Tuberculosis can manifest as either pulmonary or extra-pulmonary disease. Pulmonary TB, which accounts for over 78% of cases, is divided into primary TB occurring after initial infection and reactivation post-primary TB. Extra-pulmonary TB involves sites outside the lungs, with lymph nodes, pleura, and the genitourinary tract being most commonly affected. Symptoms vary depending on the infected site but may include cough, fever, night sweats, and weight loss.

1. TUBERCULOSIS
CLINICAL FEATURES

2. PULMONARY TB
PRIMARY PTB POSTPRIMARY PTB

3. PTB/EPTB
>78%-Pulmonary TB(PTB)
10-40%-Extra Pulmonary TB(EPTB)
IN HIV+ >65% have PTB+EPTB

4. PTB
1.Primary PTB
Initial Infection with Tubercle bacilli most often in children.
-Asymptomatic
-Fever
-Pleuritic Chest pain
-Erythema nodosum
-Phlyctenular conjunctivitis

5. PRIMARY PTB

6. PRIMARY PTB
Progressive Primary TB
Low CMI evolves
-Pleural Effusion -2/3rd
-Pneumonia
-Nodal Compression-Bronchiectasis/Atelectasis/Wheeze/Hyperinflation
-Miliary Disease
-CNS Infection

7. POSTPRIMARY PTB
Fever-Low Grade
Night Sweats
Weight Loss
Cough With Expectoration
Hemoptysis
Pleuritic Chest pain
Anorexia
Anemia, ESR, CRP

8. POSTPRIMARY PTB
Reactivation/Secondary TB
Apical,
Posterior segment of UPPER
LOBES
Superior Segment of Lower Lobes

9. POSTPRIMARY PTB
Infilteration-Cavitation-Pneumonia
LINGULAR PNEUMONIACAVITY

10. EXTRA PULMONARY TB
Decreasing Order of Frequency
1.Lymph Nodes
2.Pleura
3.GenitoUrinary Tract
4.Meninges
5.Bone & Joint
6.Intestine & Peritoneum
7.Pericardium

11. EXTRA PULMONARY TB
TUBERCULOUS LYMPHADENITIS(SCROFULA)
Most common EPTB manifestation
Painless enlargement of lymph nodes-
Posterior cervical,Supraclavicular

12. EXTRA PULMONARY TB
TUBERCULOUS LYMPHADENITIS(SCROFULA)
Initially discrete later become matted further coalesce to lead on to
fistulous tract.

13. EXTRA PULMONARY TB
PLEURA
Pleural Effusion-a Hypersensitivity
reaction to microbial antigen
Cough
Fever
Dyspnea
Dull Percussion,
Absent Breath Sounds

14. EXTRA PULMONARY TB
GENITOURINARY TRACT
Nocturia
Frequency
Pyuria
Hematuria
CULTURE NEGATIVE PYURIA
Ureteral Strictures
Hydronephrosis
Infertility

15. EXTRA PULMONARY TB
GENITOURINARY TRACT

16. EXTRA PULMONARY TB
MENINGITIS
Hematogenous spread
Headache,Fever,Vomiting,Altered Sensorium,Neck Stiffness
Seizures
Cranial Nerve Palsies

17. EXTRA PULMONARY TB
MENINGITIS

18. EXTRA PULMONARY TB
INTESTINE & PERITONEUM
Most common Caecum and Ileum
Abdomen Pain
Swelling
Intestinal Obstruction
Hematochezia
Fistula
Mesenteric Adenitis
Peritonitis

19. EXTRA PULMONARY TB
BONE & JOINT
Pain,Swelling,Warmth,redness of joint
Limitation of range of movements
Weight Bearing joints
Kyphosis(Gibbus)
Paraparesis

20. EXTRA PULMONARY TB

21. EXTRA PULMONARY TB
PERICARDIUM
-Pericardial Effusion
-Pericarditis
Dyspnea,Fever
Dull Retrosternal Pain
Pericardial Friction Rub

22. MILIARY TB