Loading in 2 Seconds...
Loading in 2 Seconds...
Lecture 1 Diagnoctics of tuberculosis (Stomat. F-t) Prof. L.A. Hryshchuk. Etiology. M. tuberculosis M. bovis M. africanum. Thin section transmission electron micrograph of Mycobacterium tuberculosis.
The granuloma consists of a kernel of infected macrophages, surrounded by FOAMY GIANT CELLS and macrophages with a mantle of LYMPHOCYTES delineating the periphery of the structure
Performed in all patients with pulmonary tuberculosis (with positive and negative sputum smear)
Test drug sensitivity to drugs and second row
Growth of Mycobacterium tuberculosis in 7-14 days.
Increases confirm TB in patients with negative sputum smear at 20%
Positive sputum smear
Carried out in parallel with the classical culture method
Detects DNK MBT , resistance to isoniazid and rifampin and isoniazid combination
Performed in all TB patients
lungs (with positive and negative smear
Bank of cultures
Test drug sensitivity
drugs II series
method to detect TB
favor the diagnosis of tuberculosis
as following :
Methods of the X-ray diagnostics of tuberculosis of respiration organs. Methodical of interpretation roentgenograms of lungs and description pathological shadows
(2) patchy or nodular shadows
(3) the presence of a cavity or cavities, although these, of
course, can also occur in lung abscess, carcinoma, etc
(4) the presence of calcification. although a carcinoma or
pneumonia may occur in an areas of the lung where
there is calcification due to tuberculosis
(5) bilateral shadows, especially if these are in the
(6) the persistence of the abnormal shadows without
alteration in an x-ray repeated after several weeks
this helps to exclude a diagnosis of pneumonia or
other acute infection
acute milliary tuberculosis
A positive tuberculin test although it is of
great use in children, but it has limited diagnostic significance in older age groups
Old Tuberculin Koch
Dry rectified tuberculin (50000 ТU), the solvent is isotonic solution of sodium chloride – 1ml with the addition of 0,25 % carbolic acid
According to the history, clinical signs, chest X-rayand some other examinations, we can diagnose TB
A patient with tuberculous pulmonary disease
will come to the physician for one of three
(1) Suggestive symptoms
(2) A positive finding on routine tuberculin
(3) A suspicious routine chest roentgenogram
Bronchiectasis may confused with chronic fibrocavenous pulmonary tuberculosis. They also have chronic cough, sputum production and hemoptysis. Usually we can use chest x-ray examination and CT scan to distinguish them.
Cavitary lung abscess often involves the
dorsal segments of the lower lobes and posterior
segments of the upper lobes.
abscess causes litt1e in the way of physical
findings, may have a fluid level, and is not
associated with patchy bronchogenic infiltrates.
In contrast, physical findings are prominent
over tuberculous cavities, fluid levels are rare.
And patchy infiltrates elsewhere are the rule.
Acute bacterial pneumonias may resemble
florid tuberculosis in all particulars except for
the sputum examination and response to
Neoplasm may resemble tuberculosis. As in
an isolated coin lesion. An obstructing and
inconspicuous endobronchial tumor causing
distal cbronic inflammation or a caviting
neoplastic mass. ( An irregular cavity wall
suggests necorotic neoplasm. )