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Body sites affected by Tuberculosis:
* Pulmonary TB: Lungs Typical symptoms of pulmonary TB include a productive cough,
fever, and weight loss. Occasionally, patients may
presents with hemoptysis or chest pain. Other systemic symptoms
include anorexia, fatigue, or night sweats.
* Tuberculous meningitis: Brain
is caused by the spread of Mycobacterium tuberculosis to the brain,
from another site in the body. The symptoms usually begin gradually.
Risk factors include a history of pulmonary tuberculosis,
excessive alcohol use, AIDS, or other disorders that compromise the immune system.
Patients may present with a headache that is either intermittent
or persistent for 2-3 weeks. Subtle mental status changes may progress
to coma over a period of days to weeks. Fever may be low-grade or absent.
* Genitourinary TB: see also uterus tb below
Reported symptoms include flank, pain, dysuria, or frequency.
In men, genital TB may present as epididymitis or a scrotal mass.
In women, genital Tb may mimic pelvic inflammatory disease.
TB causes approximately 10% of sterility in women worldwide
and approximately 1% in industrialized countries.
see also UTERUS OVARIAN TB BELOW
* Gastrointestinal TB:
Any site along the gastrointestinal tract may become infected.
Symptoms are ferable to the site infected, to include the following:
nonhealing ulcers of the mouth or anus;
difficulty swallowing with esophageal disease;
abdominal pain mimicking peptic ulcer disease with
stomach or duodenal infection; malabsorption with infection of the small intestine;
and pain, diarrhea, hematochezia with infection of the colon.
* Tuberculosis lymphadenitis (scrofula): Lymph The most common site is in the neck along the sternocleidomastoid muscle. It usually is unilateral. It usually is unilateral, with little or no pain. Advanced disease may suppurate and form a draining sinus.
* Cutaneous TB: TB of the skin
Several different types of cutaneous TB exist.
Direct infection of the skin or mucous membranes from an outside source of
mycobacteria results in an initial lesion called the tuberculous chancre.
The chancres are firm shallow ulcers with a granular base.
They appear about 2-4 weeks after mycobacteria enter through broken skin.
The immune response of the patient and the virulence of the
mycobacteria determine the type and severity of cutaneous TB.
Direct inoculation may result in an ulcer or wartlike lesion.
* Uterus Ovarian TB: Female genital organs are one of the common
sites to be involved in women.
It is a chronic disease and bacteria way remain for long time
slowly destroying the organs.
The disease may remain totally symptomless or may lead to pelvic pain,
fever, menstrual disturbances or vaginal discharge.
Sometimes fluid may accumulate in the abdomen.
In very advance disease large pus filled masses may form in the tubes or ovaries.
Infertility may be caused even by early or minimal disease.
Fallopian tubes which transport eggs from the ovaries to the
uterus are the most common organs involved and thus block the passages
and lead to permanent infertility.
It is quite difficult to diagnose genital tuberculosis.
The most important test is endometual biopsy i.e.
testing the menstrual blood taken from the uterus.
This can be obtained with the help of a thin instrument
inserted in the uterus. It is a very simple procedure.
The material thus obtained is sent to the laboratory for confirmation.
This test is positive in only 50-60 % of cases. Other tests like X-ray chest,
blood test, a skin test.
* Tuberculous meningitis:
Tuberculous meningitis is caused by the spread of Mycobacterium tuberculosis
to the brain, from another site in the body.
The symptoms usually begin gradually.
Risk factors include a history of pulmonary tuberculosis,
excessive alcohol use, AIDS, or other disorders that compromise the immune system.
* Osteo-articular Skeletal - Bone - Joint TB:
The most common site of a involvement is the spine "Potts diseases.
Symptoms include back pain or stiffness. Lower extremity paralysis occurs
in as many as half the patients with undiagnosed Potts disease.
Tuberculous arthritis usually involves only 1 joint.
Although any point may be involved, the hip of the knee is affected most commonly,
followed by the ankle, elbow, wrist, hip or the knee is
affected most commonly, followed by the ankle, elbow wrist and shoulder.
Pain may precede radiographic changes by weeks to months.
Other sites involved are the large
weightbearing bones or joints including the vertebrae (50%), hip (15%),
and knee (15%). Destruction of the bones with deformity is a late sign of TB .
Manifestations may include angulation of the spine (gibbus deformity) and/or Potts
disease (severe kyphosis with destruction of the vertebral bodies).
Cervical spine involvement may result in atlantoaxial subluxation,
which may lead to paraplegia or quadriplegia.
Physical: Finding upon physical examination depend on the organs involved.
* Patient with pulmonary TB have abnormal breath sounds, especially over the upper lobes or areas invovled.
* Sign of extrapulmonary TB differ depending on the tissues involved. Signs may include confusion, coma, neurologic deficit, chorioretinitis, lymphadenopathy and cutaneous lesions (as described above).
* Postnatal TB is contraced via the airbone route. The most common findings are adenopathy and a lung infiltrate. However, the chest radiography findings can be normal in infants with disseminated disease. Many experts increase treatment time to 9 or 12 months because of the possible impaired immune system in children younger than 12 months. Bacille Calmette-Guerin vaccine is no longer recommended for infants.
* Causes: M tuberculosis is a slow-growing organism, requiring 4-8 weeks for visible growth on solid medium. The organism grows in parallel groups called cords (see Image 1). It retains many stains after decoloration with acid-alcohol, which is the basis of acid-fast stains.
Dr. D.S. Merchant Resident Medicine
Gold Medalist (Anatomy & Histology)
Visit: http://www.lipidholdings.com
Article Source: ArticleRich.com
and Emed Tuberculosis
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