PATHOPHYSIOLOGY OF PTB

Age: Children below 14 years old & adults Economically-disadvantaged

more than 65 years old.
Poor Hygiene
Nave Americans, Black, Asians and eskimos
Immunocompromised individuals.

Inhalation of droplet infected with Mycobacterium

Tuberculosis.

It is trapped first in the upper airways, where the primary defenses are
activated referring to the mucus secreting goblet cells 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 the polymorphonuclear leukocytes and

engulfed by the macrophages.

Some mycobaterial organisms are carried off by the lymphatics to the hilar
lymph nodes.

It is now called as the Ghon complex but it rarely results in the infection of other
body organs.

As the macrophages (epithelial cells) engulf the bacteria, these cells join and form
into giant cells that encircle the foreign cell.

As a result of hypersensitivity to the organism, inside the giant cells caseous

necrosis causing some lesions.

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 tissues encapsulates the tubercle to separate the organisms from the body.
As the process progress the bacteria may or may no be killed and it continue to grow and
multiply resulting to a cell mediated immunity.

PTB