by Konrad T Juszkiewicz, MD, MPH Donald Burgess,

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tuberculosis_disease.ppt

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by Konrad T Juszkiewicz, MD, MPH Donald Burgess, Ph. D DRK Biomedical Research and Development LLCby Konrad T Juszkiewicz, MD, MPH Donald Burgess, Ph. D DRK Biomedical Research and Development LLC Almaty, November,

 Localizedtypemaybe asymptomatic  Lowgraderemittentfever, nightsweats, malaise, anorexia, weightloss  Sputumatfirstmucoidandlaterpurulent Haemoptysisinhalfofthepatients  Pleureticpain  Localizedtypemaybe asymptomatic Lowgraderemittentfever, nightsweats, malaise, anorexia, weightloss Sputumatfirstmucoidandlaterpurulent Haemoptysisinhalfofthepatients Pleureticpain

 History, physicalexamination, radiological findings “consolidation & cavitation”  Identificationoftheacid-fastbacilliinsmears andcultureofsputum“ 10 weeks”  PCRamplificationof. M. History, physicalexamination, radiological findings “consolidation & cavitation” Identificationoftheacid-fastbacilliinsmears andcultureofsputum“ 10 weeks” PCRamplificationof. M. tuberculosis. DN

 Dependson:  Theextentofthediseaseandthepatientimmune status  Secondaryamyloidosismayoccurinpersistentcases Dependson: Theextentofthediseaseandthepatientimmune status Secondaryamyloidosismayoccurinpersistentcases

1. 1. Pulmonary fibrosis Thelunglesionsmayhealwithfibrosis atanystage , particularlywith treatment This ranges fromminorapicalscarringtoextensiveandseverewidespread fibrosisproducinglocalizedtowidespreadhoney-combappearanceofthe lungtissue. Itisparticularlyseeninrelapsingandprogressiveuntreated disease1. 1. Pulmonary fibrosis Thelunglesionsmayhealwithfibrosis atanystage , particularlywith treatment This ranges fromminorapicalscarringtoextensiveandseverewidespread fibrosisproducinglocalizedtowidespreadhoney-combappearanceofthe lungtissue. Itisparticularlyseeninrelapsingandprogressiveuntreated disease Thisiscomplicatedby respiratoryfailure&corpulmonale 2. 2. Pleural fibrosis Fibrosiscommonlyobliteratethepleuralspace 3. 3. Bronchiectasis Damagetothebronchialwallsandscarringcancausedistalpulmonary collapse, secondaryinfectionandbronchiectasis

  Mycobacterialinfectionofalltypesareincreasedin immunocompromisedindividualsandisinmostcases dueto reactivation of latent infection  Featuresaresimilartoinfectioninimmunocompetent individualsbutdiseaseusually progresses more rapidly dueto Mycobacterialinfectionofalltypesareincreasedin immunocompromisedindividualsandisinmostcases dueto reactivation of latent infection Featuresaresimilartoinfectioninimmunocompetent individualsbutdiseaseusually progresses more rapidly dueto decreasedhostresponse

 Theseinfectionsarecausedbyagroupof non-tuberculous mycobacteriaofwhichthemostimportanttypesare M. avium- intracellulare and M. kanasii  Theorganismsarewidelydistributedin soil, water & domestic Theseinfectionsarecausedbyagroupof non-tuberculous mycobacteriaofwhichthemostimportanttypesare M. avium- intracellulare and M. kanasii Theorganismsarewidelydistributedin soil, water & domestic animals Infectionis acquired directly from the environment andnot bycasetocasecontact Infectionbytheseorganismsisseenin immunocompromised patientsparticularly. AIDS Itcanbeseenalsoinimmunocompetentindividualswith chronicpulmonarydisease

Thelymphnodesinthismesentery, bestseenattheleft, are enlargedandhavecutsurfacesthatappearyellow-tan. Thesenodes arefilledwithsheetsof. Mycobacteriumavium-complex(MAC) organisms, andtheimmuneresponseissopoorinthis. AIDSpatient thatthereis no focal granuloma formation Thelymphnodesinthismesentery, bestseenattheleft, are enlargedandhavecutsurfacesthatappearyellow-tan. Thesenodes arefilledwithsheetsof. Mycobacteriumavium-complex(MAC) organisms, andtheimmuneresponseissopoorinthis. AIDSpatient thatthereis no focal granuloma formation

Microscopically, Mycobacteriumavium-intracellulareinfectionis markedby numerous acid fast organisms growing within macrophages. Lotsofbrightredrodsareseen, particularlyin macrophages, inthisacidfaststainoflymphnode Microscopically, Mycobacteriumavium-intracellulareinfectionis markedby numerous acid fast organisms growing within macrophages. Lotsofbrightredrodsareseen, particularlyin macrophages, inthisacidfaststainoflymphnode

Deburgess@drkbiomed. org  Kjuszkiewicz@drkbiomed. org Cell. : +7 701 218 2377 Deburgess@drkbiomed. org Kjuszkiewicz@drkbiomed. org Cell. : +