TUBERCULOSIS (TB) Tuberculosis (TB) is a contagious infection that usually attacks your lungs. Classic example of granulomatous inflammation in humans. A potentially serious infectious bacterial disease that mainly affects the lungs. The bacteria that cause TB are spread when an infected person coughs or sneezes. Most people infected with the bacteria that cause tuberculosis don't have symptoms. When symptoms do occur, they usually include a cough (sometimes blood-tinged), weight loss, night sweats and fever. Treatment isn't always required for those without symptoms. Patients with active symptoms will require a long course of treatment involving multiple antibiotics.

1. PRESENTED BY:
ALLSUN SWEETLINE.M.S

2. INTRODUCTION
PATHOGENESIS
CAUSATIVE
AGENT
EVOLUTION OF
TUBERCLE
TYPES
MODE OF
TRANSMISSION
01 02 03
TABLE OF CONTENTS
04 05 06

3. 01

4. •Tuberculosis (TB) is a
contagious infection that
usually attacks your lungs.
• Classic example of
granulomatous
inflammation in humans

12. 02

13. Fungi

16. 03

17. INHALATION OF
ORGANISM

18. INGESTION OF
ORGANISMS

19. TRANSPLACENTAL
ROUTE

20. SPREAD
OF TB

22. 04

23. Healing and disease
DISEASE
HEALING

26. IMMUNISATION
AGAINST TB

28. TUBERCULIN /
MANTOUX TEST
Purified protein
derivative (PPD)

29. 05

38. Cold
abcess
Sinus
tracts
Coalase
FATE OF GRANULOMA
Dystropic
calcification

39. 06

40. Primary
tuberculosis
Secondary
tuberculosis
Depending upon the type of tissue, response and age

42. The infection of an
individual who has not
been previously
infected or immunized
is called Primary
tuberculosis / Ghon´s
complex/Childhood
tuberculosis.

45. Pulmonary
Component
Lymphatic
Vessels
Component
Lymph Node
Component
Consists of 3
components:

46. Ghon’s complex
Progressive fibrosis
Calcification
RANKE COMPLEX

49. FATE OF PRIMARY TUBERCULOSIS

51. The infection of an
individual who has
been previously
infected or sensitized
is called secondary/
post – primary/
reinfection/ chronic
tuberculosis.

52. •Occur most
commonly in lungs in
the region of apex.
Other sites - Tonsils,
Pharynx, Larynx, Small
intestine and Skin.

55. FEATURE PRIMARY TB SECONDARY TB
AGE Mostly children Children and adults
ORGANS Pulmonary Extra pulmonary
LESIONS Ghon’s complex
Tubercles,extensive caseation,miliary
lesions,cavitation etc
FATE
Healing by fibrosis and calcification
May get reactivated in weakened
immunity
Consolidation,parenchymal
nodules,Thickened pleura
Reactivation in impaired immunity and AIDS

56. FATE OF SECONDARY
TUBERCULOSIS
● 1. Heal with fibrous scarring and
calcification

57. The lesions may coalescence together and
produce progressive secondary pulmonary
tuberculosis with the following pulmonary and
extra pulmonary involvements
• Fibrocaseous tuberculosis
• Tuberculous caseous pneumonia
• Miliary tuberculosis

59. The original area of tuberculous pneumonia -
> massive central caseation necrosis which
may:
♥ Either break into a bronchus from a cavity
(Cavitary or open fibrocaseous tuberculosis)
♥ Remain, as a soft caseous lesion without
drainage into a bronchus or bronchiole to
produce a non-cavitary lesion (Chronic
fibrocaseous tuberculosis).

63. The caseous material
from a case of
secondary tuberculosis
in an individual with
high degree of
hypersensitivity may
spread to rest of the
lung

66. This is
lymphohaematogenous
spread of tuberculous
infection from primary
focus or later stages of
tuberculosis.

67. The spread is either by
► Entry of infection into
pulmonary vein
e.g. (liver, spleen, kidney, brain
and bone marrow)
(or)
► Into pulmonary artery
restricting the development of
miliary lesions within the lung

70. CLINICAL
FEATURES

77. Primary
Secondary
Hyperplastic
caecal
TYPES

78. - The predominant changes are in the mesenteric
lymph nodes without any significant intestinal
lesion.

79. The affected
lymph nodes are
enlarged, matted
and caseous
(Tabes
mesenterica).
MACROSCOPY

80. ► Initial stage - Ghon’s focus in the intestinal
mucosa
► Subsequently - the mesenteric lymph nodes are
affected which show typical tuberculous
granulomatous inflammatory reaction
MICROSCOPY

81. - Self swallowing of sputum in patients with
active pulmonary tuberculosis

82. ►Lesions begin in the
Peyer’s patches /lymphoid
follicles with formation of
small ulcers -> Lymphatics
to form large ulcers
► These ulcers may be
coated with caseous
material.
► Serosa may be studded
with visible tubercles.

83. ►Presence of tubercles.
► Mucosa and
submucosa show
ulceration
► Muscularis may be
replaced by variable
degree of fibrosis

84. - Variant of occurring secondary to
pulmonary tuberculosis.

85. ►The terminal ileum, caecum
and/or ascending colon are
thick-walled with mucosal
ulceration.
► Clinically, the lesion is
palpable and may be
mistaken for carcinoma

86. ► The presence of caseating
tubercles