Tuberculosis is a widespread infectious disease caused by mycobacteria that typically affects the lungs. It spreads through airborne droplets when infected people cough, sneeze or speak. Symptoms include fever, night sweats, and weight loss. While most infections are latent and asymptomatic, active disease can be fatal if left untreated. Tuberculosis is treated with a combination of antibiotics taken for at least six months.

1. TUBERCULOSIS
Presentation by,
Al auf Jalaludeen

2.  Tuberculosis,TB also called phthisis, phthisis
pulmonalis, or consumption, is a widespread,
and in many cases fatal, infectious
disease caused by various strains
of mycobacteria, usually Mycobacterium
tuberculosis. Tuberculosis typically attacks
the lungs, but can also affect other parts of
the body.

3. Mode of infection
 It is spread through the air when people who have
an active TB infection cough, sneeze, or otherwise
transmit respiratory fluids through the air. Most
infections do not have symptoms, known as latent
tuberculosis. About one in ten latent infections
eventually progresses to active disease which, if
left untreated, kills more than 50% of those so
infected.

4.  When people with active pulmonary TB cough,
sneeze, speak, sing, or spit, they expel
infectious aerosol droplets 0.5 to 5.0 μm in
diameter. A single sneeze can release up to
40,000 droplets. Each one of these droplets
may transmit the disease, since the infectious
dose of tuberculosis is very small (the
inhalation of fewer than 10 bacteria may
cause an infection)

5. Types of TB
Tuberculosis is divided into two
categories: pulmonary and extrapulmonary.
Pulmonary Tuberculosis Types:
 Primary Tuberculosis Pneumonia
 Tuberculosis Pleurisy
 Cavitary Tuberculosis
 Miliary TB
 Laryngeal Tuberculosis

6. Primary Tuberculosis Pneumonia
 This uncommon type of TB presents as
pneumonia and is very infectious. Patients have a
high fever and productive cough. It occurs most
often in extremely young children and the elderly. It
is also seen in patients with immunosuppression,
such as people with HIV/AIDS, and in patients on
long term corticosteroid therapy.

7. Tuberculosis Pleurisy
 This usually develops soon after initial infection. A granuloma
located at the edge of the lung ruptures into the pleural space,
the space between the lungs and the chest wall. Usually, a couple
of tablespoons of fluid can be found in the pleural space.
 Once the bacteria invade the space, the amount of fluid increases
dramatically and compresses the lung, causing shortness of
breath (dyspnea) and sharp chest pain that worsens with a deep
breath (pleurisy). A chest x-ray shows significant amounts of
fluid. Mild- or low-grade fever commonly is present. Tuberculosis
pleurisy generally resolves without treatment; however, two-thirds
of patients with tuberculosis pleurisy develop active
pulmonary TB within 5 years.

9. Cavitary TB
 Cavitary TB involves the upper lobes of the lung. The bacteria
cause progressive lung destruction by forming cavities, or
enlarged air spaces. This type of TB occurs in reactivation disease.
The upper lobes of the lung are affected because they are highly
oxygenated (an environment in which M. tuberculosis thrives).
Cavitary TB can, rarely, occur soon after primary infection.
 Symptoms include productive cough, night sweats, fever, weight
loss, and weakness. There may be hemoptysis (coughing up
blood). Patients with cavitary TB are highly contagious.
Occasionally, disease spreads into the pleural space and causes
TB empyema (pus in the pleural fluid).

11. Miliary TB
 Miliary TB is disseminated TB. "Miliary" describes the appearance
on chest x-ray of very small nodules throughout the lungs that
look like millet seeds. Miliary TB can occur shortly after primary
infection. The patient becomes acutely ill with high fever and is in
danger of dying. The disease also may lead to chronic illness and
slow decline.
 Symptoms may include fever, night sweats, and weight loss. It
can be difficult to diagnose because the initial chest x-ray may be
normal. Patients who are immunosuppressed and children who
have been exposed to the bacteria are at high risk for developing
miliary TB.

13. Laryngeal TB
 TB can infect the larynx, or the vocal chord
area. It is extremely infectious.

15. Extrapulmonary Tuberculosis
This type of tuberculosis occurs primarily
in immunocompromised patients.
 Lymph Node Disease
 Tuberculosis Peritonitis
 Tuberculosis Pericarditis
 Osteal Tuberculosis
 Renal Tuberculosis
 Adrenal Tuberculosis
 Tuberculosis Meningitis

16. Lymph Node Disease
 Lymph nodes contain macrophages that capture the bacteria. Any
lymph node can harbor uncontrolled replication of bacteria,
causing the lymph node to become enlarged. The infection can
develop a fistula (passageway) from the lymph node to the skin.
Tuberculosis Peritonitis
 M. tuberculosis can involve the outer linings of the intestines and
the linings inside the abdominal wall, producing increased fluid, as
in tuberculosis pleuritis. Increased fluid leads to abdominal
distention and pain. Patients are moderately ill and have fever.

