Pulmonary Tuberculosis
Chronic infection of the lungs and spread to other organs.
Signs and symptoms:
Chest pain.
Productive prolonged cough.
Cough with blood.
Systemic symptoms:
Fever.
Chills.
Night sweats.
Loss of appetite.
Loss of weight.
Fatique.
Finger clubbing.
Investigations:
1- Chest X ray: shows, scarring or cavity in the upper lobe,
enlarged bronchial lymph nodes and signs of pleurisy.
2- Sputum staining with Zheil Neelson stain: showing the
organism.
Cause:
Mycobaterium tuberculosis bacteria.
1
Treatment:
1- Patients which have Mycobaterium tuberculosis bacteria in the
sputum must enter the chet hospital to guarantee.
2- Treatment at the chest hospital for about 2 months and not
pass from the hospital except the sputum have no bacteria.
3- First line drugs :3 drugs Isoniazid( INH ) and rifampicin with a
drug from ethambutol, streptomycin and pyrazinamide.
4- Second line drugs : 3 drugs para amino salicylic acid,
cycloserine, amikacin, kanamycin , ciprofloxacin and
fluorquinlones.
5- Avoidance of risk factors: overcrowding, malnutrition, smoking,
alcoholism, certain drugs as corticosteroids and some diseases
as Diabetes mellitus.
6- Vaccination with live attenuated vaccine ( BCG vaccine ) for the
community.
Case no.1:
A patient 45 years complain from loss of apetite and loss of weight.
During discussion, the doctor know that he have chest pain and chills
that he have night sweat inspite of cold weather and that he have
prolonged cough and sometimes the sputum haveblood .
1- What you suspect?
2- What the investigations you done?
3- What is the treatment?
2
3-
3