PPT about Intro to TB

1. Presented to mam rabia
By
Group #1
Faculty of allied health sciences
University Of Azad Jammu &
Kashmir

2. Saqib Hussain Dar
Kiran Imtiaz
Maira Khan
Mahnoor Rafique
Mahnoor Sadaqat
Zarish Riaz
Jawariya Qayyum
Safi Ullah Aziz
GROUP MEMBERS
02
03
04
05
06
07
08
76

3. MYCOBACTERIUM TUBERCULOSIS
Topic:

4. WHAT IS TUBERCULOSIS?
 Tuberculosis is disease caused by tiny
microbes that enter in your lungs when
you breath them in.
 Most commonly found in the lungs but
sometimes they can move to other parts
of body like brain or spine and kidney.
 When you have tuberculosis disease of
the lungs, you can spread it to other
people.

5. Etiology
 There are three types of mycobacterium
which are responsible for TB.
• Mycobacterium tuberculosis: Human
Infections
• Mycobacterium bovis: Endemic in cattle,
rarely responsible for disease in human.
• Atypical or Opportunistic mycobacterium:
Immuno-Compromised hosts.

6. MORPHOLOGY
o Acid fast beaded, Gram
+ive bacilli.
o Arranged in bundles.
o Non spore forming.
o Non motile.
o Strictly aerobic.
o Grow slow thus require
6-8 weeks.

7. Spread of Tuberculosis
• Direct Droplet Spread: It spread from person to
person by inhaling the air-born bacilli that have been
coughed or sneezed at atmosphere.
• Indirect Spread: It spread through clothes, utensils,
dishes or other daily use materials which are exposed
with TB bacilli.
• Via Ingested Milk: It spread through by ingesting
contaminated milk or milk products.

8. Predisposing Factors
Environmental Factors
 Malnutrition
 Poverty
 Overcrowding
 Unhygienic
Conditions
 Alcoholism
 Heavy Smoking
Pathological Factors
 Diabetes Mellitus
 Steroids
 Chronic lung
Disease
 Lymphoma
 Cytotoxic Drugs

9. Pathogenesis

10. Types of tuberculosis
Primary tuberculosis
Secondary tuberculosis
 Primary TB: It develop in previously unexposed
individuals.
• It occur in the lungs. But sometime can reach in the tonsils and
ileocecal region.
• Primary focus of infection is known as Ghon focus.
• It occur in sub pleural at the lower part of upper lobe and
upper part of lower lobe.
• Then it reaches the draining lymph node at the hilum of lung .

11. Clinical Manifestation of Primary TB
• Asymptomatic in majority of patients.
• Diagnosis only on chest x-ray and tuberculin test.
• Mild fever: lasts for 7-14 days.
• Dry cough
• Erythema nodosum : Bluish-red tender cutaneous lesions in
front of leg below the knee.

12. Fate of Primary TB
1. Healing and Calcification
2. Progressive Pulmonary TB: In children having impaired
immunity such as malnutrition the primary infection don’t
heal and lead to primary progressive tuberculosis.
• Infection spread to other site of lungs and pleural causing
pleural effusion.
• Enlarged lymph nodes compress the bronchi.
1. Secondary TB: Reactivation of previous infection due to weak
immune system.
• Upper lobe and upper segment of lower lobe is infected .

13. Clinical Manifestation of Sec. TB

14. FORMS OF TUBERCULOSIS
Latent TB : TB infection but bacteria remain in body in an
inactive state & cause no symptoms.
 Latent TB is also called inactivate TB.
 It is not contagious.
Activate TB: if latent TB is not treated then it can be
turned to activate TB .
 It make you sick & can spread to others.

15. Mode of Infection
Mycobacterium TB is carried by humans
• Mycobacterium TB can present it self in the human
body in different form, effecting any where from
intestine, bones, joints, skin, nervous system.
• It occur due to the inhalation of air droplets having
this bacteria.
• It can spread from person to person.

16. Avian tuberculosis
Avian which is carried by birds
• Transmitted by inhalation and ingestion of infectious
organisms from feces.
• Oral ingestion of food and water contaminated with feces is
the most common method of infection.
• Once ingested, the organism spread throughout the bird’s body
and is shed in large number in feces.
• If the bacterium is inhaled then pulmonary lesions and skin
invasions may occur.
• Transmission of avian TB is from bird to human not from
human to human.

17. Bovine tuberculosis
Bovine tuberculosis is carried by cattle.
• People contract bovine TB by ingesting contaminated milk or
milk products.
• Drinking un pasteurized milk from cow that is infected with
bovine type virus.
• It mostly effect the joints and bones.

18. Types of TB
 In human TB is either
1. Pulmonary TB
2. Extra Pulmonary TB

20. Extra Pulmonary TB
• Pleural TB: Pleural effusion occur causing shortness of
breath.
• Tuberculous empyema may occur due to the rupture of cavity.
• Tuberculosis of upper airway: TB of larynx,
pharynx epiglottis can occur. Causing ulceration, productive
cough.
• Lymph node TB: Enlargement of lymph node, mostly
at cervical and supraclavicular sites.
• Tuberculous pericarditis: Fever, chest pain, weight
loss, pericardial effusion occur.

21. • Meningitis tuberculous : Mycobacterium tuberculosis
cause the inflammation of meningis .
Skin TB

22. SIGN & SYMPTOMS OF TB
Chest
pain
Hemoptysis

23. Investigation
Chest X-ray: At early stage small opacity or opacities in
one of the upper lobes.
• Later opacities become large and bilateral.
• Trachea and heart shadow are displaced toward the site of
lesion.
Sputum Test: Microscopic examination of at least three
specimens of sputum is collected early at the morning to check
the acid fast bacilli.
Tuberculin Test: Tuberculin is injected under the skin if
person is exposed to TB then skin become swell around the
area where it is injected.

24. Investigation
PCR:
Rapid detection of mycobacterium DNA in sputum & other
body fluids.
Needle Biopsies:
Biopsy of pleura, lymph nodes and solid lesion within
lungs.
PFA:
Pleural fluid exudates with pre dominant lymphocytes.
Culture:
Slow growing culture on Lowenstein – Jensen Solid
Medium.

25. Treatment for TB
• There are two phase of anti tuberculous therapy
1. Initial phase: Bactericidal phase, in which bacilli is killed
symptoms resolves and patient become non infectious.
Duration is 2 months.
2. Continuation phase: Sterilization phase in which
remaining tubercle bacilli is eliminated and organ is
sterilized. Duration is 7 months.

27. Duration 9 months
• Initial phase 2 month 4 drugs
1. Isoniazid with pyridoxine
2. Rifampicin
3. Ethambutol or streptomycin
4. Pyrazinamide
• Continuation phase 7 month 3 drugs
1. Isoniazid with pyridoxine
2. Rifampicin
3. Ethambutol or Streptomycin
• Relapse
• Standard Treatment Regimen
o Isoniazid and Rifampicin and Pyrazinamide or Ethambutol for 2 months
o Followed by Isoniazid and Rifampicin for at least 4 months.

28. Duration of Pulmonary TB is 9 months.
Treatment of Extra Pulmonary Tuberculosis requires
one year.