Pulmonary Tuberculosis

• Pulmonary Tuberculosis


  an infection of lung tissue caused by invasion of mycobacterium tuberculosis
• Pulmonary Tuberculosis an infection of lung tissue caused by invasion of mycobacterium tuberculosis
• Pulmonary tuberculosis is also know as Koch's disease
• Mycobacterium tuberculosis 


  an acid-fast, gram-negative, aerobic, and easily destroyed by heat or sunlight
• Mycobacterium tuberculosis an acid-fast, gram-negative, aerobic, and easily destroyed by heat or sunlight
• TB Mode of Transmission: Airborne droplet (coughing, sneezing)
• Infection occurs when the bacteria are deposited on the mucous membranes of the upper respiratory tract.
• TB Prevention: Bacillus Calmette-Guerin
• Bacillus Calmette-Guerin is ideally given at birth. If given 12 months, do PPD, give BCG if negative.
• BCG vaccine is not recommended for adults because it may cause false positive results on skin tests.
• TB Signs and Symptoms:

  • low grade afternoon fever
  • night sweats
  • weight loss
  • fatigue
  • hemoptysis (late sign)
• TB Diagnostic Procedures: Sputum Culture - confirmatory test
• TB Diagnostic Procedures: Tuberculin Test - detects presence of antibodies
• TB Diagnostic Procedures: Mantoux Test - other name for tuberculin skin test
• Mantoux Test: 5 units of purified protein derivative injected intradermal
• Mantoux Test: Read diameter of induration at 48 to 72 hours
• Mantoux Test: Induration greater than or equal to 10 mm indicates infection with MTB
• TB Diagnostic Procedures: Chest Xray - reveals pulmonary infiltrates, lesion
• TB Diagnostic Procedures: Quantiferon TB - alternative for mantoux test in some situation
• TB Class: Class 0 - not infected
• TB Class: Class I - TB Exposure
• TB Class: Class II - TB infection
• TB Class: Class 0 - not infected
• TB Class: Class I - TB exposure
• TB Class: Class II - TB infection
• TB Class: Class III - TB disease
• TB Class: Class III - TB disease
• TB Class: Class IV- TB inactive
• TB Class: Class IV- TB inactive
• TB Class: Class V - suspected disease
• TB Class: Class 0 - not infected
• TB Class: Class V - suspected disease
• Pharmacologic Management for Tuberculosis

  • Rifampicin - causes red-orange discoloration of body secretions
• Pharmacologic Management for Tuberculosis

  • Isoniazid (INH): se: peripheral neuropathy
• Pharmacologic Management for Tuberculosis

  • Isoniazid: an anti-TB drug that is safe to be given at any age, even among children and pregnant women.
• Vitamin B6 is administered to prevent INH-induced peripheral neuritis.
• Vitamin B6 or pyridoxine is administered to prevent INH-induced peripheral neuritis.
• Pharmacologic Management for Tuberculosis

  • Pyrazinamide (PZA) - se: hepatotoxicity; nephrotoxicity
• Pharmacologic Management for Tuberculosis

  • Ethambutol - se: optic neuritis
• Pharmacologic Management for Tuberculosis

  • Ethambutol - not given to children 6 years old below because they cannot reliably monitor vision.