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Respiratory system
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(f'ULMONARY TUBERCULOSIS)
I. Definifion:-
• Pulmonar!j fuberculosis (TB) is a confagious
bacferial infecfion fhaf mainl!j involves fl,e lun9s,
buf ma!j spread fo ofher organ.
• An infecfious bacferia/ disease characferized b!j
f he 9rowf'1 of nodules (fubercles) in f he fissues, especia/1!1 f he lun9s.
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!2. Causes/Efio/o:J!f-
• Pulmonar!j fuberculosis is caused b!j M,_!jcobacferium fuberculosis
• B!1 air droplefs (Coughing and sneezing)
• B!1 Close confacf wifh infecfed person.
Risk factors- Malnufrifion
Excessive alcohol addicfion
/mmuno-suppressive clienfs
Poor healfh, children under 5 age, Smoking.
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3. Sfages of fuberculosis:-
1. Primar!1 Sfage:- People wifh weak immune Sjsfem show s!jmpfoms /-2 weeks
affer microorganism enfers fhe bod:1 called primar:1 infecfion.

2. Lafenf Sfage:- Bacferia ma!1 also he absorbed h!1 macrophages or WBCs and
such bacferia can persisf inside fhe macrophages and remain dormanf for :1ears.
( no s:1mp foms & nof communicable).

3. Acfive Sfage:- Whenever immune Sjsfem weaken hacferia will mulfip/!j and
make !JOU sick ( Show s!jmp foms & communicable)
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Due fo ari!J cause ( Example- Droplef nuclei )

Bacferia frarismif fo alveoli, deposif arid mulfipl!J

Bod!J 's immune response sfimulafes

Macropha9es come arid desfro!J mari!J bacferia arid normal fissue

Dead bacilli arid live masses surround b!J macropha9es (Gohn 's fubercle)

Necrofic de9enerafiori occur (Producfiori of cavif!J filled wifh cheese

like mass of fubercie bacilli, dead WBCs arid riecrofic fissue)

Pulmoriar!J Tuberculosis
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• Long ferm Cough (>3 weeks). •NigM sweafs TUBERCULOSIS

signs and symptoms

• Blood in H,e Cough. •Loss of appefife

~ ~
.· ...
• Fever •Weighf loss l,
• Chesf pain •Weakness BLOOD COUGH FEVER CHEST PAIN CHILLS

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• Breafhing difficulf!j.
• Chills
•Fafigue
e
LONG-TERM COUGH
ii
WEIGHT LOSS FATIGUE NIGHT SWEATS
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6. Diagnosfic Evaluafion:-
• Ph:1sical examinafion IMauntoux test (TT)I
No induration

• Hisfor:J collecfion ) ~~
After 48-72 hour Nagative

• C'1esf X-rauJ (presence of nodular pafches) Inject PPD tuberculin

Transdermally
-
Positive
• Spufum fesf (presence of acid fasf bacilli)
• Manfoux fesf (fubereulin irjecfed infraderma/1:1)
• Blood fesf ffesf WBC increase durin3 infecfion , ESR elevafed ESR ma:1 be
expecfed in children wifh fuberculosis) .
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7. Medical mana9-emenf:- Trick- RIPES KEPT OCCRA

• Firsf line dru:3s:- •Second line dru:3s:-. • Newer A9enfs-

-Rifampicin. -Kanam!Jcin. -Ofloxacin
-/soniazid. -Efhionamide. -Ciprofloxacin
-P!Jrazinamide. -Para-amino salic!J/ic acid -C/arifhrom!Jcin
-Efhambuf of. -Thiacefazone. -Rifabufin
-S frepfom!Jcin. -Azifhrom!Jcin
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DOTS ( Oirecff!1 observed freafmenf, shorf-course ):-

• DOTS is a sfrnfeg!j used fo reduce fhe number of fubercu/osis (TB) cases.
• In DOTS, hea!fhcare workers observe pafienfs as fhe!j fake fheir medicine.
lsoniazid
Rifampicin
Dail!} for 2 Monfhs.
P!jrazinamide
S frepfom!jcin

lsoniazid
} Oai/:J for 4 Monfhs
Rifampicin
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