13. TB infection risk Home Environment Adapted from Etkind S., Veen J., In Reichman-Hershfield: Tuberculosis: A Comprehensive International Approach, 2000 Index Case Close Casual Leisure Environment Work/School Environment
14. Shaw JB, Am Rev Tuberc 1954;69:724-32 Grzybowski S, et al. Bull Int Union Tuberc 1975;50:90-106 Van Geuns HA, Bull Int Union Tuberc 1975;50:107-21 Percent infected Risk of M.tb transmission
68. M. tuberculosis inhalation phagocytosis by PAM live bacilli multiplies primary focus formation lymphogenic spread hematogenic spread 1) Primary complex 2) Cell mediated immunity (+) TST (+) incubation period (2-12 weeks) P r i m a r y T B 3) primary complex complication hematogenic spread complication lymphogenic complication TB disease Dead Optimal immunity TB infection Cured TB disease 4) immunity reactivation/reinfecktion bacilli dead TB pathogenesis
69. WHO FDC (H/R/Z:30/60/150 & H/R:30/60) B W ( kg) Intensive , 2 mo (tablet) Continuation , 4 mo (tablet) <7 1 1 8-9 1,5 1,5 10-14 2 2 15-19 3 3 20-24 4 4 25-29 5 5
Editor's Notes
An evaluation of the reliability of x-ray diagnosis under programme conditions in India indicated that more than half of patients who were diagnosed as having tuberculosis on the basis of x-ray did not actually have the disease. These patients are subjected to unnecessary, expensive, and potentially toxic medicines. Source: Nair SS. Significance of patients with x-ray evidence of active tuberculosis not bacteriologically confirmed. Ind J Tub 1974;21:3-5.
Nodes are part of the ghon complex
uncommon in children younger than 6 years and rare in those younger than 2 years Other features of this effusion includes: WE WILL MENTION THE CHEMISTRY AND MICRO FINDINGS OF THE FLID AND HOW TO DISTINGUISE FROM PARAPNEUMONIC AND EMPYEMA specific gravity 1.012 to 1.025, protein 2 to 4 g/dL, glucose 20 to 40 mg/dL, white blood cell counts ranging from 100 to 1000 cells/mm3 , with early predominance of polymorphonuclear cells followed by a high proportion of lymphocytes.
Usually with in 6 months after infection Incidence proven to be reduced by BCG in HIV negative children Tubercles can be in the lungs, meningitis , liver, spleen, kidney (rare), skin Look for features of dissemination in these children ie hepar, spleen, consider LP