Clinical Aspects of Adult Tuberculosis

Abstract

Tuberculosis (TB) in adults can present in a large number of ways. The lung is the predominant site of TB. Primary pulmonary TB should be distinguished from postprimary pulmonary TB, which is the most frequent TB manifestation in adults (70%-80% cases). Cough is common, although the chest radiograph often raises suspicion of disease. Sputum sampling is a key step in the diagnosis of TB, and invasive procedures such as bronchoscopy may be necessary to achieve adequate samples for diagnosis. Extrapulmonary involvement, which may present many years after exposure, occurs in a variable proportion of cases (20%-45%). This reflects the country of origin of patients and also the frequency of associated human immunodeficiency virus (HIV) coinfection. In the latter case, the presentation of TB is often nonspecific, and care needs to be taken to not miss the diagnosis. Anti-TB therapy should be given in line with proven (or assumed) drug resistance. In extrapulmonary TB, adjunctive therapeutic measures may be indicated; although in all cases, support is often required to ensure that people are able to complete treatment with minimal adverse events and maximal adherence to the prescribed regimen, and so reduce risk of future disease for themselves and others.

Mycobacterium tuberculosis Dissemination Plays a Critical Role in Pathogenesis

“…These primary lesions often calcify during the course of disease, resulting in a distinct pathology. This pattern of infection was once thought to be a hallmark of childhood tuberculosis, but in the modern era where adults in countries with low incidence of tuberculosis are less likely to have been exposed to M. tuberculosis it has become evident that this is instead the progression of M. tuberculosis infections in immune naive individuals who have not previously developed an immune response against mycobacteria (Loddenkemper et al, 2015).…”

Clinical and pathologic analyses of tuberculosis in the oral cavity: report of 11 cases

“…Primary pulmonary TB should be distinguished from postprimary pulmonary TB, which is the most frequent manifestation of TB in adults (70%-80% of cases). 2 The host inflammatory reactions play an important role in protection from this disease as well as its pathology. 3 In the initial stage of M. tuberculosis infection, additional macrophages and other immune cells aggregate with the infected cells to form granulomas, the morphology of which is characterized by a central necrotic core surrounded by concentric layers of macrophages, epithelioid cells, multinucleate Langerhans giant cells, and lymphocytes.…”

Apresentação Atípica De Tuberculose Ganglionar No Idoso: Relato De Caso

“…O tratamento precoce é essencial para diminuir morbimortalidade e quebrar o ciclo de transmissão da doença (LODDENKEMPER et al, 2015). Diretrizes atuais recomendam o mesmo regime de tratamento da TB pulmonar para a TB extrapulmonar (LODDENKEMPER et al, 2016), realizado através da quimioterapia tuberculostática, no esquema básico (2RIPE/4RI), composto por Rifampicina (150mg), Isoniazida (75mg), Pirazinamida (400mg) e Etambutol (275mg) usados nos primeiro dois meses, e Rifampicina (150mg) e Isoniazida (75mg) usados nos quatro meses seguintes, com duração total de seis meses, preconizado pelo Ministério da Saúde (BRASIL, 2011).…”