Презентация на тему Pulmonary tuberculosis

or Tuberculosis) is a common and often deadly infectious

disease caused by mycobacteria, mainly Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs (as pulmonary TB).
Scanning electron micrograph of Mycobacterium tuberculosis

2 billion people—one third of the world's population—have been

exposed to the tuberculosis pathogen.
Annually, 8 million people become ill with tuberculosis, and 2 million people die from the disease worldwide.
In 2004, around 14.6 million people had active TB disease with 9 million new cases.
The annual incidence rate varies from 356 per 100,000 in Africa to 41 per 100,000 in the Americas.
Tuberculosis is the world's greatest infectious killer of women of reproductive age and the leading cause of death among people with HIV/AIDS.
Most common infectious cause of death worldwide
Latent phase of TB enabled it to spread to one third of the world population
8,000,000 new cases each year
3,000,000 infected patients die

cases decreased from 84,304 to 22,201
- during this period

cases were reactivation of old infection and elderly
- TB and AIDS registries suggests that HIV-infected pts account for 30-50% increase in cases of TB

27% in African Americans
Populations at risk
- Foreign-born individuals
- Low

socioeconomic status
- Cancer pts
- Celiac disease
- Cigarette smokers
- TNF-a antagonists
- Corticosteroids
- HIV

sneeze, speak, or spit, they expel infectious aerosol droplets

0.5 to 5 µm in diameter.
A single sneeze can release up to 40,000 droplets.
People with prolonged, frequent, or intense contact are at particularly high risk of becoming infected, with an estimated 22% infection rate.
A person with active but untreated tuberculosis can infect 10–15 other people per year.
Others at risk include people in areas where TB is common,

and employees of high-risk congregate settings,
medically under-served and

low-income populations,
high-risk racial or ethnic minority populations,
children exposed to adults in high-risk categories,
patients immunocompromised by conditions such as HIV/AIDS, people who take immunosuppressant drugs,
and health care workers serving these high-risk clients.

wheal 6 mm to 10 mm in diameter
Represent DTH

(delayed type hypersensitivity)

injection
Measure only induration
Record reaction in mm

is classified as positive in
HIV-positive persons
Recent contacts of TB

case
Persons with fibrotic changes on CXR consistent with old healed TB
Patients with organ transplants and other immunosuppressed patients
>10 mm is classified as positive in
Recent arrivals from high-prevalence countries
Injection drug users
Residents and employees of high-risk settings
Mycobacteriology laboratory personnel
Persons with clinical conditions that place them at high risk
Children <4 years, or children and adolescents exposed to adults in high-risk categories
>15 mm is classified as positive in
Persons with no known risk factors for TB

wks to convert)
Very young age (< 6 months old)

Live-virus vaccination
Overwhelming TB disease
False positive
BCG vaccination (usually <10mm by adulthood)
Nontuberculous mycobacteria infection

segments of upper lobe or superior segments of lower

lobe
May have unusual appearance in HIV-positive persons
Cannot confirm diagnosis of TB!!

of TB
10-15% of culture-positive TB patients not diagnosed by

X-ray
40% of patients diagnosed as having TB on the basis of x-ray alone do not have active TB

and culture
Persons unable to cough up sputum
induce sputum
bronchoscopy
gastric

aspiration
Follow infection control precautions during specimen collection

sputum examination related to
the quantity of sputum (at

least 5 mL)
the quality of sputum
multiple samples obtained at different times to the laboratory for processing
3 samples obtained at least eight hours apart with at least one sample obtained in the early morning

containing acid-fast bacilli (AFB)‏
Results should be available within 24

hours of specimen collection
Presumptive diagnosis of TB
Not specific for M. tuberculosis

it is a symptom of bleeding somewhere in the

respiratory tract. Frothy and bright red blood may come from the nose, mouth, or throat (upper respiratory tract), the lower respiratory tract, or the lungs. The seriousness of the disorder depends on the cause of the bleeding.

the cause

In the first, people with TB and their contacts

are identified and then treated.
Identification of infections often involves testing high-risk groups for TB.
In the second approach, children are vaccinated to protect them from TB.

part of their TB control programs, especially for infants.

According to the W.H.O., this is the most often used vaccine worldwide, with 85% of infants in 172 countries immunized in 1993.
BCG provides some protection against severe forms of pediatric TB
unreliable against adult pulmonary TB,
Currently, there are more cases of TB on the planet than at any other time in history
urgent need for a newer, more effective vaccine that would prevent all forms of TB—including drug resistant strains—in all age groups and among people with HIV.

Bronchial Artery Embolization because of the recurrent hemoptysis.
Current

indication of Lung Resection for pulmonary tuberculosis includes MDR-TB with a poor response to medical therapy, hemoptysis due to bronchiectasis or Aspergillus superinfection, and destroyed lung as previously reported, which are consistent with our indications.   
Surgery remains a crucial adjunct to medical therapy for the treatment of MDR-TB and medical failure lesions.