4 TUBERCULOSIS BY Ms Santoshi Naik Assistant Professor

4. TUBERCULOSIS BY: Ms. Santoshi Naik Assistant Professor Yenepoya Pharmacy College and Research Centre

Definition TB is a contagious bacterial infection that mainly affects the lungs parenchyma, but may spread to other organs

Types of Tuberculosis Mycobacterium Tuberculosis • Carried by humans Avian Tuberculosis • Carried by birds Bovine Tuberculosis • Carried by cattle

1) Mycobacterium Tuberculosis Mycobacterium T. B. can present it self in the human body in different forms affecting any where from “the intestines, bones, joints, skin, genitourinary, lymphatic, respiratory and nervous systems. Causative organism- Mycobacterium Tuberculosis

2) Avian Tuberculosis Oral ingestion of food and water contaminated with feces is the most common method of infection. Once ingested or inhaled, the organism spreads throughout the bird's body and is shed in large numbers in the feces. Transmission of avian TB is from bird to human not from human to human. Causative organism- Mycobacterium avium

3) Bovine Tuberculosis People contract Bovine TB by drinking un-pasteurized milk from cows that are infected with the bacteria. Bovine TB is most likely affects the joints and bones. Causative organism – Myocobacterium bovis

Classification of Myocobacterium Tuberculosis Extra pulmonary TB i. Lymph node TB ii. Pleural TB - Primary Disease iii. TB of upper airways - Secondary Disease iv. Skeletal TB Pulmonary TB v. Genitourinary TB vi. Gastrointestinal TB vii. Tuberculous Meningitis

A. Pulmonary Tuberculosis : 1. Primary Tuberculosis: - �The infection of an individual who has not been previously infected or immunised is called Primary tuberculosis or childhood tuberculosis. 2. Secondary Tuberculosis : �The infection of an individual who has been previously infected or sensitized is called secondary or post primary or reinfection or chronic tuberculosis.

B. Extrapulmonary Tuberculosis 1) Lymph node TB �Seen frequently in HIV infected patients. 2) Pleural TB �Involvement of pleura (membrane lining the lungs and thorax). 3) TB of Upper airways : �Involvement of larynx, pharynx and epiglottis.

4) Genitourinary TB § Any part of the genitourinary tract get infected. § Symptoms : - Dysuria, Hematuria. 5) Skeletal TB : § Involvement of weight bearing parts like spine, hip, knee. § Symptoms : - Pain in hip joints and knees, swelling of knees. 6) Gastrointestinal TB § Involvement of any part of GI Tract. § Symptoms : - Abdominal pain, diarrhea, weight loss 7) TB Meningitis § Affecting meninges(protective covering of the brain and spinal cord)

Modes of Transmission of Tuberculosis

Symptoms of Tuberculosis Persistent cough Chest pain Coughing with bloody sputum Shortness of breath Urine discoloration Fever with chills. Fatigue Anorexia

Diagnosis of Tuberculosis 1) 2) 3) 4) Bacteriological test Sputum culture test Radiography (chest X-Ray) Tuberculin skin test Injection of fluid (protein extract from tubercle bacillus) into the skin of the lower arm. 48 -72 hours later – checked for a reaction. Diagnosis is based on the size of the wheal. Less than 6 mm – negative Between 6 -15 mm – hypersensitivity reactions More than 15 mm - positive

Prevention of Tuberculosis

Treatment of Tuberculosis �Antitubercular drugs Isoniazid, Rifampicin, Pyrazinamide, Ethambutol DOTS - Directly observed treatment, short-course