18. Tuberculosis Pericarditis
 The membrane surrounding the heart (the pericardium) is
affected in this condition. This causes the space between the
pericardium and the heart to fill with fluid, impeding the heart's
ability to fill with blood and beat efficiently.
Osteal Tuberculosis
 Infection of any bone can occur, but one of the most common
sites is the spine. Spinal infection can lead to compression
fractures and deformity of the back.
Renal Tuberculosis
 This can cause asymptomatic pyuria (white blood cells in the
urine) and can spread to the reproductive organs and affect
reproduction. In men, epididymitis (inflammation of the
epididymis) may occur.

20. Adrenal Tuberculosis
 TB of the adrenal glands can lead to adrenal
insufficiency. Adrenal insufficiency is the inability to
increase steroid production in times of stress, causing
weakness and collapse.
TB Meningitis
 M. tuberculosis can infect the meninges (the
mainmembrane surrounding the brain and spinal cord).
This can be devastating, leading to permanent
impairment and death. TB can be difficult to discern
from a brain tumor because it may present as a focal
mass in the brain with focal neurological signs.
 Headache, sleepiness, and coma are typical symptoms.
The patient may appear to have had a stroke.

22. Signs and symptoms
 Tuberculosis may infect any part of the body, but most
commonly occurs in the lungs (known as pulmonary
tuberculosis). Extrapulmonary TB occurs when
tuberculosis develops outside of the lungs, although
extrapulmonary TB may coexist with pulmonary TB, as
well.
 General signs and symptoms include fever, chills, night
sweats, loss of appetite, weight loss,
and fatigue. Significant nail clubbing may also occur.

24. Causes
 The main cause of TB is Mycobacterium tuberculosis, a
small, aerobic, nonmotile bacillus.[10] The
high lipid content of this pathogen accounts for many of
its unique clinical characteristics.[19] It divides every 16
to 20 hours, which is an extremely slow rate compared
with other bacteria, which usually divide in less than an
hour.[20] Mycobacteria have an outer membrane lipid
bilayer.
 MTB can withstand weak disinfectants and survive in
a dry state for weeks. In nature, the bacterium can
grow only within the cells of a host organism, but M.
tuberculosis can be cultured in the laboratory

26. Methods of prophylaxis
Stopping the Spread of Tuberculosis
Anyone who comes into contact with an individual infected with
tuberculosis bacteria is at risk of developing the disease, so one
obvious solution is to steer clear of people who are sick, sneezing, and
coughing. Follow these additional steps to help prevent the spread of
tuberculosis infection:
 People with tuberculosis infection should always cover their mouths
when they cough or noses when they sneeze.
 People with latent tuberculosis infection — when there are
no symptoms or active disease — should take medication to prevent it
from becoming active tuberculosis disease.
 People with TB should take all medications as required.
 People at risk for or who have been in contact with people with
tuberculosis infection should be tested.

27. The TB Vaccine
 The vaccine, developed nearly 100 years ago, is called BCG
(bacille Calmette-Guérin). It is made from weakened tuberculosis
bacteria that infect cows, similar to the human form of
tuberculosis.
 The vaccine works against a severe type of TB that affects young
children, but it is not effective against the type of bacteria found
in adults. That severe type of tuberculosis, called military TB , is
rare in the United States, so the vaccine isn’t used on young
children here.
 Children who live with someone infected with TB may be eligible
to receive the vaccine if they would not be able to tolerate the
antibiotic treatment or if the type of TB is antibiotic-resistant.

28. TB Testing
 Anyone who has been or may have been exposed to
tuberculosis should be tested for it right away. The sooner TB
is diagnosed, the sooner treatment can begin — and the easier
it is to prevent both its spread and serious complications.
 A simple skin test, known as the PPD (purified protein
derivative) TB skin test or tuberculin skin test, is given to
check for the presence of the bacteria that cause tuberculosis.
A chemical is injected just beneath the skin surface, and
within 48 to 72 hours the skin is examined for any reaction.
Swelling may indicate a positive test result.

30. Tuberculosis Medication
 Medications are available to treat active tuberculosis, as
well as to prevent latent tuberculosis infection from
developing into the actual disease. Isoniazid (INH), for
instance, is a drug prescribed for those with latent
tuberculosis infection.
 Medications must be started right away to control the
disease and keep it from infecting other people. They
are typically taken several times a day for at least six
months, and sometimes up to a year.

31. Protect your family and friends
If you have active TB, keep your germs to yourself. It generally takes a few
weeks of treatment with TB medications before you're not contagious
anymore. Follow these tips to help keep your friends and family from getting
sick:
 Stay home. Don't go to work or school or sleep in a room with other people
during the first few weeks of treatment for active tuberculosis.
 Ventilate the room. Tuberculosis germs spread more easily in small closed
spaces where air doesn't move. If it's not too cold outdoors, open the
windows and use a fan to blow indoor air outside.
 Cover your mouth. Use a tissue to cover your mouth anytime you laugh,
sneeze or cough. Put the dirty tissue in a bag, seal it and throw it away.
 Wear a mask. Wearing a surgical mask when you're around other people
during the first three weeks of treatment may help lessen the risk of
transmission.