This document presents information about Mycobacterium tuberculosis and tuberculosis. It discusses that tuberculosis is caused by Mycobacterium tuberculosis, which can infect the lungs and other parts of the body. The morphology, types, clinical manifestations, diagnosis and treatment of tuberculosis are summarized. Tuberculosis can be primary, secondary, latent or active. It spreads through airborne droplets or indirect contact. Risk factors include malnutrition, poverty, smoking and diabetes. Treatment involves a two phase regimen over 9 months with antibiotics like isoniazid and rifampin.

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
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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.