In the name of Allah, Most Gracious, Most Merciful.
Tuberculosis can occur
at any part of the body
but usually it affects
lungs.
Neolithic Time
>2400 B.C-Egyptian Mummies Spinal Column
460 B.C
>Hippocrates, Greece
First Clinical Description: Phthisis/ Consumption
24th March 1882 Robert Koch
>Isolated and cultured Mycobacterium tuberculosis
>Demonstrated its infectious nature
U.S.A
Pakistan
China
Bangladesh
India
oApproximately
2.0 billion people (30% of worlds population) are infected with
M.tuberculosis.
oT.B is the 2nd most common cause of death from an infectious disease in the
world, 2nd only to AIDS
oIn Pakistan, Estimated new T.B cases are 181 per 100,1000 of population.
oIndia has estimated 1.85 million, Bangladesh 0.32 million, Nigeria 0.37 million and
China 1.32 million new cases reported in 2005.
oAfrica has higher number of T.B cases in the world due to prevalence of HIV.
oRate of T.B declined in USA from 53.0 per 100,1000 population in 1953 to 9.1 per
population in 1988.
Mycobacterium tuberculosis:
Non-spore forming, non-motile,
pleiomorphic, weakly Gram-positive,
curved rods about 2-4um long.
Resist decolourization by acid alcohol
after staining with basic fuschin.
Grows well at high O2 tension and at
37 to 41 0 C
Apices of lung, the renal parenchyma,
growing at ends of bones
Differ from other organism i.e. it
replicates slowly once every 24 hours
instead of 20-40 min as do some other
organism.
Tuberculosis in Cattles
Causes
Tuberculosis is also caused by other Mycobacteria
species:
Mycobacterium bovis
T.B majorly in Africa
Causes
Mycobacterium africanum
Cord Factor
LAM factor
T.B in AIDS and Immunocomprised
Individuals
Causes
Mycobacterium avium-intracellulare
Coughs, Sneezes, Sings
Through the air
by inhalation
of aerosolized
droplet nuclei
produced
when person
with
pulmonary or
laryngeal T.B
Droplet Nuclei Can Also be Produced By:
Aerosol treatment
Sputum induction
Bronchoscopy
Endotracheal intubation.
Length of time person exposed to contaminated air
Immune status of exposed individuals.
Individual with impaired cell-mediated immunity. Such as HIV
infected.
Blood
Stream
Lymphatic
System
Result
Into
Dissimination of
Bacilli
Activation of
TLymphocytes
CD4 Helper
Tcells
CD8
Suppressor
Tcells
Killing of
Infected
Macrophages
Activation of
Macrophages
by INF
Aggregation
of
Macrophages
Formation of
Granuloma
Limitation
of Infection
1)
2)
1)
2)
3)
Consist of parenchymal or sub-pleural lesion,often just above or
below the interlobular fissure between the upper & lower lobe.
Enlarged hilar lymph node draining the parenchymal focus.
Causes more damage to lungs. Lesion is located at the apex of
both lungs.
Begins as small focus of consolidation usually <3cm in diameter.
Parenchymal focus
small area of caseous necrosis .
>10 mm is classified as positive
>5 mm is classified as positive
Cultures will reveal the
presence of mycobacterium
tuberculosis
Patients stay infectious for
as long as the bacilli are
excreted in the sputum
It takes 4 to 12 weeks for its
results
In primary TB an xray will show an
abnormality in mid
and lower lung
fields, and lymph
nodes may be
enlarged.
Reactivated TB
bacteria infiltrate the
upper lobes of
lungs.
oU.V
Irradiation of air in the upper part of room can also reduced
the number of viable air-borne tubercle bacilli
oAll health care workers and visitors who enter room of a T.B
patient should mask their faces.
oPatients with presumed or confirmed infectious T.B should wear a
protective mask
oControl source of infection
oDilute and remove contaminated air
oControl airflow (clean air to less-clean air)
oGood waste management policies
oStrict adherence to hygienic housekeeping principles
oStrict Hand washing practises has to be adhered to.
Initial Phase
Continuation
Phase
