Symptoms: Cough in pulmonary TB, abdominal pain in TB abdomen; weight loss.
Special signs: Cachexia, crepitations in lung with bronchial sounds in areas of cavitation.
Special investigations: Acid fast bacilli stain, mycobacterial culture, nucleic acid amplification, PPD skin testing, X-ray which may show solitary nodule to diffuse infiltration of lung tissue.   Pleural effusion is straw colored (light yellow) with high specific gravity (higher than 1010) and protein concentration higher than 2.0 g/10 ml. Its cytology contains mainly lymphocytes and its culture will be positive for Mycobacterium tuberculosis

This is caused by Mycobacterium tuberculosis. It often exists as co-infection with HIV/AIDS. Two tissue responses determine the course of the infection. Macrophages ingest the bacilli and then allow for stupendous growth in the macrophage. After about 2-4 weeks of infection T lymphocytes which are specific for M. tuberculosis proliferate and produce interferon-γ which activate macrophages to kill bacilli. This is the macrophage-activating response and it is cell mediated reaction. Tissue-damaging response  is caused by delayed type hypersensitivity reaction to bacillary antigens. This response is responsible for destroying macrophages not activated to destroy bacilli. If it is unable to get rid of the entire bacteria then the bacteria continues its infection. In primary tuberculosis which occur in previously unexposed individuals, it forms a focus of infection called Ghon complex. In secondary tuberculosis in which occur in patient is previously exposed to tuberculosis,  it forms caseation affecting apical pleura where it may rupture into airway and is then released in sputum or into blood where it may spread to any part of the body.


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