Tuberculosis is infectious contagious disease caused by Mycobacterium

Tuberculosis is infectious contagious disease, caused by Mycobacterium tuberculosis, and characterized by destruction of all organs, but, first mainly the lungs.

ETIOLOGY n Mycobacteria tuberculosis hominis (contamination is air path) n Mycobacteria bovis (contamination is alimentary path)

Mycobacteria n Mycobacterias are in macrophages diffuse or in the form of clusters. n Stain on the Cyle. Nilsen.

Pathogenesis n n n n Inhalation of tuberculosis sticks. The Absorption of bacillus by macrophages. Inside the macrophagial multiplication of them. Migration of these macrophages to regional lymph nodes The Appearance of sensibilized antigens. Reverse migration of macrophages with Mycobacterium to lungs or distal organs through blood or lymph. Reproduction of Mycobacterium tuberculosis in these secondary organs Activating the cell immune system.

Clinical and morphological forms of tuberculosis n I. Primary Tuberculosis n II. Haematogenic Tuberculosis n 111. Secondary Tuberculosis

Primary tuberculous complex Morphological manifestation of primary tuberculosis are as follow The Primary tuberculosis complex of Gon consists of 1. Primary Tuberculous focus (Gon center) 2. Tuberculous Lymphangitis 3. Tuberculous Lymphadenitis

Primary Tuberculous focus (Gon center) n Focus is under the Pleura, size 2 -3 cm. Yellow-white, crumbling in the form of caseous necrosis.

Tuberculous granuloma

n Lymphangitis It is a specific granulomatous inflammation along the wall of the lymphatic vessel n Lymphadenitis It is a center of caseous necrosis with surrounding granulomas in the lymph node of the lung hylus.

Primary tuberculous complex in the lung

Primary tuberculous complex in the small intestine Primary focus is ulcer in the wall of the distal small intestine n Lymphangitis n Lymphadenitis in the mesosalpinx of the small intestine n

Clinical course of primary tuberculosis n Healing with the buildup of lung fibrosis n Progression of primary tuberculosis (disseminated primary tuberculosis) n Chronic primary infection.

The Healing focus of Gon

The Healing focus of Gon

Progression of primary tuberculosis n Haematogenic dissemination n Lymphogenic dissemination n Growth of primary tuberculous focus n Mixed Path

HEMATOGENOUS TUBERCULOSIS Disseminated Hematogenous Tuberculosis: -Acute Generalized milliary tuberculosis - Acute Tuberculosis Sepsis Haematogenic Pulmonary tuberculosis: -Miliary Pulmonary tuberculosis Hematogenic outside pulmonary tuberculosis: Foci of the brain, kidneys, adrenal glands, bone marrow, fallopian tubes, the skin, the liver. n

Acute milliary tuberculosis of the lungs n Grey granules DM. 2 -4 mm in size, diffuse spread in parenchyma. Milliarymillet-like.

HEMATOGENOUS TUBERCULOSIS

Extra pulmonary tuberculosis The spleen The kidney The vertebre The orchit

SECONDARY TUBERCULOSIS Acute Focal n Fibrotic Focal n Infiltrative n Tuberculoma n Caseous pneumonia n Acute cavernous n Fibrous cavernous n The Cirrhotic n n

ACUTE FOCAL n n n Pockets of Abricosov’s re-infection 1. 2 Segments, more often the right lung They have the appearance of focal caseous pneumonia.

n n FIBROTIC FOCAL Pockets of the healing of Abricosov’s reinfections Encapsulated and petrified called the foci of Ashoff. Pullet.

Infiltrative tuberculosis n The Pockets of Assman-Redekker consist of small pockets of casein necrosis, surrounded by serous exudate with cellular infiltration.

TUBERCULOMA n n Encapsulated focus of caseous necrosis Dm. from 5 cm

Caseous pneumonia n Massive caseous necrosis with exudative inflammation on the periphery

Acute cavernous tuberculosis n The Cavity is formed among the caseous masses in 1 and 2 segments of the lungs. This cavity is DM. 2 -7 cm. , connected with the bronchi.

FIBROUS CAVERNOUS TUBERCULOSIS synonym as Pulmonary consumption The chronic process with formation fibrous tissue with petrificats in a capsule of a cavity. Below in the light can be seen: Pneumosclerosis, magic tricks of caseous pneumonia.

FIBROUS CAVERNOUS TUBERCULOSIS

CIRRHOTIC TUBERCULOSIS n Formation of a scar, focal-diffuse pneumosclerosis and bronchiectases.

THE COMPLICATIONS n Bleeding (Hemoptysis), n Pneumothorax n Purulent pleuritis (Empyema), n Amyloidosis n Meningitis.

THE COMPLICATIONS Meningitis n Hematoma n in the Cavern n

THE COMPLICATIONS pneumothorax

THE COMPLICATIONS Purulent pleuritis (Empyema)

THE COMPLICATIONS n Amyloidosis of the Kidneys

Causes of death in tuberculosis n Pulmonary insufficiency n Acute heart failure n Bleeding n Meningitis n Uremia

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