Pulmonary-Tuberculosis课件.pptVIP

2nd Respiratory Department liu yaxin aliu0707@126.com Case A fifty years old man presented to a hospital: 1)Chief complaint: hemoptysis,a productive cough, night sweats and weight loss over the previous one month. 2)He had been seen in a community health center for persistent productive cough and unexplained weight loss 10 days before, but was treated with antibiotics for a presumed upper respiratory infection. 3)Past medical history: diabetes. 4)Physical examination: thin, a temperature of 38.9 ℃; heart rate 116/min, respiratory rate 32/min, there was inspiratory crackles and expiratory rhonchi in the right upper and middle lobes. 5)His chest x-ray revealed a right upper lobe cavitary infiltrate and a sputum smear was positive for acid fast bacilli. What is the possible diagnosis of the patient? If you are his doctor, what will you do next? Pulmonary Tuberculosis A general outline Introduction Etiology agent and Epidemiology Pathogenesis and Immunity Clinical patterns of tuberculosis Clinical Manifestations Diagnosis Differential Diagnosis Treatment Tuberculosis is a chronic infection, potentially of lifelong duration, caused by bacteria belonging to the Mycobacteria tuberculosis complex. M.tuberculosis is commom, and, rarely, M.bovis. It was isolated by Robert Koch in 1882. The lungs are primarily involved, but the infection can spread to other organs. It is characterized by the development of granular tumors(nodes) in the infected tissues. If properly treated, tuberclosis caused by drug-susceptible strains is curable in virtually all cases.If untreated, the disease may be fatal within 5years in more than half of cases. Etiology agent The tubercle bacillus (M.Tuberculosis) is a rod-shaped, aerobic, non-motile,non-spore-forming, high in lipid content, and acid and alcohol-fast (AFB). It grows slowly . It cant tolerate heat, but It can live in humid or dry or cold surroundings. AFB - Ziehl-Neelson stain Acid-fast staining techniq