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TUBERCULOSIS
CLINICAL FEATURES
PULMONARY TB
PRIMARY PTB POSTPRIMARY PTB
PTB/EPTB
>78%-Pulmonary TB(PTB)
10-40%-Extra Pulmonary TB(EPTB)
IN HIV+ >65% have PTB+EPTB
PTB
1.Primary PTB
Initial Infection with Tubercle bacilli most often in children.
-Asymptomatic
-Fever
-Pleuritic Chest pain
-Erythema nodosum
-Phlyctenular conjunctivitis
PRIMARY PTB
PRIMARY PTB
Progressive Primary TB
Low CMI evolves
-Pleural Effusion -2/3rd
-Pneumonia
-Nodal Compression-Bronchiectasis/Atelectasis/Wheeze/Hyperinflation
-Miliary Disease
-CNS Infection
POSTPRIMARY PTB
Fever-Low Grade
Night Sweats
Weight Loss
Cough With Expectoration
Hemoptysis
Pleuritic Chest pain
Anorexia
Anemia, ESR, CRP
POSTPRIMARY PTB
Reactivation/Secondary TB
Apical,
Posterior segment of UPPER
LOBES
Superior Segment of Lower Lobes
POSTPRIMARY PTB
Infilteration-Cavitation-Pneumonia
LINGULAR PNEUMONIACAVITY
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
EXTRA PULMONARY TB
TUBERCULOUS LYMPHADENITIS(SCROFULA)
Most common EPTB manifestation
Painless enlargement of lymph nodes-
Posterior cervical,Supraclavicular
EXTRA PULMONARY TB
TUBERCULOUS LYMPHADENITIS(SCROFULA)
Initially discrete later become matted further coalesce to lead on to
fistulous tract.
EXTRA PULMONARY TB
PLEURA
Pleural Effusion-a Hypersensitivity
reaction to microbial antigen
Cough
Fever
Dyspnea
Dull Percussion,
Absent Breath Sounds
EXTRA PULMONARY TB
GENITOURINARY TRACT
Nocturia
Frequency
Pyuria
Hematuria
CULTURE NEGATIVE PYURIA
Ureteral Strictures
Hydronephrosis
Infertility
EXTRA PULMONARY TB
GENITOURINARY TRACT
EXTRA PULMONARY TB
MENINGITIS
Hematogenous spread
Headache,Fever,Vomiting,Altered Sensorium,Neck Stiffness
Seizures
Cranial Nerve Palsies
EXTRA PULMONARY TB
MENINGITIS
EXTRA PULMONARY TB
INTESTINE & PERITONEUM
Most common Caecum and Ileum
Abdomen Pain
Swelling
Intestinal Obstruction
Hematochezia
Fistula
Mesenteric Adenitis
Peritonitis
EXTRA PULMONARY TB
BONE & JOINT
Pain,Swelling,Warmth,redness of joint
Limitation of range of movements
Weight Bearing joints
Kyphosis(Gibbus)
Paraparesis
EXTRA PULMONARY TB
EXTRA PULMONARY TB
PERICARDIUM
-Pericardial Effusion
-Pericarditis
Dyspnea,Fever
Dull Retrosternal Pain
Pericardial Friction Rub
MILIARY TB

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