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Clinical Manifestations of Tuberculosis Tuberculosis
Easy fatigability
Anorexia or loss of appetite
Weight loss and body wasting
Persistent, long term low- grade fever
Chills and night sweats
Persistent, progressive cough which may be non-productive at first but may produce purulent sputum in the long term (2 weeks or more)
Non-resolving bronchopneumonia bronchopneumonia
Dull or pleuritic chest pains
Dyspnea
Hemoptysis
Anemia in some Schematic Diagram for Tuberculosis Tuberculosis Precipitating Factors:
Predisposing Factors:
Immunocompromised person
Age: Children below 14 y. o.
& Adults more than 65 y. o.
Malnourished individuals
Native Americans, Eskimos,
Economically- disadvantaged
Asians and Blacks
or homeless/ poor housing Living in overcrowded areas Alcohol abuse/ dependent Poor hygiene Lack of access to health care
Inhalation of droplet infected with Mycobacterium Tuberculosis
It is trapped first in the upper airways, where the primary defenses is activated referring to the mucussecreting goblet cell and the cilia.
When the initial prevention of infection is not successful, the bacteria reaches and deposits itself in the lung periphery usually in the lower part of the upper lobe or the upper part of the lower lobe; specifically in the alveoli.
The bacteria is quickly surrounded by polymorphonuclear leukocytes and engulfed by the
Progression of
alveolar macrophages
infection may lead to latent stage to active stage
Some mycobacterial organisms are carried off by the lymphatics to the hilar lymp nodes
depending on both the virulence of the bacteria and the
It is now called as the Ghon Complex , but it rarely results in the spread to other body organs.
microbicidal ability of the alveolar macrophages
As macrophages (epithelial cells) engulf the bacteria, these cells join and form into giant cells that encircle the foreign cell. ce ll.
As a result of hypersensitivity to the or ganism, inside the giant cells caseous necrosis occurs (granular chessy appearance)
There is then the proliferation of T - lymphocytes in the surrounding of the central core of the caseous necrosis causing some lesions.
Fibrosis and calcification happens as the lesion ages resulting to granuloma formation called as tubercle.
Collagenous scar tissue encapsulates the tubercle to separate the organisms from the body.
As the process progress the bacteria may or may not be killed and it continue to grow and multiply resulting to a cell mediated immunity (which can be detected through PPD)
Pulmonary Tuberculosis
For poorly immunocompromised clients, the necrotic tissue liquefies and the fibrous walls losses its structural integrity
The semiliquid necrotic material is drained into the bronchous or in the nearby blood vessel, leaving an airfilled cavity at the original site.