.
Fever and polyarthralgia
DIAGNOSIS
a) History of contact with a case of active
tuberculosis.
b) Tuberculin test
c) Chest radiograph
d) Sputum exami...
2.CAVITARY PTB
• It occurs in final stage of the disease. When
macrophases fail to sorround and digest
bacteria, a cheesy ...
• Samples taken from an infected person may
test –ve because the bacteria are hidden in
the cavities.
MILIARY TB
• Miliary TB is when the PTB becomes chronic
and spreads though either the blood stream
or the lymph system to ...
Pathogenesis
Direct progression of a primary lesion
Re-activation of a dormant primary lesion
o Malnutrition
o Diabetes
...
o Renal failure
o Haemophilia
o Silicosis
Haematogenous spread to the lungs
Common sites are apical and posterior
segmen...
CLINICAL FEATURES
GENERAL SYMPTOMS
 Loss of apetite and weight
 Fever
 Night sweats
 Tiredness
 Mental symptoms
 Am...
 Cough
 Hemoptysis
 Chest pain
 Breathlessness
 Pneumonia
PHYSICAL SIGNS
 Pallor and cachexia
 Fever
 Tachycardia and tachypnoea
 Finger clubbing(may be)
COMPLICATIONS OF PTB
 Hemoptysis
 Pneumothrax
 Pleural effusion
 Empyema
 Pulmonary fibrosis
 Bronchiectasis
 Persi...
 Scar carcinoma
 Spread of tuberculus to other organs
 Respiratory failure and R-heart failure
 Amyloidosis
 Anemia
ANTITUBERCULAR DRUGS
1. Isoniazid-10mg/kg
2. Rifampicin-10mg/kg(max 900mg)
3. Streptomycin-15mg/kg(max 800mg)
4. Pyrazinam...
VACCINE
• BCG(Bacillus Calmette Guerin), prtective
against PTB
DOTS(directly observed treatment
short course)
FIVE ELEMENT OF DOTS
 Political commitment with increased and
sustained f...
 An effective drug supply and management
system.
 Monitoring and evaluation system and impact
measurement.
THANK YOU
JAY JAGANNATH
Pulmonary tuberculosis
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Pulmonary tuberculosis

  1. 1. PULMONARY TUBERCULOSIS Submitted by- Sabyasachi Jena Guided by- Dr. Sayantan Chowdhury
  2. 2. DEFINITION • It is a contagious bacterial(mycobacterium tuberculosis) infection that involves the lungs. It may spread to other organs.
  3. 3. TYPES 1. Primary PTB 2. Cavitary PTB(post primary) 3. Miliary PTB(post primary)
  4. 4. 1.PRIMARY PTB • Primary PTB occurs in an individual who has never been exposed to the tuberculosis bacteria before. This type of tuberculosis is very uncommon and usually occurs in the very young, the very old or those with immune compromised symptoms, such as AIDS.
  5. 5. Etio-pathogenesis • From the primary site of infection, bacilli are carried to the lymph nodes via lymphatics, and the hilar nodes enlarge. This parenchymal lesion(Ghon’s lesion) with its enlarged rigional(hilar) lymph nodes and inter connecting lymphangitis is known as primary complex of Ranke(Ghon’s complex).
  6. 6. • The parenchymal lesion is subpleural and usually located in lower part of the upper lobe, upper part of lower lobe or the middle lobe.
  7. 7. • Bacilli in alveoli also invade and replicate within alveolar macrophases that interact with T-lymphocytes, resulting in differentiation of macrophases into epithelioid histiocytes. Epthelioid histiscytes and lymhocytes aggregate into small clusters resulting in granulomas.
  8. 8. • In the granuloma, CD4+ T-lymphocytes secrete cytokines, such as interferon, which activate macrophages to destroy the bacteria with which they are infected.
  9. 9. SYMPTOMS Majority are asymptomatic A brief ‘flu-like’ febrile illness, which lasts 7-14 days Reduced apetite, weight loss, fretfulness Dry cough(occasionally)
  10. 10. PHYSICAL SIGNS Majority, no abnormal signs General debility, thin, pale and fretful child Glossy hair and less elastic skin May be few crepitations over a large lung component Erythema nodosum
  11. 11. Bluish red, raised tender, cutaneous lesions on the shins and less on thigh. Fever and polyarthralgia
  12. 12. DIAGNOSIS a) History of contact with a case of active tuberculosis. b) Tuberculin test c) Chest radiograph d) Sputum examination
  13. 13. 2.CAVITARY PTB • It occurs in final stage of the disease. When macrophases fail to sorround and digest bacteria, a cheesy form of necrosis occurs in the center , known as caseation. The caseous tissue may later become calcified. But if the lesion progresses, the caseous tissues become liquefied to form purulent material. This material may be discharged into bronchi resulting in cavitation.
  14. 14. • Samples taken from an infected person may test –ve because the bacteria are hidden in the cavities.
  15. 15. MILIARY TB • Miliary TB is when the PTB becomes chronic and spreads though either the blood stream or the lymph system to infect other organs of the body.
  16. 16. Pathogenesis Direct progression of a primary lesion Re-activation of a dormant primary lesion o Malnutrition o Diabetes o Taking steroids(immuno suppresive) o HIV infection o Malignancies
  17. 17. o Renal failure o Haemophilia o Silicosis Haematogenous spread to the lungs Common sites are apical and posterior segment of upper lobe or apical of lower lobe.
  18. 18. CLINICAL FEATURES GENERAL SYMPTOMS  Loss of apetite and weight  Fever  Night sweats  Tiredness  Mental symptoms  Amenorrhoea
  19. 19.  Cough  Hemoptysis  Chest pain  Breathlessness  Pneumonia
  20. 20. PHYSICAL SIGNS  Pallor and cachexia  Fever  Tachycardia and tachypnoea  Finger clubbing(may be)
  21. 21. COMPLICATIONS OF PTB  Hemoptysis  Pneumothrax  Pleural effusion  Empyema  Pulmonary fibrosis  Bronchiectasis  Persistent of cavities even after treatment
  22. 22.  Scar carcinoma  Spread of tuberculus to other organs  Respiratory failure and R-heart failure  Amyloidosis  Anemia
  23. 23. ANTITUBERCULAR DRUGS 1. Isoniazid-10mg/kg 2. Rifampicin-10mg/kg(max 900mg) 3. Streptomycin-15mg/kg(max 800mg) 4. Pyrazinamide-35mg/kg 5. Ethambutol-30mg/kg
  24. 24. VACCINE • BCG(Bacillus Calmette Guerin), prtective against PTB
  25. 25. DOTS(directly observed treatment short course) FIVE ELEMENT OF DOTS  Political commitment with increased and sustained financing.  Case detection through quality assured bacteriology.  Standardised treatment, with supervision and patient support.
  26. 26.  An effective drug supply and management system.  Monitoring and evaluation system and impact measurement.
  27. 27. THANK YOU JAY JAGANNATH
  • AjaySharma1304

    Oct. 11, 2018
  • SasankSurapaneni

    May. 23, 2018
  • Drdinushi

    Apr. 5, 2014

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